HealthAffairs.org, Matthew Meyer, May 24, 2023
In 2015, The World Health Organization identified climate change as “the greatest threat to global health.” This exact statement was reiterated by over 200 medical journals including the New England Journal of Medicine in the middle of the COVID-19 global pandemic.
The healthcare sector is responsible for one sixth of the US GDP, 8.5 percent of US greenhouse gas emissions, and, a proportionally estimated 23 to 44 million tons of municipal solid waste. Healthcare’s pollution has been so ignored that investors encouraged start-up medical device companies to add single-use components to capture recurring revenue.
On the clinical frontlines, with frequent exposure to issues surrounding care delivery and coordination, we know much waste can be eliminated without impacting patient outcomes. Frustratingly, despite the health implications of pollution, the automotive industry appears to have a more developed plan to address environmental sustainability than the US healthcare industry.
Recently, the healthcare sector has started to recognize its responsibility for planetary and public health. Unhealthy environments lead to unhealthy patients. England’s National Health System (NHS) is leading, and in 2020 it committed to becoming the world’s first net-zero national health service. With thoughtful regulation, the US healthcare sector can also decarbonize, reduce waste, and improve public health.
The future of healthcare is sustainable healthcare. This is being modeled by the NHS, and can be replicated and improved upon in the US healthcare sector. Our healthcare sector in the US has an historic opportunity to leverage its economic, political, and ethical influence to create a better, healthier future. Below, I look at one potential standard that can catalyze industry-wide action and the barriers that may need to be overcome to realize a more sustainable US healthcare sector.
US Healthcare Sector Tiptoes Towards Sustainability
The US is finally considering making healthcare more sustainable. In 2022, the Centers for Medicare and Medicaid Services sought input from stakeholders regarding decarbonizing healthcare. The Department of Veterans Affairs released a Climate Action Plan with energy efficiency and renewable energy goals. A handful of health systems are truly championing waste reduction and decarbonization. And the Department of Health and Human Services created an Office of Climate Change and Health Equity, and promoted a voluntary pledge for health systems to reduce greenhouse gas emissions that 116 health organizations have signed.
The US healthcare organization which has generated the most excitement with its entry into the sustainable healthcare discussion is The Joint Commission (TJC). Over 22,000 healthcare organizations are accredited by TJC, including many major U.S. health systems. Typically, TJC accreditation lasts three years, and when TJC accreditation is about to expire, TJC surveyors visit and intensely observe how well the organization follows TJC accreditation standards. At the end of the survey, organizations are accredited, denied accreditation, or given time to address concerns. As a clinician who has experienced multiple TJC surveys, the attention hospitals give to TJC standards is unparalleled. If TJC created a thoughtful standard for decarbonization and waste reduction, 22,000 healthcare organizations would start decarbonizing and reducing waste.