One of the largest health care providers in the US has decided that there is a major threat to its mission. That threat is climate change and the impact it appears to be having on patients. What Kaiser Permanente is seeing is quite specific. Research on trends based on bioinformatics data show that respiratory and infectious diseases are on the rise. Catastrophically severe weather is also increasing demand for a variety of emergency and longer term care resources.
The potential for crisis is exacerbated by budgetary stresses. Many household budgets are strained, paid health care is unavailable to over 10% of the US population and health benefits are being cut by both private and public employers.
The result is a squeeze on serve provision driven by increased demand and decreased ability to pay. The danger posed by ideological opposition to publicly organized and funded solutions is that citizens with limited means will simply get sicker, increasing the threat to the rest of the population.
Part of the problem is that health care has become a major front in the political culture wars roiling the US. Proposed solutions are refracted through the prism of ideological beliefs rather than rational scientific and managerial effectiveness. Until the basis for decision-making returns to the realm of medical efficacy rather than moralism, the threat of broader contagion and an inability to respond to it, will remain.
Fortunately, independent, for-profit providers like KP are beginning recognize that their financial security and operational mission both depend on addressing these risks. JL
Andrew Winston reports in Harvard Business Review:
Kaiser Permanente (KP), one of the largest health care providers in America, has a clear mission: improve health. In a surprising and welcome twist, KP is publicly recognizing that climate change threatens that mission. INSERT> This health care leader is showing how an authentic, mission-driven connection to global issues can drive change.
The topic of climate change has become so politicized, it's rare to hear company representatives and CEOs admit that they're taking a course of action specifically in response to a climate-related threat. But that's starting to change, even in sectors you might not think have a direct stake in climate change.
KP is not a minor player in a health care industry that accounts for 16% of U.S. GDP and 8% of greenhouse gas emissions. With $44 billion in revenues, KP runs hospitals, clinics and health plans, serving more than 9 million members in nine states (and Washington, DC). The "company" is technically a not-for-profit, but in my experience that matters little to medical device and pharma companies that experience KP as a very, very large customer with large demands.
The company has made increasing commitments to renewable energy as part of its aggressive greenhouse gas (GHG) reduction goals (30% by 2020). KP is buying both carbon offsets and significant onsite energy — 11 megawatts of solar and 4 megawatts of fuel cell generation, for example.
All of this is surprising since the health care sustainability agenda has mostly focused on supply chain issues, reducing exposure of patients and workers to toxic chemicals, green building, and general eco-efficiency. Why are they doing so much on renewable energy?
I spoke recently with Kathy Gerwig, KP's Environmental Stewardship Officer, to find out. I expected a more typical answer about achieving GHG reduction goals or doing the right thing. What I got instead was one of the most straightforward statements about the role of climate change in public health and in corporate strategy.
As Gerwig put it, "there's credible evidence of significant climate change that will impact our ability to provide quality health care."
She laid out four broad categories of the health effects:
1.Severe weather: Hurricanes, wildfires, floods, and heat waves all injure and kill people. Hospitals — and all businesses for that matter — need to prepare for these extremes.
2.Respiratory diseases: Air quality in general deeply affects health. This is, as Gerwig says, mainly about the short-term consequences of not dealing with burning fossil fuels and the changing climate.
3.Infectious diseases: As the planet warms, bugs like mosquitos can survive and thrive further north, spreading diseases to new areas. According to the UN, previously untouched areas like the southern U.S. and Mexico will face malaria, yellow fever, and dengue by 2050.
4.The "what we don't know" bucket: While the science is clear that climate change is a serious problem, we still don't know a lot about how it will play out (this is not the same as saying the science is so uncertain that we shouldn't do something). "What we know so far about the repercussions of climate change isn't good," Gerwig says, "such as water shortages and increased wars over resources, and all the health issues that go along with those."
KP is not laying low on the other areas of the health care sustainability agenda, with many impressive initiatives, such as its sector-leading supplier scorecard. But KP is demonstrating a larger view of the company's place in society and in the battle to salvage a healthy, stable climate.
We need all sectors to man the barricades and take positions. Setting a 30 percent absolute GHG reduction goal by 2020 is in line with what scientists tell us we need to do, and it's unusually aggressive. But integrating sustainability and climate change into the health care mission of the organization is the real story here, and its one that companies should emulate quickly.
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