“Better late than never.” – Geoffrey Chaucer (1340s – 1400)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
Pam and I are presently hiding from the heat of summer 2022 in the lakes region of central Maine. Pam’s family has maintained a cabin in the area for over 100 years. We are indeed fortunate to have the means to travel to cooler climates within the United States. At the same time, so many Americans must withstand the daily onslaught of over 90° F temperatures.
As I write this editorial, a large swath of the western U.S. is presently burning, drought plagues much of the country, and global ice caps are melting at rates far beyond predictions only a decade ago. I doubt many Americans are left who have not experienced some impact from the changing climate (unless they work for the fossil fuel industry). Despite decades of warnings from climate scientists regarding the myriad known and potential planet wide disasters arising from atmospheric pollution (mainly carbon dioxide and methane from fossil fuel use) related to human activity, little has been done to curb our dependence on fossil fuels for energy. The fabulous wealth enjoyed by the fossil fuel industry and the politicians it buys has prevented any serious movement to alter our continued damage to the Earth’s climate.
I am, therefore, genuinely pleased that the House of Representatives passed the Inflation Reduction Act for President Joe Biden’s signature on Friday, August 12. This legislation establishes significant federal spending on numerous issues of interest to federal medicine providers. Most significantly, in my mind, is the $392 billion directed at clean energy initiatives, including incentives for green energy infrastructure, manufacturing and individual taxpayer incentives (energy efficient properties and electric cars).
One can hardly turn on a major news network today without hearing a story concerning the growing impact of global warming on our environment. Perhaps the most significant change that will impact everyone on the planet is the accelerating melting of the land ice sheets covering Antarctica (losing 150 billion tons per year) and Greenland (280 billion). Two-thirds of all the fresh water in the world is contained within these ice ecosystems. Approximately one-third of global sea rise is attributed to this melting. It is hard to comprehend the devastation to human life that continued sea level rise will represent as coastal populations are forced to move inland (looking at you, New York, Los Angeles and San Francisco). The global friction and public health issues caused by this mass migration of people will likely spark conflicts that will occupy the careers of federal medicine providers for decades.
Of course, sea level rise only represents the tip of the global warming iceberg (pun intended). Excessive heat, increasingly violent weather and disease migration as climate biomes move toward the poles as the planet warms is the reality of our collective future. These are the consequences we know about and can measure; even more frightening are those unknown unknowns of climate change as humans continue to stress the planet with carbon and methane emissions. Sadly, the recent climate legislation, though certainly a step in the right direction, is too little too late for the changes I am describing. Federal healthcare providers will have to learn how to cope with the medical consequences of our warming planet. Hopefully, this first baby step toward reducing greenhouse gas pressure on our atmosphere will lead to more aggressive change that will stave off the worst changes to our planet.
Another positive outcome of this legislation was the $98 billion directed at expanding Affordable Care Act health insurance and Medicare’s prescription drug benefit. As I have lamented numerous times in this column, it is unconscionable that a society as wealthy as ours still cannot provide healthcare equally to all its citizens. I personally feel, healthcare is a fundamental human right that all free societies should establish as a cornerstone of their democracies. I have always relished my association with federal medicine as the best example of how healthcare could be demonetized in this country and equal healthcare standards established. Unfortunately, those in Congress who would damn the idea of national healthcare standards due to the cost and necessary tax increase it represents do so as they enjoy taxpayer-subsidized healthcare. Again, this legislation is a move in the right direction. Still, millions of Americans remain uninsured or under insured, and healthcare costs remain the No 1 cause of bankruptcy for the average citizen.
This editorial may seem a bit contradictory. Is it a positive or a negative comment on legislation directed at these monumental issues impacting our environment and healthcare? It is both. As federal medicine providers, we have the unique advantage of working within a healthcare system that is not biased by profit-taking. Therefore, I feel opinions expressed by federal medicine leaders on these topics of national and global importance are free of the bias that comes when medicine is administered through the lens and motivations of business. For this reason, I believe our opinions on these topics are more valuable. I would encourage all federal medicine providers to be aware and conversant regarding climate and national healthcare issues. The impact of the Inflation Reduction Act is firmly in the ‘better late than never’ category. Federal providers will be in the vanguard of the medical response to climate change and issues regarding healthcare access. Our leadership in these areas will be essential to avoid the worst consequences of our collective inaction on these issues for decades.