Science

Pandemic Could Stymie Effort to Cut Health Care Emissions

The National Academy of Medicine yesterday launched an initiative to reduce the U.S. health sector’s greenhouse gas emissions. But even leaders of the so-called Climate Collaborative fear that it faces insurmountable obstacles from the ongoing pandemic.

The public-private partnership among NAM; the Department of Health and Human Services; and more than 50 partners, including big-name health care organizations like Kaiser Permanente and UnitedHealth Group, will explore ways to cut emissions from all aspects of the health care industry.

“We have a duty not only to raise the alarm on the health impacts of climate change, but also to do our part in addressing the impact that our own sector is having,” said National Academy of Medicine President Victor Dzau, who is co-chairing the collaborative.

But reducing the carbon footprint of a sector that accounts for 8.5 percent of all U.S. emissions is a hefty goal made more complicated by the pandemic, which is already overtaxing health care workers. One member of the collaborative’s steering committee said at the program’s virtual launch yesterday that “the odds are low” that the initiative would make a large dent in emissions.

“I don’t think our success is assured at all,” said Donald Berwick, former administrator for the Centers for Medicare and Medicaid Services who now works at the Harvard T.H. Chan School of Public Health. “We have to understand the ask here and that what may happen is a complaint response, or a green washing.”

Berwick said he was impressed with the Biden administration’s leadership on climate change. But that might not convince health care workers and hospital administrators that addressing climate change should be a top priority when the pandemic is draining hospital funding, overrunning emergency departments and intensive care units, and burning out staff.

“And now we are showing up saying, ‘Oh, by the way, save the planet,’” he said. “Any executive with a brain will say, ‘Sure, I’ll do my part,’ but what they are thinking is this is just one more thing on my plate.”

The program’s leaders say they understand why some health care administrators might question whether the sector has the bandwidth to battle two existential health threats at once. But they said time is running out for climate action.

“Our world is telling us that it has been pushed to the extreme, and now is the time for us to listen to it as we would listen to a patient coming in with health symptoms in our clinical work,” HHS Assistant Secretary Rachel Levine said. “While we cannot for a moment take our eye off the COVID-19 response, we have still seen how extreme weather, stoked by climate change, has added to the health threats of COVID-19, for example even shutting down testing and vaccination sites.”

Greenhouse gas emissions from the health care sector come from three categories: health care facilities operations; energy, heating and cooling purchases; and the broader infrastructure and supply chain. The largest chunk of emissions, roughly 80 percent, comes from the last category.

The Climate Collaborative has four “workstreams” to address emissions, with focuses on supply chain infrastructure, health care delivery, professional education and communication and policy, and finance and metrics.

Multiple collaborative co-chairs and steering committee members mentioned the possibility of encouraging hospitals and even medical suppliers to reduce their carbon footprints through new policies or regulations.

“The fact is that we are constrained in some respects to have the highest impact on climate change mitigation because of antiquated and sometimes conflicting federal, state and local regulations,” said American Hospital Association Executive Vice President Michelle Hood, who is on the steering committee. “The ability of this collaboration to identify those and bring those to light and advocate on behalf of our joint mission here to have those regulations updated and changed will be an important contribution.”

Though no officials at the launch offered any specifics, climate-minded health experts, including Berwick, have raised the idea that the Biden administration could leverage Medicare to incentivize hospitals in particular to move to renewable energy (Greenwire, Dec. 8, 2020).

Asked about such an idea this winter, Berwick said, “Certainly, the way Medicare payments work would have the ability to be supportive of those changes.”

The Biden administration has not ruled out using its regulatory authority to force the issue. When HHS established the new Office of Climate Change and Health Equity last month, which also has the goal of reducing health care greenhouse gas emissions, Secretary Xavier Becerra told reporters, “We will use every authority to its greatest advantage because it’s time to tackle climate change now” (Climatewire, Sept. 13).

“If we think there is a way to do it and if we have the tools and authorities to do it, we will move,” he said.

At yesterday’s launch, Berwick said the collaborative would have to spend time convincing health care workers that climate change is akin to a slower-scale cardiac arrest. When someone’s heart stops, doctors and nurses have just three minutes to restore the blood supply before the brain dies.

“We don’t have a choice, so we build our system around getting to their bedside in time,” Berwick said. “It is the same thing now. Climate change is slower but it is just as dramatic. … We’ve got three minutes left on this planet and we better do something.”

Andrew Witty, CEO of UnitedHealth and a co-chair of the collaborative, agreed that “we have a very limited amount of time to make an impact.”

“None of this is easy; there’s not just a box to unwrap with an answer inside, which is why the collaboration is an important step to bring together folks from different perspectives,” he said.

Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2021. E&E News provides essential news for energy and environment professionals.

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