Up next for some of the groups that wielded their expertise and influence in Washington to shape and push through a landmark healthcare overhaul: Save the planet?
An alliance of 120 health organizations and experts signed a letter last week to the White House, Senate and House of Representatives urging that they treat climate change as a serious threat to public health. The signatories include the American Medical Association, the American Nurses Association and the American Public Health Association.
“If you want to reduce healthcare costs, then we've got to start thinking about health well before people get to the doctor's office,” APHA Executive Director Georges Benjamin said. “The big story that people always quote is heat waves. We just went through one this summer. We had several deaths from it.”
The Obama administration and some lawmakers agree with Benjamin that curtailing global warming is an important piece of keeping people healthy, but during the summer heat wave they failed to advance legislation attacking the problem amid a hostile political environment forged and hardened in the long and contentious healthcare debate.
But the motivation for the health groups that have banded together now is not principally to make a far-fetched plea for the embattled Obama administration and congressional Democrats to resurrect the issue as a priority. The goal, rather, is to allow the Environmental Protection Agency to regulate greenhouse gases, and to steel lawmakers from blocking such a move. The letter warns somewhat obliquely of “efforts to weaken, delay or block the EPA from protecting the public's health from these risks.” “We're pretty dead set that the EPA has broad authority to regulate the air, and there's a medical imperative to do so,” Benjamin said.
Democratic leaders in the Senate backed away from a comprehensive climate and energy bill drafted by Sens. John Kerry (D-Mass.), Joe Lieberman (I-Conn.) and Lindsey Graham (R-S.C.), which adopted the cap-and-trade approach to emissions, a direction favored by the White House. Graham withdrew his support before the bill was even introduced.
A spokeswoman for Senate Majority Leader Harry Reid, responding to the letter about the public health risks of climate change, said in an e-mail that Reid “agrees with the need to do something, but we will need Republicans to work with us to do so.”
The House and Senate both adjourned last week until after the midterm elections, meaning nothing of that magnitude will be taken up before the next Congress is sworn in.
In December 2009, the EPA issued a finding that humans are harmed by emissions of six greenhouse gases, including carbon dioxide. The conclusion set the table for the government to begin regulating those emissions under the Clean Air Act, and in the succeeding months the EPA developed thresholds and a permitting process aimed at large industrial facilities such as power plants and oil refineries, triggering a fierce response from business lobbies.
The EPA finding stemmed from a 2007 U.S. Supreme Court ruling that greenhouse gases could be considered pollutants but left it up to the EPA to assess the scientific case for attributing harm to them. Twelve states, along with several local governments and environmental groups, triggered the case by petitioning the EPA to begin regulating the emissions from new vehicles.
“The accumulation of CO2 and other greenhouse gases in the atmosphere can lead to hotter, longer heat waves that threaten the health of the sick, the poor, the elderly—that can increase ground-level ozone pollution linked to asthma and other respiratory illnesses,” EPA Administrator Lisa Jackson said at the time.
Sen. Lisa Murkowski (R-Alaska) floated an unsuccessful resolution to strip that authority from the EPA. But resistance has come not just from Republicans.
Sen. Jay Rockefeller, a Democrat from the coal-producing state of West Virginia, was a vocal Obama ally in the passage and defense of the Patient Protection and Affordable Care Act and someone Benjamin credits as a strong supporter of public health.” Yet Rockefeller is aggressively pushing a bill that would suspend the EPA's ability to regulate CO2 or methane under the Clean Air Act, except in the context of setting limits for vehicle emissions.
Rockefeller's office did not respond to a request for comment. Appearing at a Washington rally of coal miners last month, Rockefeller said Jackson doesn't understand the importance and fragility of those jobs in his state. “Her job is relatively simple: Clean everything up, keep it clean, don't do anything to disturb perfection,” Rockefeller said, according to the Associated Press. “Well, you can't do coal and do that at the same time. God didn't make coal to be an easy thing to work with.”
Reid has indicated he may allow Rockefeller's bill to get a vote during the lame-duck session after the November elections. If passed, it most likely would be met with a veto from President Barack Obama.
The public health association and its allies, however, are reluctant to rely on that assumption, arguing that there is no time to waste.
“If we could somehow or another today stop all human-caused greenhouse gas production, there is enough energy stored in the climate system of the Earth that climate change would continue for 50 years before we would see some amelioration,” said Jerome Paulson, a co-director of the Mid-Atlantic Center for Children's Health & the Environment at Children's National Medical Center in Washington, speaking on behalf of the American Academy of Pediatrics in a call with reporters publicizing the cause. “We really can't afford to wait, it just makes the situation worse,” Paulson said.
Also speaking on the call was Nancy Hughes, director of the American Nurses Association's Center for Occupational and Environmental Health, who warned that “any action that interferes with or dilutes EPA's efforts will have a very negative effect on our public health.”
An AMA spokeswoman said that signing on to the letter was consistent with AMA policy advocating government action to protect the public from adverse health effects of pollution, specifically citing “the greenhouse effect” as a threat.
Another signatory to the letter was the American Thoracic Society, whose members treat the people most likely to be afflicted by the consequences of climate change. “What we're finding out today is when you have emitters of CO2, you have interactions with both ozone and particulate matter,” William Rom, a member of the organization's environmental health policy committee and professor of medicine and environmental medicine at NYU School of Medicine, said in an interview.
“As respiratory physicians we're concerned about the effects of ozone and particulate matter on mortality, hospitalizations and emergency room visits, particularly for people with increased susceptibilities, such as asthma, or patients with cardiovascular disease,” Rom said.
Not everyone is sympathetic to that portrait of imminent danger. The U.S. Chamber of Commerce (which continues to battle elements of the Patient Protection and Affordable Care Act) in August petitioned a federal appeals court to review the EPA's scientific findings regarding harm caused by greenhouse gases. The Clean Air Act, the chamber said in announcing the lawsuit, “simply was never intended to regulate something as complex as global climate change.”