Why are Congress’s budget experts failing to address the rise of climate-related health care spending?

Beyond its role of assessing the budgetary and economic impact of proposed legislation, the Congressional Budget Office (CBO) independently issues reports and research papers that address: doze off twicen topic This is intended to increase the transparency of the Bureau and encourage external review and comment. With the theme of “climate and environment”, since 2015, CBO has 9 reportsthe two most recent articles published in December last year Transportation facilities and electricity pahour sector Greenhouse gas (GHG) emissions.

But it’s worth noting that the CBO has yet to release a single report on the impact of the climate crisis on federal health spending, for at least two obvious reasons.

From an anthropocentric perspective, the climate crisis is fundamentally a threat to human health and survival. In his April 2021 Climate and Environment Report for the CBO, “Budget impacts on climate change and potential legal responses‘recognised that climate-related Medicare and Medicaid costs are ‘expected to increase’ as beneficiaries “increase cases of heat exposure, air pollution, or environment-related illnesses.” [sic] Vector-borne disease. ” In fact, these costs are already rising.

Second, when federal budget issues are discussed, the government is often thought of as a giant insurance company with an army.Health care accounts for a significant percentage of federal spending, approximately 30 percentand nearly 90 percent of this spending is is required.

The reason the CBO has not so far published a climate crisis-related health spending report or a report estimating future health budget savings from mitigating climate change is that, as the 2021 report notes, the CBO has “There is currently no basis for estimating how much the climate crisis could be reduced.”such initial costs [mitigation] These policies could lead to future budget savings, as many of the links between climate change and the federal budget require additional information and analysis. The statement is based on the belief that “mitigation investments can lead to future federal budget savings if policies are effective.”

The CBO believes that ways the federal government can mitigate the health impacts associated with the climate crisis include reducing the rate of greenhouse gas emissions, or, as the report puts it, “slowing the pace” or “increasing the extent and pace of climate change.” We believe that it is to reduce The report specifically defines climate mitigation as “reducing the extent or pace of climate change”.

This poses a serious problem because the CBO is wrong on both counts. There is a solid basis for estimating budget savings. But mitigating the climate crisis by reducing the extent and pace of GHG emissions is not the answer.

Estimates of climate-related budgetary health care costs and mitigation savings are both based on a fundamental law of physics: the law of conservation of matter.

ingenious in 2007 paper, John Sterman of MIT and Linda Sweeney of Harvard University found that understanding climate physics was difficult even among highly educated people (their work included MIT graduate students). proved to have failed remarkably. This leads organizations like CBOs to mistakenly believe that the climate crisis can be solved quickly, allowing CBOs to take a “wait and see” approach.

In a paper subtitled “The Adult Mental Model of Climate Change Violates Conservation of Matter,” Sterman and Sweeney argued that reducing the “degree or pace” of greenhouse gas emissions would reduce the atmospheric It is an illusion to believe that greenhouse gas concentrations in the atmosphere will decline. As a result, the average temperature drops. Because matter is conserved, he cannot create or destroy it, because even if the GHG emission rate decreases, the GHG concentration will continue to rise.

Unfortunately, we are far from achieving net zero emissions. Her anthropogenic GHG emissions are more than doubled by him. Rising GHG emissions mean temperatures will continue to rise. Defined as a stock and flow problem, the analogy here is a bathtub of water. Believing that the climate crisis can be mitigated by slowing the amount or pace of greenhouse gas emissions is the same as believing that a bathtub will never overflow if it fills up faster than it drains. To believe such things violates the conservation of matter.

In other words, CBO replaces fundamental stock and flow inferences with false pattern matching. The CBO believes that temperature is linked to emissions. Reducing emissions can therefore reverse global warming and the resulting health hazards. Again, this is false because the tub still has water in it. As Starman and Sweeney make the analogy, a country’s debt is reduced only if the government runs a surplus. “As long as the budget deficit is positive, the national debt will increase even if the budget deficit decreases,” they write.

There are further problems with the CBO’s understanding of and solutions to climate change that rationalize the ‘wait-and-see’ approach. Because, even if we get it right, the effects of the climate crisis cannot be reversed as quickly as the CBO believes. This is because the climate crisis presents a long lag between gradual changes in atmospheric GHG concentrations and net radiative forcing, the difference between the amount of energy entering and leaving the atmosphere. (net amount of solar radiant energy carried by the planet doubled ) In addition to increasing the global energy imbalance, the climate crisis also brings about higher-dimensional dynamic systems with multiple feedback loops and nonlinearities.

Calculating the impact of the climate crisis on health care costs and the associated budgetary savings from mitigation efforts is critical. The laws of physics make it so. If federal policymakers at least try to keep bathtubs from flooding, or, say, to keep average temperatures below 1.5 degrees Celsius, there is little or no chance that appropriate mitigation investments will save the federal budget. No room. The CBO could start by considering the 2021 Medical Societies Consortium on Climate and Health. report It estimates that health care costs related to the climate crisis are well over $820 billion annually.

The CBO would be wise to recognize that our economy is in full recession. subsidiary natural and not vice versa.

Dr. David Introcaso is an independent health policy consultant specializing in health policy reforms related to the climate crisis. He has conducted environmental and health policy research for the US Congress and the Department of Health and Human Services. He is also the creator and host of “The Healthcare Policy Podcast.”