Posted By: Francis Koster Published: February 28, 2021

As I listen to intense discussions between various political tribes about the need to stop the spread of Covid-19 verses claims of excessive government regulation, I am reminded of a story I heard sitting around a campfire at Boy Scout camp many decades ago.  My camp had a hand-pumped well, and the story made quite an impression on me at the time.   In 1854 London had no running water.  Local municipalities would tax citizens and businesses to fund the digging of public wells located in town squares to provide water for bathing and drinking.  At this time, since there were no indoor toilets or sewers, human waste was also being put in pits, called ‘cesspools’. They were everywhere. Both men and women wore perfume to mask the odor that was everywhere. A plague of cholera had started.  Millions were dying all around the world. The spread seemed to occur in areas with high odors.  The commonly held belief by both doctors and citizens was that cholera was spread by stinky air, then called ‘Miasma’.  

Posted By: Francis Koster Published: February 23, 2021

America’s health insurance system is like a ratty old quilt.  If your body is covered by the thick part of the quilt, you can feel more or less comfortable.  If your quilt has too many holes in it, you suffer. North Carolina has 17% of its population uninsured. We rank 6th worst out of all 50 states for our percentage of uninsured.[1]   Those uninsured who get sick will have mountains of debt they will not have the ability to pay. Insurance claims filed by Covid-19 patients show that if you catch mild Covid-19 but can recover at home, the cost of treatment averages around $750 for your care.   If you need to be hospitalized, the bill from the hospital is around $34,000.  If you are so sick you need to be in intensive care, the cost is about $84,000.[2]

Posted By: Francis Koster Published: February 8, 2021

When I was in school, one of the most dreaded sentences my teacher uttered was “Close your books, we are going to have a pop quiz.” Over the past few months, I have written a number of columns each teaching little-known facts. Have you been paying attention? Surprise! Here is your quiz: 1.    How much more does the average American adult weighs now compared to 1960? 28 pounds. [1] 2.    What percentage of American school buildings have unhealthy levels of indoor air pollution? Nearly half.[2] 3.    How much invisible microplastic does the average American eat each week? Equal to one credit card.[3] 4.    Is our life expectancy getting longer or shorter? Shorter [4] 5.    Of all the nations of the world, where does America rank on the happiness scale? 35th.[5] One of the major obstacles to improving our society is that a large number of things that need fixing (as you saw above) are not well known. We have to make the invisible visible. One way to do that is to measure indicators of Quality of Life.

Posted By: Francis Koster Published: February 4, 2021

Do you remember when you were given your first goldfish?  The gift was probably a little bowl of water containing a few tiny fish and some fish food.  I remember receiving mine when I was in grade school.  It was probably the first time I was officially made responsible for caring for other living creatures.   I also remember how sad I was when weeks later I found them floating in cloudy water, dead.  As a child, I felt my failure deeply.   I still remember when my brothers and sisters and I buried them in the garden with a little ceremony overseen by my mom. I will never know what killed that fish, but the range of possibility is large – the amount and kind of food, jimmy germs from failing to wash hands before putting them in the bowl, not enough or too much light, high or low water temperature, and acidity – the list can go on and on.  Just like the list of things that impact the quality of life and health in our cities and towns.  We all live in a ‘human aquarium, and the lives of our friends and neighbors in our cities and towns are just as vulnerable as those little fish.  Any number of elements in our local aquarium can encourage or stop a wide range of physical, emotional, intellectual, and financial growth for our citizens, and impact our collective quality of life.

Posted By: Francis Koster Published: February 3, 2021

We have two healthcare calamities unfolding before us – one visible, the other not yet. The first you at least know something about - Covid-19.  On January 14, one in 15 Americans (24 million) have been diagnosed with Covid-19.[1]  Of these, around four million survived, but are suffering after-effects ranging from brain fog, lung issues, and sexual disfunction.[2],[3]  Another 380,000 Americans have already died from it.[4]  Experts predict that the number of dead will grow to over half-a-million by April 2021,[5] even with an aggressive vaccination campaign, because around one-third of Americans say they will not take the vaccination at all.[6] This is only the visible part of our national tragedy. The second (still invisible) crisis is caused by the fact that out of every ten Americans, six have what is called a “chronic disease” – things like heart disease, diabetes, and kidney disease.  These do not heal. They do get worse over time and must be carefully managed for as long as you live. [7],[8]

Posted By: Francis Koster Published: January 10, 2021

When I was a kid, there is a little ritual that happened in private. I later learned my parents referred to it as “The Talk”. At some age-appropriate point, my dad would invite “just the two of us” out for a fishing trip. After we dropped an anchor and threw our baited hooks into the water, I was trapped. After we caught a fish or two, he would bring up changes he was seeing underway in my body, and how I was probably beginning to face new biological urges. He explained that these changes carried with them moral and ethical responsibilities. The discussion was uncomfortable - but necessary. He was a good parent. As you contemplate your future and think about how your survivors will manage after you leave them, talking with them about your inevitable death is potentially a similarly stressful conversation, but because your parent can no longer trap you in a boat, you can avoid it. Most of us do. We stop behaving like responsible adults and shirk our responsibility as parents.

Posted By: Francis Koster Published: December 27, 2020

My mom and dad always ended the Christmas and New Year’s holiday period exhausted. They took six kids and grandma on a holiday schedule filled with choir rehearsal, church events, pancake breakfasts, and fundraisers. There were serious moments - as kids, we were asked if we had been naughty or nice, and by the time we entered high school we were reminded of our obligation to become a role model for others. We were often asked, “Are you walking your talk?” I have been thinking about this. Are we, as a country, being "naughty or nice?" Does our behavior reflect what we proclaim are our values? I do not think so. Across our country, our life expectancy has been falling, particularly among the poor, even before the Covid epidemic.[1] [2] Many years of failure to adapt public policy to scientific findings is causing great pain and suffering.

Posted By: Francis Koster Published: December 20, 2020

Chances of catching Covid-19 are up to 18 times higher if you are exposed to someone who has it while you are indoors compared to being outdoors.[1] This is because the virus particles do not blow away like it would if you were both outside. If you are in a modern building with a new air conditioning system, the danger is less because it was designed bring in oxygen rich fresh air frequently. If you are unlucky enough to work in an old building, the virus concentration grows hourly as the infected folks near you continue to breathe it out. This infection is spread by people who do not know they are infected and for a 10 day period unknowingly infect others until symptoms begin to show up. Every unknowing but infected person appears to infect one other person during that period.[2] On the single day of December 9, 2020, Covid-19 killed more than 3,157 Americans[3], and almost 300,000 newly infected were identified.[4]

Posted By: Francis Koster Published: December 12, 2020

When I was a kid, my mother used to start all serious conversations with some remark about “The only certainty in life is death and taxes”. I did not like hearing this, because it was usually followed by some explanation of why some exciting planned trip to the beach was not going to happen. Now I learn she was wrong (one of only a few times, I must admit.) Turns out for an astonishing number of Americans, even having to pay taxes is not certain. The IRS estimates that individuals and corporations fail to pay one dollar out of every six that should have been paid to the federal government.[1] This is enabled by our Congress who cut funding for law enforcement audits and collections. Starting in 2010, Congress has reduced the IRS law enforcement budget by millions of dollars each year. It is now only 80 % of what it was in 2010. The number of employees was also reduced by one fifth. [2] In 2019 the IRS had 8,004 auditors – less than it had back in 1953 when the economy was about one-seventh its current size.[3],[4],[5] As a consequence, three major bad things happened.

Posted By: Francis Koster Published: December 6, 2020

My father was a fireman and ambulance driver in a small town in Ohio. I have clear memories of going to the funeral of a fireman killed in the line of duty in a neighboring town. I was very young and had to hold my dad’s hand when we walked from the church to the cemetery. Flags at half-mast still have a powerful impact on me. Over Thanksgiving, I had a chat with a friend who is a lifelong member of the law enforcement community. We were discussing the existing and expanding stresses on First Responders as Covid-19 explodes around the coming holidays. I was explaining how awful the next few months are going to be, given the fact that it took 3 months for the first one million Americans to be infected, and 6 days for the latest one million, and the rate is rising.[1] I said I was worried about the stress on our doctors and nurses. He replied, “Do you know that more law enforcement officers die by suicide than are killed in the line of duty?” I did not. After we parted, I could not shake the emotions that statement caused in me. Got out my laptop and started researching. He was right.

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