Point of View

Act Now—Before Climate Change Destroys Healthcare

May 10, 2021

The US health and healthcare construct has barely supported us in normal times— increasing costs, worsening health outcomes, and declining longevity—so imagine the outcomes as climate change’s impacts become even more aggressive.

Health plans and healthcare service providers must urgently leverage the potential climate change disaster and turn the current construct on its head by making big investments in health and wellness—the proactive side of the equation—versus healthcare, the reactive side. This is perhaps our best opportunity to execute the Triple Aim: improving health outcomes, reducing healthcare costs, and improving experiences. The Triple Aim is perhaps the only material contributor in slowing climate change for the sustainability of humankind.

Exhibit 1: The Triple Aim: Care, Health, And Cost

The Triple Aim

Source: HFS Research, 2021

Our health and wellbeing are perpetually influenced by the social determinants of health (SDoH). SDoH reflect the conditions in which people are born (race, religion, genes), grow (food security, access to education), live (crime levels, access to safe water and clean air), work (income, opportunities), and age (social support, community inclusivity). Let us recognize that climate change disrupts these attributes, pressuring elements of the Triple Aim and leading to irreversible deterioration.

Healthcare, or its twin “sickcare,” is delivered based on a certain risk profile (actuary), the finite capacity of doctors and hospitals, and pharma’s capacity to deliver treatments. Climate change disrupts this construct, rapidly making healthcare resources scarce as demand exponentially increases. We are seeing it right now in the middle of the pandemic as the US has sometimes struggled to support its citizens. Healthcare will buckle and eventually crumble.

COVID-19 was just a curtain-raiser compared to what climate change is unleashing

Land and ocean temperatures have increased an average of 0.32°F every decade since 1981. Habitable land is disappearing as oceans and seas quickly rise 3 mm each year. Tangiers Island, MD, about 100 miles east of Washington, DC, has lost an average of 8 acres per year since 1850. Eighty percent (80%) of the Maldives will be under water by 2100. Warming seas impact fishing, and other climate change effects make agricultural conditions less predictable. These production and transportation disruptions impact availability and increase prices, diminishing global food security. Humans—like animals—will move to higher ground, and mass migrations of people will add to SDoH scarcity, causing significant disruption to the Triple Aim.

Hurricanes and tornados lead to floods and destruction of property, as do forest fires. Hurricanes Katrina, Sandy, and Harvey cost us over $120 billion and countless lives, and none of these were Category 5 hurricanes! Severe weather is displacing populations, translating into significant economic challenges and impacting people’s overall wellbeing.

Another Triple Aim disabler is increasing ground-level ozone and particulate matter air pollution, impacting 90% of people in urban areas worldwide. This is a likely cause or risk factor for COPD (Chronic obstructive pulmonary disease) and various respiratory diseases, including cardiovascular problems and some types of cancer.

Polarization worldwide has already driven deep societal fissures, which will worsen as resources dwindle (food, land, water, etc.), potentially translating into escalating crimes and increasing tension. As we have seen with COVID-19, resource scarcity causes enormous physiological and economic stress, leading to significant mental health challenges.

Upend health and healthcare now to deliver the Triple Aim—or else…

This recipe is not for the faint of heart or those who have already made peace with the status quo. It’s an urgent call to action for change agents to accelerate the Triple Aim to help slow down the pace of climate change, adjusting the healthcare ecosystem to align with nature, accept, and adapt.

Improve health outcomes

  • Transform children’s health education: Influence young minds to make intelligent choices. Help them pick up an apple vs. a pizza, a carrot vs. a fry; embed Pavlovian conditioning early on to adopt lifestyles that will protect the planet and their health.
  • Increase access to fresh food: Deploy strategies to dilute and eliminate the food deserts that impact 10% of the US population, as Geisinger Health Plan did with its Farm Food Farmacy program.
  • Kill the sugar subsidies: Repurpose the $4 billion per year in sugar subsidies to craft a collaborative program with the snack and beverage industry to wean us of sugary snacks, reskill people, and repurpose the land for healthy produce.

Reduce the cost of delivering health and care

  • Reduce your carbon footprint: Drive adoption of smarter food choices, such as eating a pound of vegetables, which have a carbon footprint equivalent to driving two miles vs. 30 miles when consuming one pound of beef.
  • Support sustainable farming: Adopt and invest in local farms in a meaningful manner, expand access to fresh produce, and make it part of the benefits plan for your members.
  • Integrate and consolidate: Sunset or streamline existing systems that cost health plans up to 4% of their annual revenue.

Improve the experience

  • Improve SDoH: Influence societal equity to protect and better all lives. Participate in bettering local community access to education, produce, utilities, healthcare, etc. Drive adoption of community programs to increase safety, for example, gun control efforts.
  • Reengineer access: Reimagine processes to accelerate consumer access to all health resources quickly and easily. Access is the new currency to manage utilization better.
  • Redefine business process: Adopt 21st-century technology and process paradigms to streamline how you enroll members, administer benefits, pay claims, and support them inside and outside a clinical setting.

The Bottom Line: Health plans and service providers must urgently concentrate big investments on the proactive (health and wellness) while optimizing the reactive (healthcare) to realize the Triple Aim and sustainably combat climate change.

Frame your investment decisions on a set of drivers that incorporate combating climate change. Part of the formula is to arrest wastage, purposefully digitize, engage consumers smartly, and repurpose resources systematically across the healthcare ecosystem. While this is not a comprehensive to-do list, it is a call to action for all of us who participate in the ecosystem to make the changes we need, think differently, and have the courage to act before it is too late!

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