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4 posts from February 2021


Stanford's Mark Jacobson's Discusses How the Healthcare Industry Can Eliminate Its Carbon Footprint (February 25th)

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Per the essay I posted last week concerning federal policy makers' indifference toward the health harm imposed on Medicare and Medicaid beneficiaries via the healthcare industry's carbon emissions, I thought it useful to discuss however limitedly why and how the US healthcare industry  can rapidly transition to the use of clean or renewable energy resources, i.e., wind, water and solar (WWS).  Possibly, if not likely, the leading US researcher on transitioning to 100% clean energy is Stanford's Professor Mark Jacobson.   For example, as early as 2009, in an article published in Scientific American, he and a colleague argued the barriers to a 100% conversion to WWS worldwide are primarily social and political, not technological nor even economic.  In a 2017 article published in Joule he and 27 colleagues summarized the development of what they termed “roadmaps” to transform energy infrastructures for 139 countries to 80% WWS by 2030.  In 2020 Professor Jacobson published a text titled, “100% Clean, Renewable Energy and Storage for Everything."  In it he explains in detail how the world can rapidly and entirely transition the world’s current combustion-based energy to 100% clean renewables and storage.  

During this 34 minute conversation Professor Jacobson begins by briefly explaining clean energy's numerous advantages.  Beyond avoided human and environmental harm, substantial economic savings are accrued from costs associated with continuing fossil fuel combustion, land use savings (e.g., clean energy does not require an extraction industry), permanent job growth, substantially cheaper energy costs, reductions in large scale energy disruption, increased access to energy by up to four billion people currently in energy poverty, and a decentralized world power supply.  He then discusses generally how the US healthcare industry can convert to 100% clean energy in part by offering lessons learned from building his own 100% energy clean home and Stanford University's substantial transition to clean energy.  Professor Jacobson concludes by making comment on carbon tax policies.

Mark Z. Jacobson is Professor of Civil and Environmental Engineering, Director of the Atmosphere/Energy Program, Senior Fellow at the Woods Institute for the Environment and the Precourt Institute for Energy and Co-Founder of The Solutions 2018-08-05 11.24.12.LAH Project, 100.0rg and 100% Clean, Renewable Energy Movement.  His work provided the primary scientific justifications behind the Green New Deal and House bills H.R. 3314, 3671, and 330 and Senate bill S.987, all of which called for the U.S. to go to 100% clean, renewable energy.  In addition, his 100% roadmaps were the scientific basis behind the platforms of three presidential candidates and a major political party in 2016.  To date, he has published three textbooks and over 165 peer-reviewed journal articles.  He has testified four times before the Congress.   In 2005, he received the American Meteorological Society Henry G. Houghton Award.  In 2013, he received an American Geophysical Union Ascent Award and the Global Green Policy Design Award.  In 2016, the Cozzarelli Prize from the Proceedings of the National Academy of Sciences.  In 2018, he received the Judi Friedman Lifetime Achievement Award and in 2019 he was selected as "one of the world’s 100 most influential people in climate policy" by Apolitical.  He has also served on the Energy Efficiency and Renewables advisory committee to the U.S. Secretary of Energy.  He earned undergrad degrees in civil engineering in economics and a masters in environmental engineering from Stanford and was graduated from UCLA with a Ph.D. in Atmospheric Science.

(The sound quality of some portions of this discussion are poor, my apologies.) 

Information on Prof Jacobson's 2020 text, "100% Clean, Renewable Energy and Storage" is at: https://www.cambridge.org/highereducation/books/100-clean-renewable-energy-and-storage-for-everything/26E962411A4A4E1402479C5AEE680B08.

His 2009 Scientific American article is at: https://www.evwind.es/2009/11/16/a-plan-to-power-100-percent-of-the-planet-with-renewables-by-mark-z-jacobson-and-mark-a-delucchi/2259

His 2017 Joule  article is at: https://www.sciencedirect.com/science/article/pii/S2542435117300120.

Prof. Jacobson's 2015 Energy and Commerce testimony is at: https://web.stanford.edu/group/efmh/jacobson/Articles/I/15-11-19-HouseEEC-MZJTestimony.pdf

His Stanford webpage, that contains a significant amount of information, is at:  http://web.stanford.edu/group/efmh/jacobson/Articles/I/15-11-19-HouseEEC-MZJTestimony.pdf.



Dr. Bob Berenson Discusses Healthcare's Pricing Problem and Potential Remedies (February 18th)

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(As explained on the podcast home page, this is the second of eight interviews concerning federal healthcare policy reform.  This discussion with Dr. Berenson was conducted in mid-November.  As you will hear this podcast like all others is introduced by ProMedica's CEO, Randy Oostra.  This series was produced in an effort to interest or persuade federal healthcare officials to pursue substantive healthcare policy reform.)    

US healthcare prices, moreover in commercial markets, have for decades been significantly higher than in comparative countries.   In addition, the US healthcare market suffers wide price heterogeneity or significant price discrepancy.   Total US healthcare spending, per capita spending and spending growth are in multiples of most other rich countries.  While there will remain debate regarding how to best calculate prices or interpret price signals, there is consensus the healthcare industry suffers a significant pricing problem.   As Uwe Rinehardt and his colleagues concluded in a widely referenced 2003 article, “it’s the prices stupid.”  Unlike the US, developed countries throughout the world, control for price via a mix of policies that correct for market failure and constrain price growth.   

During this interview Dr. Berenson begins by explaining what largely explains, or which industry sectors largely explain, healthcare's pricing problem.   He discusses the extent to which stimulating market competition and fielding new payment models can work, explains most comparative countries stimulate competition via regulating prices and explains the opportunity to address providers charging outlier prices, or prices significantly higher than Medicare rates, by placing upper payment limits, setting all payer rates as done in Maryland and as in other states, for example Montana, limiting payments or providing differential payment updates.  He notes the success of rate regulation and competition via the Medicare Advantage program, whether Medicare Advantage should participate in ACA marketplaces and comments on the extent to which more affordable prices paid can be offset for providers by increased utilization.               

Dr. Robert Berenson joined Urban as an Institute fellow in 2003.  In 2012, Dr. Berenson completed a three-year term on the Medicare Payment Advisory Commission, the last two years as vice chair.  From 1998 to 2000, he was in charge of Medicare Berenson-robert_1 payment policy and private health plan contracting at CMS.  Previously, he served as an assistant director of the White House Domestic Policy Staff under President Carter.   Dr. Berenson is a board-certified internist who practiced for 20 years, the last 12 years in a Washington, DC, group practice.  While practicing he helped organize and manage a successful preferred provider organization serving the Washington, DC metropolitan area.  He is coauthor of The Managed Care Blues & How to Cure Them with Walter Zelman, and Medicare Payment Policy and the Shaping of U.S. Health Care, with Rick Mayes.  He publishes frequently in numerous publications, including the New England Journal of Medicine, Health Affairs, New York Times, and New Republic.   Dr. Berenson is a graduate of the Mount Sinai School of Medicine, a fellow of the American College of Physicians and on the faculty at the George Washington University School of Public Health.

For a transcript of this interview go to: https://commissiononhealthcare.org/

The Brookings/Schaeffer two-part healthcare price regulation series noted during this interview is at: https://www.brookings.edu/events/are-u-s-health-care-prices-too-high-too-low-or-some-mix-of-the-two/ and https://www.brookings.edu/events/health-care-price-regulation-and-public-options-assessing-approaches-to-increasing-the-public-role/.  

To read this interview's transcript or to post a comment or question, please go to: https://commissiononhealthcare.org/


Essay: President Biden's Climate Crisis Executive Order Fails to Tackle the Obvious (February 15th)

Today, 3 Quarks Daily posted my latest climate crisis-related essay.  

It's at: https://3quarksdaily.com/3quarksdaily/2021/02/we-must-connect-the-climate-crisis-with-human-health.html#more-193186

3 Quarks has posted a few of my previous related efforts, for example, here's a June 2019 essay: https://3quarksdaily.com/3quarksdaily/2019/06/can-the-climate-crisis-continue-to-go-begging.html.
Today's piece opens with this paragraph: 

Tragically, President Biden’s 21-page “Tackling the Climate Crisis” Executive Order signed January 27th failed to make any effort to address the increasingly dire health effects caused by the climate crisis.  This may seem surprising since, for example, just one-month earlier Lancet published its fifth, well publicized and highly regarded annual report, “Countdown on Health and Climate Change.”  The report’s introduction opens by asserting planetary warming is “resulting in profound, immediate and rapidly worsening health effects.”  Nevertheless, the executive order makes no mention of the Medicare and Medicaid programs and ignores the fact the US health care industry’s greenhouse gas emissions significantly contribute to climate crisis-related health effects.  This is disturbing since the federal government, responsible for safeguarding the health of America’s most vulnerable citizens, should not allow the healthcare industry to systematically harm their health.


Co-Editor Dr. Howard Frumkin Discusses "Planetary Health, Protecting Nature To Protect Ourselves" (February 1st)

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Last year Island Press published Planetary Health, Protecting Nature to Protect Ourselves, considered the first textbook for the field of planetary health.  As the title suggests, the work provides an overview of our planet's health under the Anthropocene era.  As the work notes, per work by the Global Footprint Network we have been increasingly living beyond our environmental means, or  beyond the earth's carrying capacity, since 1970.   Of nine planetary boundaries, including climate change and ocean acidification, we have crossed two and two more are considered to be in a zone of uncertainty.  This is due to the fact no country today meets the needs of its population at a globally sustainable level of resource use - and this is due in turn to a global economic system that assumes natural resources are inexhaustible, or that no amount of resource use would reduce the quantity or quality for future generations.  As the coeditors write in afterword concerning COVID-19 the pandemic, the current state of planetary health “reflects a rupture of the human relationship with the natural world," i.e., as Charles Yu as stated, we live under the fiction or shared illusion "that we are separate from nature." 

Dr. Frumkin begins this 35 minute conversation by discussing the antcedents for the book (see chapter 2).  He goes on to explain his and his colleagues' expectations for the work or what it may accomplish, discusses what findings he found surprising, provides an overview of the books' biodiversity discussion, discusses how/why our economic model explains the current state of our planet's health, makes comment about the health care industry's role in addressing planetary health and the relevance of the Gaia hypothesis.  

Howard Frumkin, MD, DrPH, is Emeritus Professor of Environmental and Occupational Health Sciences at the University of Washington School of Public Health. 2010-2016. Frumkin2016 Immediately previously, he led the Our Planet, Our Health program at the Wellcome Trust.  From 2005 to 2010, he served as Director of the National Center for Environmental Health and Agency and for the Toxic Substances and Disease Registry (NCEH/ATSDR) at the CDC and as Special Assistant to the CDC Director for Climate Change and Health.  From 1990 to 2005, he was Professor and Chair of Environmental and Occupational Health at Emory University’s Rollins School of Public Health and Professor of Medicine at Emory Medical School.  Dr. Frumkin has served numerous boards and committees including the NASEM Committee on Measuring Community Resilience, on the Steering Committee of the Planetary Health Alliance (Harvard University), on the advisory committees to the Global Consortium on Climate and Health Education (Columbia University), the Medical Society Consortium on Climate & Health (George Mason University), the Canadian Urban Environmental Health Research Consortium (University of Toronto), the National Environmental Education Foundation, the American Public Health Association (as Chair of APHA’s Science Board), the Association of Occupational and Environmental Clinics (AOEC) (including a term as President), and the Washington Global Health Alliance.  He has published or edited over 200 scientific journal articles, chapters, and books.  Beyond Planetary Health, he is also editor the text, Environmental Health: From Global to Local (3rd edition, 2016).  Other books include Making Healthy Places: Designing and Building for Health, Well-being, and Sustainability (2011), and Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities (2004).   Dr. Frumkin is a Fellow of the American College of Physicians, the American College of Occupational and Environmental Medicine, Collegium Ramazzini, and the Royal College of Physicians of Ireland and a member of the Washington State Academy of Sciences.   He earned his MD degree from the University of Pennsylvania and his DrPH and his MPH from Harvard. 

For information on Planetary Health go to: https://islandpress.org/books/planetary-health.

Concerning biodiversity or depreciating (literally) the value thereof, see this just published report titled , "The Economics of Biodiversity, The Dasgupta Review" at: https://www.cisl.cam.ac.uk/news/news-items/cisl-responds-to-the-economics-of-biodiversity-the-dasgupta-review