Board of Health: December 9, 2025

Transcript captured from MHTV’s Vimeo auto-captioning. No speaker labels; proper names and dollar figures occasionally misheard. Click any timecode to jump to that moment in the source video.

0:00 On the ninth, the 9th of December. I’d like to open the, uh, board itself meeting for tonight, and I’ve had trouble with my computer, so hopefully Andrew has my, uh, slides. Um, and if I wanna try something tonight, um, um, to be able to help people understand a little bit more about the crazy healthcare system we live in. Um, so one way to, to understand our healthcare system is maybe to take a perspective and to see what other healthcare systems look like. So I’m gonna spend a, a very brief time today

0:47 talking about, um, comparative systems. Um, this is a, this is a topic that I’ve caught for many, many years. Usually it takes about 15 to 20 hours to cover the whole thing, but I’m gonna try to do it in about 25 minutes. So I’ll talk a little fast, but if you can put up the first slide, Andrew, just, um, let me just find it again. Save that in you. Okay. I’m gonna look at this as, as if you guys are going to a movie theater, you know, you pay your ticket price to get in to see the feature film, but when you go, when you see the, when you know you’re gonna get the feature,

1:32 feature film first 15 or 20 minutes sitting in your chair, you’re gonna get previews of coming attractions. So tonight I wanna present what I consider to a preview of what it would be like if the Board of Health offered a mini MPH or a, a program to help people understand the health system environment better. Um, so, um, this is in effect a trailer or a preview of that, and why would anyone want to think about doing, uh, an M mini am h now

2:19 that Steve has mentioned he’s been in the police academy, uh, and that, and I’ve talked a little bit to the chief about that, apparently he really well received. Lots of people have done it for years, and they learned more about what it’s like the police in a town like Marblehead. Well, my question, my thoughts here, if you really might be interested in a, in a mini MPH, um, if it to understand better the, the, uh, healthcare issues which are relevant to the town. Like, for example, why is healthcare so expensive in the United States? You really have to go into the weeds to understand that. Um, why is it so difficult to get primary care physicians,

3:05 even though some of some of them may be out sick tonight, but even on a daily basis, very difficult to find primary care. Um, one, I say the US system compared to other systems. What might we learn from other systems? Um, is there a better way of doing things? Um, what can be done to help make the community healthier? Um, and, and finally, because this is public health department, what, what is really public health and what might we, um, learn about it? How you doing? Andrew can get it. Glad to see your, yeah, tell me, sorry. Listen.

3:54 Uh, is yours frozen or is it just frozen on the meeting? Yeah, I think it’s frozen on the, no, I think, well, I’m going to talk about, about a half a dozen, uh, different countries. Um, and I’ve worked or studied or lived there in almost all of them except one, and I’ve given some of them names. So we’re gonna talk about the British system, the German system, the Australian system, the Canadian system, the Dutch system, Singaporean system, and the Swiss Swiss American systems. Um, Germany is, Germany was the first country to start a health,

4:42 health insurance system. Otto von Bismarck, the prime minister, whatever he was at the time, started the German system in 1883, I think it is. And he did it not, uh, he wasn’t a doc, wasn’t a nurse, didn’t know much about health, but there was this other Bri, other German in London who was writing nasty things about, uh, workers’ rights and capitalism and things like that kind named Karl Marx. And so Bismarck said to himself, what can I do to make the German industrial worker feel better?

5:25 You got it. It just, I, it’s on my screen, but it’s not sharing across, feel better about working for the system. And so he said to the German industrial groups, why don’t you provide health insurance for each of your employees? So the ger, so the German system then was, started out as an employment based in, in insurance one. And it was done to, to provide a benefit to workers. Not he, he, he wanted a list of benefits. He built highways, he built buildings, he did all those sort of things. So we call the German system a social insurance system.

6:13 We call the British system, as an example, a national health service. And I’ll come back and we’ll talk about the definitions of of those in in a minute. Uh, when we get to the slide, I’ve got a slide on health system organizations. Any health system organization has to start at one place in the, in the social political environment of the context, raise a bunch of money, um, use the money to, to get a workforce, to have some capital investments and build all the, develop all the sali supplies and things that you need to run a, a health delivery environment.

6:59 And so you set up institutions and processes, um, that are, uh, that are in tune. So that’s pretty straightforward. Anything you’re gonna wanna build. The trick becomes in a health system, what’s the output and how do you pay for it. Now, if you go tomorrow to Mass General Brigham, and you get a colonoscopy probably within a week, um, there, you’re gonna get a bill for your colonoscopy. You’ll get a bill from the hospital, and you’ll get a bill from the doc. Um, but, but in fact, the cyst, the, the society really doesn’t get any value out of the fact that you got a colonoscopy. The goal for the colonoscopy is to prevent colon cancer.

7:48 We haven’t figured out, no system really has figured out how to prevent, how to pay for positive outcomes. You can’t tell whether my colonoscopy is gonna keep me safer than it would be if I hadn’t had it. And you can’t tell that output, and you can’t tell that’s a value, uh, for another 20 years if I die of old age rather than colon cancer. And so the society really wants the system to be developing, uh, outcomes, not outputs. And in fact, what society really cares about

8:33 is it wants to do that at the highest value. It wants to, to be able to say, wow, I’m getting a whole bunch of colonoscopies, which, which prevents a whole lot of colon cancer, and I’m getting at the best possible price in the environment. So that’s what the health system is. I do have a slide and a nice slide that I’ve drawn up and we’ll, we’ll, we’ll come back to it. Um, there are a couple of, uh, things that, that, if, if any one of us in the room were to sit down and talk about how are we gonna design a healthcare system, we, there’s some questions that we might ask ourselves. Where, where I have a think,

9:19 think there’s a triangle up on the screen, um, and, and ask, we can ask ourselves, if you’re gonna build this healthcare system, where should the power lie? Does the power lie in the individual who really wants to live longer and healthier? Does the power rest in the government that’s setting up this infrastructure to allow this to take place? Or is it in the power of the business organizations, perhaps that either the govern, the gov, the, the government or the individual have to use in order to, um, carry out the functions of the system?

10:06 So what do you all think about? Where should the power lie in in a healthcare system? I can tell you, as a physician in my lifetime, as a physician, I have seen an enormous change from, um, the environment in which I was trained to now, the power and influence of the business organizations in the community. Um, it, it, the healthcare system in the United States today is worth $5 trillion. It would, if it were a country, it would be the fourth largest economy in the world. So it attracts financial people.

10:54 So more and more of them are coming into communities and states and countries in order to make money off of healthcare. Massachusetts has a great example of Steward Healthcare. They came into the town, bought the old hospitals, I guess, from the diocese that had them, and ran them into the ground using private equity to steal money from the system. So, um, that’s a, that’s a real, oh, there we go. That’s a real question that, that needs to be asked in the design of any healthcare system. Uh, you are almost there. Yeah. Um, there’s one, okay, there’s the preview, that’s mini MPH. There’s the list of systems we’re gonna talk about.

11:41 The next one is the slide. That is the health system organization. You have that social political environment. You have the money on the left hand side going through various institutions and processes, and it produces outputs, which are easy to bill for. The hospital wants to do as many colonoscopies as possible. Um, outcomes which are harder to assess in the short term. Um, um, and you really, really want a high value system. Next slide is the one, the first triangle. Who should, where should the power lie? Business, individuals or government? Next slide is, uh, and who do you want to be making the decisions about your care? Do you want your physicians and hospitals

12:28 and nurses, primary care people like, uh, dr. Uh, specialty type old guys like me? Um, all now, when I was training, I trained in Colorado. It was absolutely against Colorado law for a hospital to employ a physician. They could buy a physician’s time, maybe 10, 20% for medical directions of ICUs. But except for anesthesiologist, pathologists and radiologists, which were hospital employees time, they were not LA able, they could not have hired Dr. Redlow and, and could not have hired me to practice. So over time, in my lifetime, now, 80% of the residents

13:18 who finished training today, the in, in the United States will be employed by large corporations. Okay? And, and so it’s a major fundamental change. And you have to decide, do you think that’s good for you and your long-term healthcare? All right. So, so we have a, we, we, we, we have a lot of questions that if there, we get this many MPH, we got a lot of things to talk about. Next slide, please. Okay. The universe, whatever, however you design your healthcare system, there are gonna be challenges you’re gonna face. And what we think as a board of health, I believe we’re together in this, that a Andrew, Amanda, Tom, and I, that we want to, we want our colleagues in town

14:03 to understand more about the challenges. Okay? The first challenge is do, do you really emphasize cost containment? Or do we really introduce new medical technologies? If you wanna run the lowest cost system, do you wanna focus on cost containment? But if you want, perhaps to keep people living longer, you want to be able to invest in new technologies. I mean, obviously in, in the New England area, this has, this has been a real source of those sort of things. So you’ve got cost containment versus, um, new technologies. He, do you decide on individual medicine, each person is different? Or do you decide to decide to make some rules

14:50 for populations? So that’s part of the other tension. Do you want your, your, your healthcare system to be basically a local business? Again, when I was in training, the, the word always was, all healthcare was local. You went to your local hospital, you went to your primary care physician, physician, um, you, you stayed in the environment. And rarely did outside influences come into town. Certainly, I, I grew up in Pittsburgh, university of Pittsburgh hadn’t blossomed yet. Um, and so we, we, we, we are very local, very local environment.

15:36 Um, do you want government agencies or private firms to be running your healthcare system? Big question. Ev every, virtually every health system in the country, in the world has to deal with that. And again, do you want your system to be focusing on prevention or response to disease? Next slide, please. Okay. And the universe, the challenges are easy to think of in, um, in, in health systems. Um, on, on the left hand side, uh, um, yeah, blurry even for me. Um, you have the, the cost of, of,

16:27 Uh, You know, the growing burden of chronic disease. We’re all getting older. As we get older. We all have lots of things going on with it. And the other increase in demand is higher patient expectations. The, the more we know about what’s available, the more we want, um, on the, on the, on the su supply side of healthcare, the challenge is everything. It costs more. Certainly everything costs more in the United States. Drugs cost more. Physicians make more money. Hospitals charge a great deal more. And then, uh, there is the suboptimal use of resources, which is, uh, which we use in the system. We spend probably a lot of money in the system

17:18 doing very little to probably improve outcomes at all and having no value. Um, okay. So let’s go back and talk a little bit about the systems.

17:35 Uh, I can, these are nine names for most of them. If you wanna talk about a national health service, probably six. Some people have been to Great Britain. Um, and they have the classic, the classic National Health Service. By National Health Service, we mean a, a government that owns all of the means of production.

18:02 It owns it, it employs the physicians, it employs the nurses, it builds the hospitals. In most the National Health Services, air is free to the individual at the point of service. If you go, if you have a primary care physician in the National Health Service, that person decides what you’re gonna, if you need a colonoscopy, he’s gonna set it up for you. You go to the colonoscopy, he’ll get your results, he’ll talk to you. She will talk to you. Uh, and there will be no charge to you for any of that. Now, national Health Services tend to, on the, on the slide we just had before, tend to be cost conscious by

18:50 reducing the available services. There tends to be lines, there tends to be wait lists, and they tend not to have, not to have all the services that you might have. I worked in New Zealand. Um, it’s in New Zealand, of course, is very much like a small, great Britain, um, national health Service, um,

19:16 less dependent on the primary care physician. The hospitals were built up. I, I know less about Taiwan, it’s newer. I’ve never worked there. The, the American equivalent to a National Health Service. The closest we have is the Veterans Administration. If you’re a veteran and you have a VA near you, you get care with that. That’s free or very low cost at the point of service. And the government takes care of all of the paperwork. Okay? So nationalized services for basic systems work pretty well. But if you are concerned about some of the downsides, most of the, all of these countries,

20:04 and everyone I know at the National Health Services also have small amounts of private insurance that’s available to allow the, the citizens to bypass some of the details, uh, of, of the inconvenience details of a national health system. So, what happens in Great Britain, the National Health Service built this big hospital, 20 story hospital. They may rent three, three floors of the National Health Service Hospital and rent back to a private health insurance firm. And so somebody pays a premium to get in

20:50 and to come in, get in faster to bypass the waiting list for the other 17 floors in the hospital to get their surgery or their care done faster. So in the United Kingdom, um, maybe, um, 10 or 12% of the people who have free care and free care at everything they wanna do in the private, in the private system, New Zealand, much higher than that. Uh, maybe 40% of the people will buy, will buy insurance. Not necessarily to get a different type of care, but to bypass the wait list and to have, have, go, go through all of the, the, the, the inconveniences. And in the Taiwan system, again, I read this,

21:37 I don’t know this for a fact, I’ve not worked there. Um, it, it’s as many as 70% of pri private insurance. ‘cause Taiwan is, is a very, very bare bones system. Okay? So Germany, we talked a little bit about it in the, in the old days, it was simple. If you worked for Volkswagen, you got your health insurance from Volkswagen. If you work for Mercedes, you got your health insurance for Mercedes. And in fact, if you worked for Volkswagen, you couldn’t get your health insurance for Mercedes O Over time, it’s evolved. I’ve spent the most, well, the most policy time in Germany, I happened to be there during transition when they, um, merged with East Germany and all of that.

22:23 So basically over time, now, the Germans have the sickness funds. The employer, the employer agencies still provide that kind of service for the employers who want to, but if you work for Volkswagen, you can join the Mercedes. If they happen to have a dock in their system that’s, or a hospital or a treatment that’s not in the, the Volkswagen system, you can join the ME Mercedes system. And in addition to that, for all the people who don’t work for the industrial giants, who, who are students or are retired or any of that, they now have relatively large government health, i i insurance agencies that you can get your care from. But, but the nature of the German system

23:09 is a social insurance system. It’s doing that because it wants to provide benefits to, its, its citizens. Australia’s kind of my favorite system because I think they’ve thought through the, the benefits of the National Health Service, or you probably can get things done fairly, uh, cost effectively. But a private system allows people to buy into things that are important to them. So what the, what the Australians do, they have a universe. All of these countries, except the United States, have mandatory health insurance. Every a hundred percent of all the citizens have to have health insurance. So, so that’s, that’s not a, not a, a debatable issue.

23:57 So they have a very good public it, national Health Service in effect, which they call Medicare. But then they set up a structure and they say, well, let’s set up another private health insurance system and make the private insurance system more attractive to the people who may have a little more resources, who may have important, you know, who, who can’t afford to take time off to wait in line, all that sort of stuff. And they build a system that makes the private system, they build a, an, an infrastructure that makes the private system very attractive to particularly the young people.

24:43 If you’re under 30 in Australia and you are willing to go to, to pay a premium every year into the private, and there are five or six, I got to know, uh, one of the docs who worked for one of ‘em. So know a little bit about it. Um, if, if you wanna work for one of the private systems, you, you wanna be insured by one of the private systems and you are willing to sign on before you’re 30, they will guarantee you that your health insurance premium will not go up by more than 2% per year for your entire life. Think about the compound savings that

25:28 that would’ve occurred, if that would’ve happened in here. I think it’s now up to two and a half percent, or some, it was 2% when I was teaching this all the time. But, so it’s, it’s, it’s a very different and smart way of promoting private insurance. Some people would argue we have that with Medicare Advantage Part C, but Medicare Part C is really a parasite on the traditional Medicare system in her life. In, in, in the mini, in mini mph, h we talk about, uh, me, Medicare Part C, but that, but Australia’s kind of one of my favorites. Canada looks at and says, well, you know, um, ca Canada has in its constitution that basically says,

26:16 if it’s important, it has to be government run, which is unlike what ever had you’d have that in the United States, probably. ‘cause things are important. We like to have private sector involved. Anyway, what, what Canada is it? It’s, it’s a single payer system. It’s a monopsony, which means there’s only one buyer. So what Canada’s structure is every province, how many provinces are there? 10 or 11? Five. Five. Anyway, every province has runs its own health system system, health insurance system. So they, they’re private hospitals, doctors in private practice, if you want, doctors can be in groups, and then they build a state insurance system,

27:04 and the state insurance system pays them in effect, um, as if it were, um, a private insurance company. Um, it’s worked relatively well. Canada was just like the United States in a, what we call entrepreneur and market-based system till early in the 1970s. And they realized that the costs were out of control and people weren’t getting the services they wanted. And, and, and the Canadian rural versus urban distinctions are even greater than the United States. 90% of all Canadians, I think live within 90 miles of the United States border, but the other 10% are all over hell. They have to really get a very different kind

27:51 of healthcare structure. So they want, they want local lake, local governments. So they broke away and became a monopsony. Um, my mentor, my one of my teachers in Stanford had designed the Dutch system. Um, guy named Alan Ovn wrote a book, uh, and he called it Managed Competition. Alan is a fascinating character. He was one of, um, uh, the, the wiz, the wiz kids in, um, um, MC MA’s, uh, defense department many years ago. And his big biggest thing that he did in the health in the, in the defense department, is he wrote a report on

28:40 how many bombs it would take to destroy the Soviet Union. And it, he, he, his question was, how much is enough? And when he retired, he moved to the Stanford Business School to teach healthcare to people like me. And he asked the same question, how much is enough? And he decided that the way that health systems would work best if you had not individuals competing or trying to find the lowest cost or the highest value, because we may not know enough to do that. But that if you had the next higher level of aggregation, the health insurance companies, and they competed sort of like Volkswagen and Germany,

29:28 and Volkswagen and Mercedes are doing today in Germany. But so the, the, the, the Dutch system, everyone has to have an insurance policy in a private health insurance firm. Um, and the Dutch, when, when there’s rankings of European firms or European countries or, or international companies, the Dutch system always works pretty well. They are regulated private insurance companies that do very well by their, their systems. Um, Singapore is the most, in my mind, I like the Australia, but Singapore is the most interesting.

30:15 Singapore and Malaysia broke away from the British Commonwealth. Um, during that, you know, period of the fifties and sixties, and Singapore and Malaysia were a, a, a, a fit together. And the Malaysians looked at the little island of Singapore and says, you got no natural resources. You got nothing. We don’t wanna be working with you. Malaysia is potentially much richer. So they dismissed Singapore. Singapore got this really very innovative, very creative prime minister who ran the country for many, many years. And he said, okay, we don’t have natural resources. All we have people, all we have is hardworking people, smart, hardworking people. We’re gonna do the best we can in healthcare.

31:01 He said, the first principle is nothing is free. You have to continue to pay, you have to be willing to pay for anything you want in healthcare. So the way the Singapore system is that he, he, Tom works for company X, regardless of what it is, Tommy’s going to have to take about 40% of, of, of his salary and put it into a personal savings account, a medical savings account that he will use to buy into every anything that he wants in, in the healthcare system. Um, and he’s, he’s then for, he’s surely motivated to buy very little if he can,

31:47 and to buy only the things that really matter to him. Um, but over time, the system, he eventually puts enough money into the system that he no long, uh, no longer has to contribute out of his wages. And what, what the government of Singapore does, what one of the things that Tommy can do is buy, um, casual, high casualty insurance, catastrophic insurance. So if you are, if all of a sudden you come down with a big cancer, then it, it, it’s gonna be pretty expensive, much more than the resources you have in, in your personal savings account. You can buy, buy into a casualty account. But, uh, but the Singapore system is,

32:34 is absolutely amazing. They, uh, have some of the best outcomes in the world. Uh, two great ma teaching hospitals. And, uh, as we all know, knows Singapore’s one of the richest, uh, richest country in, in the world, but they still have stuck by this sense that, um, uh, nothing’s free. You pay, for example, um, the standard free healthcare in, in the, in the, if you needed in Singapore hospital, would be a room of four people, four, four beds. Um, if you want to have a double room, you pay a little more money. If you wanna have a single room, you pay a little more money. So, so, and, and that’s the story.

33:20 And, and you can actually, uh, buy into a system where your family will bring food to you. So you don’t have to, you don’t even have to use the hospital, the hospital cafeteria. Not by and large Singaporeans are wealthy enough that none of them bought. But, but when, when, when I started going there, there were people who clearly, um, didn’t buy off from the eight bed rooms and did allow their families to come in with, uh, food and care. And so it, it, it’s really actually an amazing, uh, an amazing system. Okay, so the last is us and, uh, the Swiss, and we are the most market oriented.

34:09 Now, most, most people don’t really, don’t really realize that until 1963 in the United 64 5, when it, the, the United States, there was a battle between, there was a major study of the American health structure in 1912 called the Flexner Report. And it said, geez, you guys need a lot, need a lot of work. And there was a battle between the public health people and the market oriented health people from 1912 until Lyndon Johnson was president, and he passed a law on Medicare and Medicaid. And it was only at

34:54 that time did we irreversibly become a market oriented bo mostly private based system. Okay? So we have all of that background. The Swiss have four cantons. They speak differently, uh, uh, and they’re very business oriented, banking oriented too. So they tend to have the similar openness about business involvement in, in, in their system. They have good outcomes. Um, they, um, they’re probably, I think they’re still the most expensive of the European healthcare system. All of them are much cheaper per, per unit, per, per, per,

35:40 per capita than we are. Um, but Swiss, because it’s, it’s, uh, business oriented, uh, tends to be a little, little more expensive. Okay? Um, next slide is just, uh, uh, a summary. Even though I talk about these d different groups. You see one healthcare system, you see one healthcare system, you, you have to go down into the weeds a little more. Like I’ve mentioned that three, at least three of these countries, the Dutch, the American, the Swiss, and or Australians partly, uh, have private for-profit healthcare systems, uh, insurance systems. Um, but they’re very different when it comes to operation.

36:26 The United States, as unfortunately many people know, the largest source of bankruptcy in the United States is medical debt. That would never happen in, in Holland. That wouldn’t happen in Australia. It could happen rarely in Switzerland. So it depends where you are, the ba the culture of the country, the, the economic culture of the environment. Okay? So that’s, I’ve talked fast, gone through a whole bunch of stuff that again, would take normally several hours, but these are the kind of topics that we would be presenting to the community

37:14 where the community to come to an equivalent public health program. Like the police academy that you’re talking about, that you, that you know about. So, so the question is, we hope that, that, that the examples that I’ve given and the, the vocabulary or the thought process, I, I, when I, I did this when we lived in New Mexico, we, we had about 30 people in the room, and they spent a lot of time on those two triangles that I talked about. Where do you think the power should lie? Who should be making decisions? That’s the kind of conversation that I believe we would have in a mini MPH if people were to sign up for it.

38:03 If we get feedback that it’s worthwhile, then we have to think about how we do it. But first, I wanted to present this, this trailer to see if people fought, at least for marble. Marble is very different than Santa Fe, New Mexico. Santa Fe, New Mexico didn’t have, uh, I mean, I’ve done this in at a lot of places, but that’s the most recent one. Santa Fe doesn’t have a university, it’s not an academic state. It’s a very poor state. It is more of a retirement community than a, than a than a commercial environment in Boston. It so very different population, but this kind of, we didn’t call it a mini MPH, but this kind of public, um,

38:48 educational environment was very positive there. I think it would be fun for me to do, I, I kind of love this kind of stuff, and especially the questions and answers that come about, but in any event, that’s something that the Board of Health can do. Um, if the town wants it, we probably, I’ve talked more time than I’ve taken, but Amanda’s not gonna be here for, uh, a, a an important report that she has that’ll do next time. Um, are there any questions?

39:23 I think, um, the class could be very beneficial, especially a lot of older people, as we all seen on tv. There’s a bazillion ads sign up for this, sign up for that. It’s so damn confusing as to what you should do or not to do. I think you’d find there’d be a good turnout of older people at the senior center. I know at the police thing I took, there was a couple of younger people, but most of ‘em were retired type of people. And they’re doing a part two starting in January. So many people have signed want to sign up, they’re gonna have to do a lottery to choose it. I, I think there’s quite a lot of benefit to it. Well, I would hope that we can attract younger people. ‘cause I think younger people, uh, uh,

40:12 one of the challenges today for our Board of Health, but every public health office in the country is people don’t trust public health as much as they did prior to the pandemic. And I think we need to, to make certain that the younger group understands the complexities of the system as well as the seniors. I’m not the right guy to be the resource to tell a 65-year-old person, whether they go into, um,

40:49 AARP’s, uh, advantage or Marblehead, uh, uh, uh, mass General Brigham’s a Advantage program that I, I I wanna go at the next level of why are they different? What might you look for in the different programs And the senior, they already provide those type of things over there. Yeah, because I just had to sign up for Medicare last year and I called up to get an appointment over there to talk to one of their counselors. Okay. But I retired from the state. So the state only has their own plan. I, I didn’t that, even though I made two different appointments, the guy called me back from over here that I didn’t need. They didn’t wanna see me over there. ‘cause I didn’t qualify for any of the plans that they,

41:36 I in the state mandates me take certain plans. So, so it is misleading and a lot of people see that on tv. You get this free, you get a card, you get two or $300 a month to buy, you know, other things you can get free transportation. Uh, most working people don’t qualify for that stuff. It’s for people that don’t, you know, I had to pay my copays and stuff. Um, you know, if if you’re under a real low income, people qualify to practically not even pay that. That’s Medicaid, of course. Yeah. Yeah. But Mass Health, right. Okay. Well, anyone in the audience who think wants to, I, I think my email’s available. Let me know. Uh, I,

42:22 we, we are here, we, we are prepared to, to see if we can, we can add value to the town in this way. Would you think of doing this in daytime or in evenings? Well, that’s one of the things, younger Senior thing you’d people Are working, um, yeah. They’re not gonna wanna take and go like nine to 11 on Tuesday or whatever. One of the things that we, we’ve explored is what a little certificate that we could get a certificate work with one of the Salem State people to help us get a certificate that you fill. If you say, we did 10 classes over a a period, the 80, 80 minute classes. If you, if you, uh, showed that you learned something in, in those 10 classes, then you get a certificate

43:10 in contemporary healthcare system, something like that. Um, does that matter in today’s world? Um, I, I think you’re absolutely right. Selfishly, completely selfishly, I would prefer to have people in the room when I’m talking. I don’t enjoy teaching on Zoom as much as it, it matters when I, you, you looking, when I say something, I can see, oh, They’re interested. Yeah. That’s, or, or Right. You’re getting to the persons. Some, Something looks, to me, that’s the dumbest thing I’ve ever heard enough you bought. Yeah. And you might, you might be able to teach it a different way.

43:56 See, see that. Yeah. And, and so it becomes a challenge for me, which I enjoy. But, but if the only way it could work is, is to make it mostly Zoom and have a few people, you know, giving feedback, we’ll make it happen. Um, in any event, you know, uh, we’re here, we’re willing to do whatever we can. I really do believe with all of the issues, all the things about the CDC and everything, the changing, the, the conversation that Amanda is gonna have the next time about, for example, the hepatitis, uh, B vaccine for kids

44:41 that they’ve just changed. People need to understand that at a level that I think the board can help get to beyond what you can get out of the, the craziness of social media or TV or anything else. So I think we’re a resource that’s here. If the town wants to use this, we’re available. Okay. One thing you could get, well, first I’ll say my pet peeve that everyone, when it comes to health insurance, no one, the thing that drives me nuts is when people, if sometimes you ask people like, how much do you pay for your health insurance? And if it’s provided by their employer, they’ll be like, I don’t know, my company pays for it.

45:27 Not true. It’s like, it’s part of your salary. So if like they’re paying a thousand dollars a month, even, even it’s paying a fortune. It’s never free. It’s how much you’re worth to that company. Singapore was absolutely right. Yeah. Yeah. No Question. It’s a hundred percent you, that is your worth to the company. And that is basically, you know, if, if they’re paying you a hundred thousand, but your worth to them is 130,000 with all the other benefits and stuff like that. And people never take that into Account. Well, but a a parallel irritation for me is the employer buys the, in the health insurance from somebody to lower his or health costs. And then when the employee says to the her boss, gee, I really can’t get that service. Oh, we had nothing to do with that.

46:12 That’s the insurance company. Yeah, well, they’re buying the insurance company. They could buy a different insurance policy. I mean, it, it, it all comes down to being the individual has to pay E Yes. Either by labor that they’re putting in or, or dollars out of The, the other one that drove me nuts. And I don’t know if you could incorporate this in, so I messed around with a lot of insurances when I was, you know, I try to high deductible plan, which basically means you pay less into it. Yeah. But a lot comes outta your pocket because I was a very healthy person. So like my, um, you know, my physicals would be, you know, free. But if I had something else, you know, there, there was like an account, it was kind of interesting, but I really had to know the cost of everything because it was gonna come out of my pocket, even though I had insurance up

46:59 to like $3,000 or something like that. That’s What we car youth head in Singapore. Yeah. And so it’s interesting because if I was to go to a, a, any dentist office, and I was like, I wanna come and get whatever they can tell me how much it is. If you go to a doctor’s office or a hospital and say, Hey, I wanna do this, how much is it? They’ll say, uh, that’s, you’re gonna have to contact your insurance company. And you’ll be like, no, no, no, no. I’m walking in. I wanna know. No, no, no, no. When I was in practice, and this was a long time ago, I’m sure it’s much worse for Amanda. Yeah. When I was in practice, the University of Virginia had 85 insurance companies that they would, they accepted their policies. Yeah. But every one of them is different. Yes.

47:46 So the doc that you’re asking that question to, you want her to be doctoring you. Yeah. Not looking at 84 different, uh, but that’s insurance Plans. But like what I was saying is like, I can’t come off the street and say, I don’t know, think of something random. I want a war removed or something like that. And be like, how much is this? They will be, we don’t have a number for you. That’s, that’s so inri, that’s one of the quest. How do you, how do you make it more? Yeah. How do you make it more user friendly? Yeah, yeah, yeah. So you understand the cost. Like, like look, so I could walk off the street and be like, I wanna do this. Can I pay for it? And they’re like, uh, Can you pay for it? Or what’s your copay? Uh, yeah, what do you have? What diagnosis do you have to have to get it? I mean, it, it’s, it’s a crazy system.

48:32 Yeah. It drove, it drove me nuts for the three years that I had that. Well, anyway, we could talk for a long time, but, um, we, we saved that for the class. Yeah. Yeah. If you could explain that to me. Um, okay. Well, thank you for giving me the opportunity and, um, a as you, I I, I do enjoy this kind of interaction. Okay. Um, we have some back to the regular, uh, uh, business of, of the board. We have approval of minutes that the board received for the meetings of October 27th. I was fine with those. Yeah. Uh, I remove that.

49:19 They be accepted. I see. Uh, Amanda Comes up And so we’ll pass those, those minutes. Thank you very much for, for uh, doing, um, I have a very brief report about the, uh, comm program. The, um, as I think everyone knows, we, we turned off the, we turned off the computing system at UMass Boston in the SEC end of the second week of November. We had a very brief introductory meeting with UMass Boston the other day. And, um, they’re trying to put the, the results together so that we can understand them so that we can prevent them to the, uh, to the town.

50:05 One of the most interesting things that, that came, Dr. Coyle said was that in, when we were talking about the questions, we had a lot of questions in there that had other, please explain. She said that Marvel had more people, took more time to write answers to questions like that than she is she’s used to. So it’s gonna take a little while for her to read, not her particularly, but, but to co collect each of those things. But she thought that the, that the responses were, uh, were clear. Um, and we’re looking forward to be able to report, um, probably one little report by before the end of the year,

50:51 but really be able to give them a pretty good summary of what’s available very early in the new year. So thank you for the two, the 2,547 people who filled the survey out, and all the people who, who helped us promote it. And you’re gonna get a percentage of the age groups, you’re gonna break it down just Yes. Oh yeah. That was, that’s one of the clearest issues. We had much better response from 40 to 50, 50 to 60, Which younger people, Younger people we expected. We, we are the first town that UMass Boston worked with that went all the way to 18.

51:37 Okay. And they told us 18 to 30 would be very difficult, in part because, uh, lots of people who were in college or away working or something used the address where they grew up as their mailing address. So they’re listed as being a resident of Marblehead, and they probably think of themselves as mar marble headers, but they aren’t really here to either answer questions or to think about things like that. But we, we saw somewhat less, but we still saw a much lower response in the 30 to 40 age group than I would’ve expected. The, I think the 60 to 70 age group

52:26 showed the highest percentage of the people in that group filled out the response. But we actually got, uh, a bunch of, uh, non-engineers that, I think it was over 20, wasn’t it? Um, so what, what Is that? I don’t Understand. 90, 90, or, oh wow. That’s brilliant. Yeah. But we bundled, I mean, they’re still smaller than the eight, but the 80, we now we’re, we’re gonna have a category of 80 plus. So we’re gonna have below 40, 80 plus and then deciles in, in the, in the breakdown. And, and so what, what the UMass Boston do when they have all of this in their computer, they’ll be able to say, well, we have a bunch of people in the town who, who, um,

53:15 who say work, I don’t think we asked who, who, who have two jobs. People with two jobs feel this about the wellness situation for them or people who are disabled. What does it, what’s it like, um, the, uh, we ask a, one of the questions we ask about spiritual wellness, uh, what do you think about the re the faith environment in Marblehead? And not surprising, it’s totally consistent with everyone else. Younger people have less ties to organized churches, organized faith structures in Marblehead than the older generations. Well, what does that mean for the town in the long run?

54:00 So anyway, that’s the kind of question that we hope we’ll be able to get and, and we will all be in the report.

54:10 Alright, so moving on to the, um, ssociate chair for Waste Management, who also has, uh, the, the wellness, uh, um, I issues and, uh, substance use issues. So just briefly talk about the substance use issue. I don’t think they’ll have much of an update now as we would the next meeting. Um, I did speak with the chair of the select board. It, despite what the newspapers may have made it seem, it was very cordial and very, you know, um, we might not agree on everything on it or the approach, but we both want the best outcome. He wants time to talk to the district attorney

54:55 to clarify on the laws. I don’t necessarily agree. I mean, I think our laws were signed by the Attorney General and we have state laws pretty clear. Um, but if he wants clarification, that’s fine. Uh, he should be doing that I think later this week or next week. I think. Um, my hope is that regardless of what was done in the past, we, and, you know, who’s at fault, whatever we move forward, where we enforce the laws that are on the books. And I think it’ll make an almost, and I think there would be, I’d like to see a public declaration mostly that this is, there’s one thing about growing up in Marblehead and it, this is just the way it is

55:42 and everyone will tell you the same thing. 99.5% of the population are just awesome. There is a tiny pop bit that is the most entitled, spoiled brats. And I mean that with the parents too. You can’t do this, you know, laws don’t apply to them. You, you can’t do this. I’ll sue you, blah, blah, blah, blah, blah. In my mind, these people are the biggest problem when it comes to this situation in social hosting. And what I think our local police officers need, which are the ones that are on the boots on the ground that are, are facing these particular parents, is they need to know that they have the full backing

56:27 and full support of both the chief and the select board. That when those parents come and they decide to, you know, serve them whatever they wanna do, citation, summons, whatever, that while they’re enforcing the law, that we have their back as a town. And so that’s what I’d like to see. Like with the public declaration, these are laws, we’re gonna enforce them and we have these guys backs. And so that’s what I hope will be the outcome In, in that regard. Um, on Friday, the weekly news, we’ll have one of the regular columns that the board is allowed to publish. And I’ve done a fair amount of work looking at the neurosciences and how they’ve changed about

57:14 what we know about adolescents and alcohol. So this is a column that will deal with the science of alcohol and health, the number of publications, the books that are out there, the tools and the research that’s been done in the, in the past couple of years is unbelievable. I, it, it was a fascinating area to study. I hope those of you that have the time will read, read the article. ‘cause I think it will be easier once people understand why this is an issue. The adolescent brain is going through

58:03 enormous changes.

58:06 There are three, I’m a pediatrician. There are three time, three stages in the development of the adult brain. The first is the month before the baby’s born. Probably everybody in this room was able to drink a beer or go to a bar before we had, uh, neonatal abstinence syndrome problems. We, the science came to be clear that moms who unknowingly had a couple of glasses of wine in the last month of pregnancy or something like that, was causing serious harm to the infant. The brain of the, the infant. Very dynamic from one

58:53 to three ages. The brain, the, the cerebellum part of the brain, you know, the baby’s learning how to crawl the baby’s learning how to walk, the baby’s the beginning to get language, language skills. So the brain is very dynamic. Fortunately, there’re not very many external toxins that influence, that influenced that part of the maturity. The next, the final developmental stage before the a before you, you get a, an an adult fully adult brain occurs in the teenage years. And what the new science is showing is that the, the influence of alcohol and other toxins. And the next article I hope to write for the current is,

59:41 is gonna be about, uh, uh, uh, re recreational cannabis. Um, because it’s the same thing. It interferes with the normal development, uh, the normal maturation of the adolescent brain moving to the adult. So I think when parents begin to, if they, if they understand, I, I was even surprised the depth of the change that takes place during that time and the, the, the real, uh, amazing invasiveness that these external chemicals can do to that maturing brain. So, uh, we all, I think we all agree that one of the roles of the Board of Health is to provide the science

1:00:30 for the kind of laws and, and municipality we wanna be. And, um, I’m not a great writer, uh, not the smartest guy in the world, but I enjoyed writing this. I really hope that people will read it and ask questions about it because it’s fundamental to what, what Tom is saying. If you really understood what you’re doing to the 15 or 17-year-old grade by, uh, allowing them to get drunk in your house. Um, and you could read this paper and do it with a straight face. Um, I don’t know. So, um, that’s this Friday’s weekly news,

1:01:19 That’s The Lynn item one, right? Sorry, weekly news. Yeah. Yeah. Okay. 10 grants broken. Yeah, we’ll flip, I, we, we go back and forth. Uh, we are very fortunate in this town. We, we times like us have nothing and we have two. Um, okay. And also, I’ll just say one of the responses kind of veered and made it seem as though I wanted to see kids who are caught drinking be, have the hammer dropped on them, arrested, stuff like that. Absolutely not. And I actually made that, I’ve said to be clear in one of my statements, I do not want kids to have rec permanent records or anything for any, something we all did as a kid, you know, getting caught, drinking, you know, whatever,

1:02:04 you know, I think diversion programs, education, things like that are, are great. I do not think anything permanent should be having to kids. My statements are directed at the parents and social hosting, just to be clear. Okay. You wanna talk about your wellness fair? Yeah. Um, well I was, you know, I hadn’t forgotten about this. We wanted this to be annual, but I knew that we had a lot on our schedule between the trash contract and, you know, these, um, social hosting things. And I didn’t want to have it just be something that fell in the background. So I think we can talk about it more when Amanda’s here. Um, but I think it’d be wise to wait till those things are kind of settled

1:02:50 and maybe shoot for like a February type thing instead of a January when, you know, so we should have the contract all done and tell that to everyone in January, and then we can kind of focus on, you know, turning and promoting in February. And we can discuss more when Amanda’s here, what, you know, to add in To that. But yeah, I, I will reach out to Park and Rec and to Jamie, um, and see what potential dates we have for February and we’ll Avoid holidays, weekends this time. Yeah. Yes. Holiday weekends. No, it was a very successful event last year. Yeah. Um, people are definitely looking for us to do it again. Mm-hmm. Um, it was very inclusive. Um, so we let it, you know, essentially everybody who attend, they could both their business. Um, it was a well attended event, so it would be great to do it. Mm-hmm.

1:03:38 Okay. Moving to the director’s reports, uh, budget. So, um, I have budget sheets for all of you. Um, so Amanda, I will send these to you. Um, again, we’re, we have been asked to sub submit a level funded budget. Um, obviously we have the waste, uh, contracts. Um, so we do not, you know, we’re not able to do that for the town at this point. Um, so there’s two sides. We have a, a health department budget and we have a waste department budget. Um, so we can start with the health department first. Um, so you’ll see at the very top of this,

1:04:24 you’ll see all the, um, salaries. What’s The third One? Uh, the third one is for the landfill monitoring expenses. Okay. Yeah. So they have it kind of broken into three sections. The landfill monitoring expenses are part of the waste department budget, um, but it’s its own kind of line items and stuff. Mm-hmm. Um, so you’ll see at the very top, um, those are all your contractual obligations for, um, your salaries. Um, the health, you know, myself, the director, um, the two assistant directors are, they’re just labeled as assistant directors. It’s the public health nurse, uh, and the health inspector. Um, we have a senior clerk who is 50% health department and 50% waste department. Uh, we have a night clerk. We have overtime longevity, six bonus annual

1:05:12 in-service training and stuff like that. Then you get into the va, very basic health budget. Again, we always talk about the underfunding of the health department. Um, when we look at the state of Massachusetts, um, recommends that we appropriate $39 and change for every resident. Uh, technically our budget should be around $744,000. Um, unfortunately we’re unable to afford that. Um, so we try to provide as many services as possible. Um, we do have a vaccine revolving account that allows us to do some flu vaccine. Um, again, we’re not really in the business to be vaccinating a large population. Um, generally for flu vaccine, we’re vaccinating, uh,

1:05:59 employees in a small portion of the senior population. Um, and so that’s really about it. The big piece about this is that for the last couple years, we are very lucky that we have Marble Head Counseling Center. Um, we have appropriated $60,000 for a very long time. Last year we had talked about going up to $120,000. We had the approval of the finance committee. They had, you know, they had promoted this. Um, and finally, unfortunately at the very end, that had to be reduced back from one 20 back down to the 60. So I’m asking again that it goes back up to the one 20. Obviously there is a mental health need. Um, again, you know, this is something

1:06:44 that might not be funded, but we are asking for him again Interrupting. One minute. Yep. We used to be at the hundred 20. Yeah, we used to be even hot. Yeah, it’s not just New. It’s not at out. It’s a, going back to the old days, the good Old days. The good old days. Yeah. Um, another big portion of our budget for the health department is testing services. The testing the services is all your water quality testing, as well as rabies testing that might need to be done in town. Um, again, we’re contributing $4,000 to Hawk, which is healing abused, um, women and, you know, in the community, uh, which is another really important program, um, that we’ve supported for a very long time. Um, besides that is very basic costs, medical supplies,

1:07:34 um, for the public health nurse that’s around your vaccination clinic and all that. And anything else that might come up? What’s the assistant department head number two? Why does that seem The assistant department head number two is two positions. Okay. Okay. So that’s your public health nurse? Yeah. And your health inspector. Gotcha. Okay. Yeah, that’s why that’s so high. Yeah. Okay. Yep.

1:07:57 Um, going over to the waste department again, you have the health director over on this side. Um, it’s a 70 30 split. Um, you have a senior clerk, which is again, 50% of the health department and 50% of the waste department. Uh, you have a special clerk. Um, she’s the one that sits in the scale house operating the scale. You have multiple heavy equipment operators. There’s, there’s three heavy equipment operators up there currently. Um, and then you have two transfer station operators. The transfer station operators are the guys that sit in the back or are in the residential area. They operate the booth. They do the, um, LPR station. So that’s the license plate reader. They do the transactions. They are also helping residents, um, put their rubbish

1:08:45 and trash and recycling in the correct place. Um, again, you have overtime, which includes both scheduled overtime and unforeseen overtime. So because we operate six days a week, we always have scheduled overtime. We have, we know there’s gonna be a certain portion of employees that are gonna be there on Saturday. Um, and then we have overtime that covers anything else that might come up. Um, again, with this, this is a level funded budget besides the fact that we need to go out for a curbside trash recycling collection. So there’s a large increase for that. We will need a new disposal contract. The disposal contract covers the disposal of the trash, um, and then there is gonna be a recycling processing fee,

1:09:32 and that’s covered under, um, other disposal, so for trash disposal. Um, and then the way we calculate this out is that we track every tonnage. Um, there’s two sides to the tonnage. There’s residential tonnage and then there’s commercial tonnage. So we track both tonnages. Um, we know how much commercial tonnage there is and we know how much residential the tonnage there is. Um, we multiply that by what we figure is the going rate per ton, um, which includes truck trucking. Um, and that gives us the 858,000 to 520. Yes, that’s an increase, but we know we’re going up for this contract. Um, for the other disposal, again, we have been very, very lucky with this current contract where we have not been paying anything for the disposal

1:10:19 of recycling curbside. That’s a large quantity of material. That’s a large expense. Um, and so yes, we now have to factor that in. Again, we’re, we’re tracking all of our waste, all of our recycling items. So we’re taking a formula and, and multiplying that by the tonnage that we have for that. And again, so we’re estimating that’s going up to $410,000, um, from 180. So again, that’s a, that’s a very large increase, but that’s what we are expected to go. Um, for the trash collection, again, this is a new contract. We have estimates we’re using other contracts across the state of Massachusetts to give us a, uh, essentially a cost per household. Um, and so that’s how we came up with the figure. Um, this year we will spend 1,046,293.

1:11:08 Our estimates is that we’re gonna go up to somewhere around $1.6 million. Those are really the big pieces. Um, and so yes, as far as the curbside collection, um, RFP that’s on the street currently, we have an open, uh, question period, um, that will occur on December 17th and this building where contractors are able to come and ask questions as we get questions currently. Now, we will answer those questions and push that out back through the RFP process. Um, final bids are due at this point, January 14th. So yes, we will have hard numbers as we work into the budget season. Mm-hmm. Um, the last page I have for everybody is the cost

1:11:55 for the landfill monitoring. Um, so the big costs is the monitoring, the engineering costs to deal with all of that. Um, we do carry some additional costs for grinding the compost removal. Um, this could also be used for additional waste removal, but the idea with that is that if we had a large storm event and we had to deal with additional waste, this is where you’re gonna become using some of the money to deal with that. So the actual was 2,400 for that. That’s what we spent last year. Okay. Yeah. And you Expected almost 25? Yeah. Oh, we’re covering it. It’s, it’s really, it’s kind of like an emergency follow Yeah, yeah. Stuff like that. So yeah. Yep. Um, again, as we’re entering into the budget season, we have the state of the town, um,

1:12:41 which is the kickoff to the budget season. Um, this Wednesday they will do a, a quick presentation of a select board meeting about kind of estimating where some of our costs are tomorrow. Yeah. Tomorrow at the select board. Um, but state of the town is the kickoff to the budget season. That’s gonna be believe January 28th. Um, that’s gonna tell, this is where we are. This is what we’re gonna expect. This is what we’re asking everybody to do. Again, the town has some financial constraints at this point. Um, and going through the budget process, you’ll hear a lot of discussion about the need for overrides. Mm-hmm. So once we go through the state of the town, we have liaisons that we will be working with the fin comm. So with the finance committee, um,

1:13:27 they will appoint two liaisons with us. You and I will meet with them. We will go over a budget again, we’ll have better numbers regarding our curbside trash or recycling contracts. And so we’ll really be talking about a lot of that stuff. Um, the only other big piece that is not really on here is that we have a waste revolving account, um, that covers additional costs. So that covers several employees, the assistant waste director, um, a transfer station operator, some of my salary out of that. And then costs, so commercial trash. Um, another big item that’s gonna be coming out of there is that with this new contract, we will most likely be going to automation, which will require curbside trash and recycling bins for all homes in town.

1:14:14 Um, we’re estimating the cost of all those to be $900,000. We can finance those costs over five years. So that’s roughly $180,000. We would be using the waste revolving account to cover those costs. It’s kind of like saying we appreciate the town, the support of us doing a lot of commercial work and commercial trash of the transfer station. This is, we’re passing on some of the, the benefits of that to the community. Right. And that, and you think that’s pretty, the expectation that it would cover it in full? Yeah. With waste revolving is, is, yep. Yeah. Okay. That’s the idea is to try to, you know, give back to the community. Yeah. No, I think that’s the right way to do it. Yeah. I mean, you could do it, uh, you could slice it so many away other ways, but I think that’s the easy way to do

1:15:00 It. Yeah, yeah. Yeah. That way everybody’s seeing the benefit of it. Yeah, Exactly. No, I think that’s exactly where I’d like to see that. Right. Um, I know that’s a lot of information, so we can continue to talk about this at our meetings coming up. Again, this is just the beginning of the finance, the budget season and everything. Um, so I wanted to ha you know, have all of you guys take a look at this. And again, we can discuss this in depth. Any questions we can answer. Um, so please, you know, this is just kind of the start of it. Mm-hmm. Yeah, I think it’s good to have them broken down into the three. Oh, yeah. Yeah. I mean, it’s easy for, easier for me to understand. Yep.

1:15:44 I, And then as far as project update, um, so we’re, you know, making great progress up there. Again, it’s a very tight schedule. Um, we’ve done the, all the foundation for the scale house is complete. Um, they’ve been working on the rough plumbing for the scale house. They’ve been working on the wing walls. So the concrete work, um, in the lower section for the trucks. Um, the scale isn’t they, they poured the foundation for the scale itself. So the scale pit has been poured. Um, the schedule, we are estimating that we will be moving the scale over into the pit on December 19th. Um, once we move that over, we will be blocking off exit access for the residents.

1:16:30 Um, so beginning the, the 19th of December, residents will be turned around and exit out Green Street. Obviously the employees will be there to help them. Um, they’ll be doing a lot of work upfront at that time. Um, so obviously they’ll be moving all the Jersey barriers. They’ll be doing work along the fence line. They’ll be doing work on the gates. They’re gonna try to accomplish a lot of work that needs to be done in that area. So I am anticipating that the exit for the residence will be out Green Street, most likely from December 19th through the new year. Okay. And when was, when is the expectation that the pit would be back open? I believe the expectation at this point that the pit would be back open right after the new year. Right after the new Year. Yep. Okay. If everything goes well, then they can. Yep.

1:17:16 So yeah, we’re, we’re trying to get that open as quickly as possible. Um, we understand, you know, it’s a highly coveted access for commercial. Um, and we don’t wanna be down as as long as possible.

1:17:31 Questions On the budget or in agenda? Anything you want, Steve? I think we’re at that stage in the, in the agenda. Public comment. Um, We may not bring this up. Are we still on track for the five member board coming up? Yeah. Okay. I’m gonna ask you every time for this. Yes. Um, last Saturday we unloaded the 2,700 reads for the wreath and across America. And normally we take the pallets up and you guys do your magic. That’s not gonna happen. So you have the pallets. Yeah, I, I put ‘em aside, I’ll do something with them. Yeah. So talk to me afterwards. Uh, we might need some That, that part doesn’t bother me. I can get rid of those other places. We,

1:18:17 We might have the Res, that’s the big problem. ‘cause usually the res Oh, we can figure that out too. We normally take and throw those in the pit ‘cause they have metal down. We’ll Figure that out. Yeah. And that’s, I’m not too connect. Yeah. Yeah. No, I, I think there’s somebody that has a, I Wanna make you aware that’s, Yeah, I think there’s somebody that has a need for pallets right now. Um, so common contact me. We’ll try to figure it out. Ones, some are really good ones. Yeah. Okay. I’ll check with you. Yeah. Thank you. Yep. Anytime. And the last thing is, when’s their next meeting? Good question. So I’m away the week. Um, I’m away the next, on December 22nd through the new year. So we do, we wait till the new year After the new year?

1:19:04 Yeah. I guess. Yeah. I think it’s important. I see us functionally as a four person, right? Yeah. Team. So, And, and obviously if something comes up we need to meet. Yeah. Yeah. We would meet, we’ll plan the second Tuesday of Yep. January. Yep.

1:19:27 But e each of us and individuals, if there are questions we can e try to answer even when, when, if it say Andrew’s away or whatever. Yes. That’s the 13.

1:19:46 Any, uh, public comment from the public? I nobody raising their hand at this time. I’ve noticed. And it doesn’t usually stay that way. There’s nine consistently. And normally it seems to go up and down and up and down the whole time. It’s been nice. Must have been. There’s a lot of People that watched the recording. Yeah. There’s a lot of people that were watched The Yeah, I, I’ve gotten in the habit of watching school committee and select board recording. Yeah, it’s good because you can go through ‘em faster. Correct. You it’s, yeah.

1:20:21 And you don’t have to go out in the middle of the night and this cold weather.

1:20:27 Okay. Um, um, I think then we’ve met the agenda. Um, I guess we won’t meet again. Hope everyone has a, a, a great holiday season and we’ll look forward to seeing you all again, um, in the 2026. And we’ll do the best we can to make 2026, um, the most supportive itself, uh, that we possibly can be. We all will hope Amanda’s back on track. Lung can’t get sick. Read your contract And Absolutely. It’s uncharacteristic sound, Sound worse. Okay. I, um, I move that we adjourn second.

1:21:12 And uh, here, see you hand raising. See you all next year. Bye everybody. Bye. Stay healthy. Yeah, you too. Take care of yourself. Thank you. Bye.