For Ramadan, the monthlong Muslim holiday of fasting which begins this year on Tuesday evening, Feb. 17, families and friends gather for festive dinners to break the fast.

Tahini, sesame seed paste, is a nutritional powerhouse that’s well suited for Ramadan dishes. Popular in Middle Eastern cooking, its flavor profile — nutty, slightly bitter and creamy —makes it versatile in the kitchen. Most tahini dishes are savory appetizers but tahini is also used in sweet specialties like halva. Thus it is useful for iftar, the sunset meal, and for suhoor, the pre-dawn meal eaten before the day’s fasting.

While meat is a traditional staple for iftar, appetizers are often plant-based. Made with vegetables and grains, their fiber promotes satiety, enabling people to eat less meat.  Because tahini is rich in heart-healthy monounsaturated fats and protein, it provides an energy boost and helps people feel full for longer.

Basic tahini sauce, made of tahini paste mixed with lemon juice, garlic and water, is a luscious-textured sauce often served with grilled vegetables, salads, fish and falafel, and can replace cream in dressings and dips. Like natural peanut butter, tahini should be stirred before being used.

Tahini’s bitterness balances the intense sweetness of dates, the traditional Ramadan break-the-fast food; stuffing dates with tahini is a Ramadan treat. A popular breakfast spread is tahini mixed with date molasses; in Istanbul, some call such a spread “Turkish Nutella” or “liquid halva”.

Quinoa patties are served with chanterelles and topped with tahini sauce. (Photo by Yakir Levy)

Quinoa Patties with Chanterelles and Tahini Sauce

Quinoa patties become an elegant dish when dressed up with tahini sauce and exotic mushrooms. You can substitute shiitakes or oyster mushrooms for the chanterelles.

Yield: 3 or 4 servings

INGREDIENTS

Tahini sauce:

1 small garlic clove, minced
3 tablespoons tahini paste, stirred before measuring
1 to 2 tablespoons lemon juice
1 to 2 tablespoons water
Salt to taste

Quinoa patties and chanterelles:

3 tablespoons extra virgin olive oil
One 1.1-pound (500-gram) roll of cooked quinoa, cut in 6 to 8 slices
Salt and freshly ground pepper
1/2 pound fresh chanterelles
1 garlic clove, minced
Red pepper flakes to taste

DIRECTIONS

1. Tahini sauce: In a mini food processor blend garlic, tahini paste, 1 tablespoon lemon juice, 1 tablespoon water and salt. Add more lemon juice or water to adjust consistency and taste.

2. Quinoa patties: Heat 2 tablespoons olive oil in a heavy-bottomed skillet over medium-high heat. Season quinoa slices with salt and pepper; add to pan. Sear quinoa slices on both sides until golden brown. Remove from pan.

3. Chanterelles: Add remaining tablespoon olive oil to pan and heat over medium-high heat. Add mushrooms; cook for 8 minutes or until browned. Add garlic, salt, pepper and pepper flakes and cook about 1 minute.

4. Serve quinoa patties with chanterelles and tahini sauce.

A platter of roasted vegetable is served with Pepper-Swirled Tahini. (Photo by Yakir Levy)

Pepper-Swirled Tahini with Roasted Vegetables

Greek yogurt makes tahini creamier and a good counterpoint for the pepper sauce.

Yield: 4 servings

INGREDIENTS

Tahini yogurt sauce:

1 small garlic clove, minced
3 tablespoons tahini paste, stirred before measuring
1 to 2 tablespoons lemon juice
1 to 2 tablespoons water
1/2 cup Greek yogurt
Salt to taste
2 pounds vegetables, such as whole Anaheim or jalapeño peppers, medium-wide strips of sweet peppers, sliced Chinese eggplants, sliced zucchini, half slices sweet onions, halved cremini mushrooms
2 tablespoons extra virgin olive oil, or to taste
Salt, freshly ground pepper and Aleppo or other semi-hot red pepper to taste
1/2 cup thick salsa such as taqueria-style salsa

DIRECTIONS

1. Tahini yogurt sauce: In a mini food processor blend garlic, tahini paste, 1 tablespoon lemon juice, 1 tablespoon water and salt. Transfer to a bowl. Stir in yogurt. Add more lemon juice or water to adjust consistency and taste.

2. Heat oven or air fryer toaster oven to 400 degrees. In a bowl toss vegetables with enough olive oil to moisten them. Sprinkle with salt, black and red pepper; toss to combine.

3. Spread vegetables on a baking sheet (lined with parchment paper or foil if desired). Roast for 10 minutes. Turn over; drizzle with more olive oil if needed. Roast for 10 to 15 more minutes or until tender. (They roast faster in an air fryer toaster oven or convection oven than in a standard oven.)

4. Put whole peppers in a bowl, cover and let stand for 10 minutes. Peel when cool enough to handle. Remove caps;  scrape out pepper seeds.

5. Arrange vegetables on a plate. Set a bowl of salsa in center of plate. Spoon tahini yogurt sauce onto salsa’s center. With a knife, swirl tahini sauce gently into salsa.

Red Pepper Baba Ghanoush is made with roasted Chinese eggplant, tahini sauce, roasted peppers and labneh. (Photo by Yakir Levy)

Red Pepper Baba Ghanoush

Chinese eggplants roast quickly and are easy to turn into a creamy red pepper dip. Just add tahini sauce, roasted peppers from a jar, and labneh — strained yogurt that is almost as thick as cheese.

Yield: 3 or 4 servings

INGREDIENTS

1 1/2 pounds Chinese eggplants
2 large garlic cloves, minced
3 to 4 tablespoons tahini paste (stirred before measuring)
1 to 2 tablespoons strained fresh lemon juice
1 to 2 tablespoons water
2 fire-roasted peppers (from a jar)
2 to 4 tablespoons labneh (or Greek yogurt)
Salt and freshly ground black pepper
Extra virgin olive oil (for drizzling)
2 teaspoons chopped Italian parsley (garnish)

DIRECTIONS

1. Preheat broiler or Roast function of air fryer toaster oven (convection oven). Prick each eggplant 3 or 4 times with a sharp knife.

2. Broil or roast eggplants, turning a few times, until very tender when pressed on neck end, about 15 to 20 minutes. Remove eggplants; let stand until cool enough to handle.

3. Cut off eggplant caps. Halve eggplants lengthwise. Scoop out eggplant pulp. Chop pulp with a knife.

4. Make red pepper tahini sauce by blending minced garlic, tahini paste, 1 tablespoon lemon juice and 1 tablespoon water in a food processor. Add roasted peppers and blend until smooth.

5. Add labneh and pulse until blended. Add chopped eggplant pulp; pulse just until mixture is blended. Gradually add more water or lemon juice if needed. Season with salt and pepper.

6. Spread on a serving plate or on bread. Serve drizzled with olive oil and sprinkled with parsley.

Persimmon Cake is topped with a halva glaze made with powdered sugar and lemon juice as well as chopped pistachios. (Photo by Yakir Levy)

Persimmon Cake with Halva Glaze

In this cake’s glaze a touch of tahini balances the sweetness of the powdered sugar. Use soft persimmons for the puree; slice firm persimmons for garnish.

Yield: 2 small cakes (32 small portions)

INGREDIENTS

Persimmon cake:

2 cups all purpose flour (260 grams)
1 teaspoon ground cinnamon
3 teaspoons baking soda
1/4 teaspoon salt
1/2 cup unsalted butter (4 ounces or 110 grams), room temperature
1 1/3 cups granulated sugar (240 grams)
2 large eggs, beaten
1/2 teaspoon vanilla extract
2 1/2 cups persimmon puree (4 or 5 persimmons)
1 cup dried cranberries
2/3 cup red walnuts, chopped

Persimmon halva glaze:

2 cups powdered sugar
4 teaspoons lemon juice
4 tablespoons persimmon puree
2 teaspoons tahini paste (stirred before measuring), or to taste

Garnish:

About 1/3 cup chopped pistachios
Slices of small firm persimmons

DIRECTIONS

1. Cake: Heat oven to 350 degrees. Line two 7 1/2-inch square pans with foil. Butter foil.

2. Mix flour, cinnamon, baking soda and salt.

3. With a stand mixer, beat butter until smooth; add sugar and beat until smooth. Add eggs; beat until well blended. Add vanilla; beat until blended.

4. Add half of dry ingredient mixture to butter mixture; stir until blended. Stir in persimmon puree, followed by remaining dry ingredient mixture. Stir until blended. Stir in dried cranberries and walnuts.

5. Spoon batter into pans. Smooth tops. Bake until a toothpick inserted in center of each cake comes out clean, about 25 to 30 minutes.

6. Cool cake in pans on racks for 10 minutes. Turn out onto cake racks. Let cool completely.

7. Glaze: Whisk half of powdered sugar with the lemon juice until blended. Whisk in remaining powdered sugar. Add persimmon puree and whisk until blended. Whisk in tahini.

8. Spread glaze in thin layer over cakes. Sprinkle with pistachios. Let stand several hours or refrigerate overnight until glaze sets.

9. Cut cake in pieces and put on a serving plate. Surround with persimmon slices.

This Mushroom Tahini Toast is inspired by a recipe in Dr. Michael Crupain’s latest book, “The Power Five: Essential Foods for Optimum Health.” (Photo by Yakir Levy)

Mushroom Tahini Toast

For this appetizer inspired by a recipe from Dr. Michael Crupain’s latest book, “The Power Five: Essential Foods for Optimum Health,” you spread toast with pure tahini paste, then top it with sauteed mushrooms.

Yield: 4 or 5 servings

INGREDIENTS

1 pound exotic mushrooms, such as shiitake, oyster or maitake
1/2 teaspoon Turkish pepper flakes, Aleppo pepper or other pepper flakes
3 tablespoons extra virgin olive oil
3 garlic cloves, minced
1 shallot, finely chopped
1 teaspoon fresh thyme leaves, chopped
Salt to taste
1 cup dry white wine
3 tablespoons tahini paste
4 or 5 slices whole wheat or sourdough bread, toasted and rubbed with a raw garlic clove

DIRECTIONS

1. Coarsely chop mushrooms; add to a bowl with pepper flakes and oil. Toss to coat mushrooms.

2. Cook mushrooms in a large, heavy-bottomed skillet over medium-high heat for 8 to 10 minutes or until browned. Add garlic, shallot, thyme and salt. Sauté for 4 minutes or until shallot is soft. Stir in wine; cook until evaporated. If mixture is too dry, add 1 to 2 tablespoons water.

3. Spread tahini on toast. Spoon mushrooms over toast, sprinkle with salt, and serve.

Roasted Eggplant Salad with Tangerine Tahini balances sweet tangerine juice with lemon juice, minced garlic, salt and red pepper powder. (Photo by Yakir Levy)

Roasted Eggplant Salad with Tangerine Tahini

Adding sweet tangerine juice to tahini sauce might seem surprising but tahini eggplant drizzled with silan (date syrup) is popular in Israeli restaurants. Our dish isn’t sweet. Tangerine zest, lemon juice, minced garlic, salt and red pepper powder balance the flavor.

Yield: 2 or 3 servings

INGREDIENTS

Tangerine tahini sauce:

1/2 teaspoon minced garlic
1 tablespoon fresh lemon juice, or to taste
2 to 3 tablespoons tangerine juice
1/4 cup plus 2 tablespoons tahini, stirred before measuring
Pinch of salt, or to taste
1 tablespoon cold water (optional), more if needed
1/2 teaspoon grated tangerine zest, or more to taste

Roasted Eggplant and Salad:

1 Chinese eggplant (about 9-10 ounces), sliced diagonally 3/8 to 1/2 inch thick
2 tablespoons plus 1 teaspoon extra virgin olive oil
Salt, freshly ground pepper and hot red pepper powder to taste
5 romaine or other lettuce leaves, cut in bite size pieces
1 teaspoon lemon juice
1 tangerine, cut in rounds, then in half slices
Walnuts, preferably red (garnish)

DIRECTIONS

1. Tangerine tahini sauce: In a medium bowl mix garlic, lemon juice and tangerine juice. Stir in tahini paste. Keep stirring until sauce is smooth and thick but still pourable. Add more tangerine juice or water, 1 teaspoon at a time, to adjust consistency and taste. Stir in tangerine zest. (You will have extra sauce to enjoy for 2 days.)

2. Preheat oven to 400 degrees. If you like, line a roasting pan with foil. Set eggplant slices in pan. Brush them with about 1 tablespoon olive oil; sprinkle with salt and black and red pepper. Turn them over; repeat brushing with olive oil and sprinkling seasonings. Roast for 17 to 25 minutes (or 15 minutes using the Roast function of an air fryer toaster oven), turning them once, or until tender to your taste.

3. Make a bed of chopped lettuce; drizzle with light dressing made by whisking 1 teaspoon olive oil with 1 teaspoon lemon juice and a pinch of salt. Set eggplant slices on lettuce and spoon tangerine tahini sauce over them. Garnish with tangerine pieces and walnuts.

Faye Levy is the author of “Feast from the Mideast.”

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By Phil Galewitz and Amanda Seitz, KFF Health News

The Trump administration’s move to give deportation officials access to Medicaid data is putting hospitals and states in a bind as they weigh whether to alert immigrant patients that their personal information, including home addresses, could be used in efforts to remove them from the country.

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Warning patients could deter them from signing up for a program called Emergency Medicaid, through which the government reimburses hospitals for the cost of emergency treatment for immigrants who are ineligible for standard Medicaid coverage.

But if hospitals don’t disclose that the patients’ information is shared with federal law enforcement, they might not know that their medical coverage puts them at risk of being located by Immigration and Customs Enforcement.

“If hospitals tell people that their Emergency Medicaid information will be shared with ICE, it is foreseeable that many immigrants would simply stop getting emergency medical treatment,” said Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families. “Half of the Emergency Medicaid cases are for the delivery of U.S. citizen babies. Do we want these mothers avoiding the hospital when they go into labor?”

For more than a decade, hospitals and states have assured patients that their personal information, including their home addresses and immigration status, would not be shared with immigration enforcement officials when they apply for federal health care coverage. A 2013 ICE policy memo guaranteed the agency would not use information from health coverage applications for enforcement activities.

But that changed last year, after President Donald Trump returned to the White House and ordered one of the most aggressive immigration crackdowns in recent history. His administration began funneling data from a variety of government agencies to the Department of Homeland Security, including tax information filed with the IRS.

The Centers for Medicare & Medicaid Services, part of the Department of Health and Human Services, agreed last spring to give ICE officials direct access to a Medicaid database that includes enrollees’ addresses and citizenship status.

Twenty-two states, all but one led by Democratic governors, sued to block the Medicaid data-sharing agreement, which the administration did not formally announce until a federal judge ordered it to do so last summer. The judge ruled in December that in those states, ICE could access information in the Medicaid database only about people in the country unlawfully. KFF Health News contacted more than a dozen hospitals and hospital associations in states and cities that have been targets of ICE sweeps. Many declined to comment on whether they’ve updated their disclosure policies after the ruling.

Of those that responded, none said they are directly warning patients that their personal information may be shared with ICE when they apply for Medicaid coverage.

“We do not provide legal advice about federal government data-sharing between agencies,” Aimee Jordon, a spokesperson for M Health Fairview, a Minneapolis-based hospital system, said in an email to KFF Health News. “We encourage patients with questions about benefits or immigration-related concerns to seek guidance from appropriate state resources and qualified legal counsel.”

Information on applications

Some states’ Emergency Medicaid applications specifically ask for a patient’s immigration status — and still assure people that their information will be kept secure and out of the hands of immigration enforcement officials.

For example, as of Feb. 3, California’s application still included language advising applicants that their immigration information is “confidential.”

“We only use it to see if you qualify for health insurance,” states the 44-page form, which the state’s Medicaid program, known as Medi-Cal, posted on social media in January.

California Department of Health Care Services spokesperson Anthony Cava said in a statement that the agency, which oversees Medi-Cal, will “ensure that Californians have accurate information on the privacy of their data, including by revising additional publications as necessary.”

Until late January, Utah’s Medicaid website also claimed its Emergency Medicaid program did not share its information with immigration officials. After KFF Health News contacted the state agency, Kolbi Young, a spokesperson, said Jan. 23 that the language would be taken down immediately. It was removed that day.

Oregon Health & Science University, a hospital system based in Portland, offers immigrant patients a Q&A document developed by the state Medicaid program for those with concerns about how their information might be used. The document does not directly say that Medicaid enrollees’ information is shared with ICE officials.

Hospitals rely on Emergency Medicaid to reimburse them for treating people who would qualify for Medicaid if not for their citizenship status — those in the country illegally and lawfully present immigrants, such as those with a student or work visa. The coverage pays only for emergency medical and pregnancy care. Typically, hospital representatives help patients apply while they are still in the medical facility.

The main Medicaid program, which covers a much broader range of services for over 77 million low-income and disabled people, does not cover people living in the country illegally.

Examining Emergency Medicaid enrollment is the most obvious way, then, for deportation officials to identify immigrants, including those who might not reside in the U.S. lawfully.

HHS spokesperson Rich Danker said in an email that CMS — which oversees Medicaid, a joint state-federal program — is sharing data with ICE after the judge’s ruling. But he would not answer how the agency is ensuring it is sharing information only on people who are not lawfully present, as the judge required.

With ICE now getting direct access to the personal information of millions of Medicaid enrollees, hospitals — while “definitely in a tough position” — should be up-front about the changes, said Sarah Grusin, an attorney at the National Health Law Program, an advocacy group.

“They need to be telling people that the judge has permitted sharing of information, including their address, for people who are not lawfully residing,” she said. “Once this information is submitted, you can’t protect it from disclosure at this point.”

Grusin said she advises families to weigh the importance of seeking medical care against the risk of having their information shared with ICE.

“We want to give candid, honest information even if it means the decision people have to make is really hard,” she said.

Those who have previously enrolled in Medicaid or can easily search their address online should assume that immigration officials already have their information, she added.

Emergency Medicaid

Emergency Medicaid coverage was established in the mid-1980s, when a federal law began requiring hospitals to treat and stabilize all patients who show up at their doors with a life-threatening condition.

Federal government spending on Emergency Medicaid accounted for nearly $4 billion in 2023, or about 0.4% of total federal spending on Medicaid.

States send monthly reports to the federal government with detailed information about who enrolls in Medicaid and what services they receive. The judge’s ruling in December limited what CMS can share with ICE to only basic information, including addresses, about Medicaid enrollees in the 22 states that sued over the data-sharing arrangement. ICE officials are not supposed to access information about the medical services people receive, per the judge’s order.

The judge also prohibited the agency from sharing the data of U.S. citizens or lawfully present immigrants from those states.

Deportation officials have access to personal Medicaid information of all enrollees in the remaining 28 states.

The federal health agency has not clarified how it is ensuring that certain states’ information on citizens and legal residents is not shared with ICE. But Medicaid experts say it would be nearly impossible for the agency to separate the data, raising questions about whether the Trump administration is complying with the judge’s order.

The Trump administration’s efforts to deport immigrants living in the country illegally have had implications on immigrant families seeking care. About a third of adult immigrants reported skipping or postponing health care in the past year, according to a KFF/New York Times poll released in November. (KFF is a health information nonprofit that includes KFF Health News.)

Bethany Pray, the chief legal and policy officer at the Colorado Center on Law and Policy, warned that sharing Medicaid data directly with deportation officials will force even tougher decisions upon some families.

“This is very concerning,” Pray said. “People should not have to choose between giving birth in a hospital and wondering if that means they risk deportation.”

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

By MIKE STOBBE

NEW YORK (AP) — Daniel Moore was about 30 the first time it happened. At the end of a long, hot, stressful day, he chugged an ice-cold glass of milk.

“It felt like a bunny rabbit trying to jump out of my chest,” said Moore, now 60.

Moore, a radiologist, knew what it was: A-fib.

Dr. Daniel Moore poses for The Associated Press with his dogs Nani, left, and Gracie Feb. 2, 2026, in Coppell, Texas. (AP Photo/Julio Cortez)

Short for atrial fibrillation, A-fib is a quivering or irregular heartbeat that is a worrisome stage-setter for blood clots, stroke and heart failure. Some researchers believe more than 10 million Americans have it — most of them older. And it’s expected to become even more common in the years ahead.

Yet, University of Utah heart researcher Dr. T. Jared Bunch sees reason for optimism.

“Even though we see more of the disease, we’re better at treating it,” said Bunch, who co-authored a book on A-fib.

Symptoms can include shortness of breath

A-fib occurs when the heart’s upper chambers, called the atria, beat out of sync with the lower chambers, the ventricles. Not everyone is aware something is wrong, but some people suffer alarming symptoms like a pounding heartbeat and shortness of breath.

“I definitely have no exercise tolerance when I’m in it,” Moore said. “I can’t run. Walking is tiring faster. I get a little light-headed standing up.”

The heart can surpass 200 beats per minute for someone with A-fib, more than double the 60 to 100 beats typical for a healthy adult’s resting heart rate.

Symptoms can come and go, and it’s not usually life-threatening by itself. But the erratic beating can lead to blood pooling in the heart that can become clots in days or even hours. Those clots, in turn, can travel to the brain and cause strokes.

A-fib also can increase the risk of developing ventricular fibrillation — a more serious condition.

Diagnosis is becoming more common

Experts say smartwatches and other devices that can detect erratic heartbeats are one reason A-fib diagnoses are increasing.

Many people who experience symptoms don’t understand what is happening.

The American Heart Association found that more than half of people with A-fib didn’t know about the condition before they were diagnosed.

Studies have suggested 15% or more of strokes can be tied to A-fib, and that the percentage rises in older people. The condition is one reason that U.S. stroke deaths rose in the last decade, although the stroke death rate has dipped in the last few years.

What causes A-fib?

Researchers attribute A-fib to damage in the heart’s upper chambers and its electrical signaling. Genetics can play a role, but other contributors include high blood pressure, diabetes, stress, sleep apnea, smoking and alcohol.

Those harms accumulate over time, which is one reason why the condition tends to hit older adults. About 70% of A-fib cases are people 65 and older, Bunch said.

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Viruses can also pose a threat because they can affect the proteins behind the heart’s electrical signals or prompt an immune response that damages heart tissue. COVID-19 is among the list of viral culprits, and likely contributed to A-fib in some patients, experts say.

Studies have found no link to COVID-19 shots, said Dr. Jose Joglar, a Dallas-based expert who helped author American Heart Association guidelines on A-fib diagnosis and management.

Doctors have a range of treatment options

There’s no cure, but a number of therapies can help manage the problem.

“We’re miles beyond where we used to be” in treating A-fib, said Dr. Laurence Epstein, of Hofstra University and Northwell Health. “The technology has really evolved.”

One initial treatment is a cardioversion, which involves using a defibrillator to deliver an electric shock to the heart to restore rhythm. It’s often successful, but sometimes only temporarily.

For some patients, doctors may recommend implanted devices. Pacemakers can regulate heart rhythm, and a device called a Watchman can close off a clot-prone area of the upper heart.

And then there’s ablation. It’s a procedure in which a doctor uses heat, cold or electric pulses to zap certain areas of the heart, creating scars that block faulty electric signals. Traditionally, ablation was used when other approaches failed, but in recent years ablation techniques have become more advanced and it has become a first choice for certain patients, including those with heart failure.

Medications to regulate the heart or thin the blood to reduce stroke risk can have problematic side effects.

How to lower your risk

People can lower their risk of developing A-fib by living a healthy lifestyle. That includes exercising, getting enough sleep, eating a healthy diet, managing high blood pressure, and avoiding tobacco products and alcohol.

Doctors also have long warned about excessive levels of caffeine, although some new evidence suggests that at least a little may be OK. One small study published recently found that patients who averaged one cup a day saw less recurrence of symptoms than those who abstained entirely.

If symptoms do develop, it’s important to take them seriously, said Amy Stahley, who was first diagnosed three years ago.

She went to bed one night and her heart began racing to more than 150 beats per minute. She immediately went to a hospital.

“If you’re feeling a little off, get it checked out,” said Stahley, who is a nurse and dean of Davenport University’s College of Health Professions in Michigan.

Moore, a radiology professor at UT Southwestern Medical Center in Dallas, agreed.

“The longer you stay in A-fib, the more likely you are to stay in it for life,” he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Edward Lotterman

Disturbances in the force of the economy have been common in recent news. Prices of crypto currencies, especially bitcoin, did a deep-knee bends, ditto for gold and silver.

The Dow and S&P indexes are up setting records, and then down. Some foreign banks and countries apparently are reducing their holdings of U.S. dollars.

In a financial hangover from their bidding binge that raised farmland prices over 50% in five years, U.S. farmers want a large bailout. Housing prices remain out of reach for the children and grandchildren of baby boomers.

The common factor in all of this is the Federal Reserve (albeit acting in very good faith in response to successive defense, financial and health crises) increased the amount of money sloshing around relative to the size of the economy to unprecedented levels. The Fed, the media and many economists prefer to focus elsewhere — on the causes, not the results. And events will force us to do so.

If one wants to be prepared for that, it is necessary to understand banking — and central banking — from the ground up.

Start with the very basics. These were visible in Venice, Milan, Geneva and Amsterdam in the 1400s. Ditto in the Minnesota counties of Martin, Olmstead, Pipestone and others 150 years ago.

In all modern ages, some people have money that they save now so they can spend later. They want it safe and hope to earn some return on it in the meantime by investing. Others want to spend now. Some will have income in the future, but have no cash at the moment. They are willing to pay a fee to borrow spendable money today and pay it back later.

At some point in history, people started accepting money from people wanting to save and lending it to those who want to borrow. The borrowers pay interest, which is income for this intermediary. We call it a “bank” from the bench at which Italian merchants did business. A bank pays interest on deposits. The rate is low on small accounts or those with frequent deposits and withdrawals. It may be higher on larger amounts or to those who agree to leave alone for longer periods of time.

There are two dangers to any bank and its depositors. If some borrowers never repay their loans, a bank might not have cash to meet withdrawals by depositors.  This would be “insolvency.” The bank is “busted” or “broke.” Even if the borrowers offer collateral, say real property like with a mortgage, the repossession or foreclosure process could take more time than the bank has to meet its depositors’ demand. To prevent this, its bank owners must have money of their own, capital, in the bank business as well as the funds of depositors. If a loan turns bad, the cushion of adequate capital plus the collateral protects depositors.

The second danger is that, even if all loans are safe and will be repaid when promised, a large number of depositors may suddenly want to withdraw their money. This flows from “mis-matched maturities.” Deposits can be demanded but loans may not be due until a ship returns from its voyage, wheat is harvested or the mercantile sells its large stock of calicos, coffee pots and pickaxes. This problem is “illiquidity,” or the lack thereof. Assets exceed liabilities but these assets cannot be converted into cash rapidly enough to satisfy withdrawals of deposits.

To guard against this, banks don’t lend out 100% of their deposits. If these total 10,000 dollars or guilders or ducats, wise bankers may lend out only 9,000 and keep 1,000 in reserve.

Having both adequate owners’ capital against insolvency and deposit reserves against illiquidity were voluntary prudence early in this historical evolution. But guilds of merchants in places like Venice or banking commissions in states like Minnesota eventually set uniform regulations. They may perform audits to ensure that rules are being followed.

Smaller banks also developed business relationships with larger banks. If a bank in Coblenz, Germany, had reserves greater than needed for prudence or legal compliance and no local borrowers, it might deposit money with a larger one in Amsterdam. One from Litchfield might put it in a Minneapolis bank. That Minneapolis bank or one from Des Moines or Lacrosse, with too much cash might place it with a still larger bank in Chicago or New York, and so on.

Moreover, funds might flow the other way. When Twin Cities banks were flush with cash from Dayton’s, Donaldsons and other merchants just finishing holiday sales, or from Cargill having shipped wheat to New York and Pennsylvania, they might lend it to smaller banks in Marshall or Chippewa Falls. These would lend to farmers facing spring planting needs for seed, new plows and additional horse feed.

Small town banks borrowing such cash temporarily unneeded by regional city banks had to put up collateral. This would be promissory notes signed by their own local customers. If a small town bank did not repay a Minneapolis bank, that larger one could collect directly from the farm or main-street borrower.

If a small bank had $20,000 in promissory notes signed by farmers and main street merchants and wanted to borrow from a Twin Cities bank, they knew they might be able to get only $19,000. The IOUs presented as collateral would be “discounted.” The office of the large bank that handled such deals was its “discount window.” The bigger bank would be the “correspondent bank” for the smaller one.

A city correspondent bank that had an established, trusted relationship with the small-town bank might be willing to help this client with cash if it faced illiquidity. And, after careful examination of books, it might be willing to advance funds to a small bank that actually faced going broke because one of its major borrowers defaulted on its debts. The larger bank might demand a temporary or permanent ownership share in the troubled bank in return for saving it from total failure.

All of this is commercial banking, all done with minimal government involvement. It first took place under rules of merchant-bank guilds and later under government banking laws. However, some large, major-city banks, say in London or Stockholm, gradually became dominant as bankers for smaller banks. They had few or no business customers themselves. Hence the rise of central banking, or what is known in America as the Fed.

Eventually these got special charters from government. The Riksens Ständers Bank (“Bank of the Estates of the Realm”) established in Stockholm in 1668, was directly run by the Swedish government. The Bank of England, chartered in London in 1694, was a private joint-stock business but one with special privileges and duties.

Governments created these entities to facilitate commerce. However, funding governments, especially for military operations, was an underlying need. The Swedish bank was established soon after a war with Russia at the end of the 1650s and facilitated the Great Northern War of shifting coalitions that engulfed the Baltic from 1700-1721. The Bank of England mobilized money for two decades of English wars against Louis XIV’s France.

The economies of the 13 American colonies were not complex. There were few true banks. Philadelphia, New York, and Boston had merchants who functioned much like those in Florence, Venice or Amsterdam centuries earlier. Tobacco, rice and indigo planters dealt directly with England through “factors,” or merchants, in London or Bristol. These sold their products, procured supplies and luxury goods, and wrote mortgages on their plantations and slaves when spenders like Thomas Jefferson lived beyond their means.

After independence, more banks regulated by individual states, if at all, were established. Out on the frontier west of the Alleghenies or north of the Ohio River, “wildcat banks” with little supervision but that could issue their own “banknote” currencies with little “backing” by gold or silver flourished. Failures were common. Deposits often disappeared, loans often not repaid. Regional inflations and deflations were common as were “panics” that slowed economic activity sharply causing much social pain.

This review of banking basics that are universal, plus some historical and institutional details for our country, facilitates understanding the challenges we face now.

The U.S. financial system, including its commercial banks, has been a source of true wealth for us. By “true wealth,” an economist means that we achieve high levels of satisfaction of the needs and wants of our people from resources we have available. But in recent decades, our financial system has become more erratic, “needing” more frequent and larger government intervention to stave off possible catastrophes. Exactly how and why that is playing out is something to explore next week.

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St. Paul economist and writer Edward Lotterman can be reached at stpaul@edlotterman.com.