Poor must not shoulder responsibility for reducing healthcare carbon emissions

 

The pursuit of net zero healthcare risks targeting the poor and exacerbating existing unfair heath inequalities unless careful consideration is given to the re-allocation of healthcare resources. A group of global health researchers, writing in the Journal of the Royal Society of Medicine, say that as with pandemic measures, the burdens of climate impacts and cutting emissions are not equally shared.

The NHS in England has committed to ambitious net-zero targets – an 80% reduction in emissions under its direct control by 2028-2032 and across the supply chain by 2036-39, reaching net zero by 2040 and 2045 respectively.

According to the researchers, the most deprived people have poorer health, a lower life expectancy and consume a greater amount of health services. Given healthcare consumption is the ultimate driver of healthcare emissions, they write, this has important implications in terms of justice for the pursuit of net zero healthcare.

Lead author Dr Anand Bhopal, a PhD research fellow at the Bergen Centre for Ethics and Priority Setting, said: “Lifetime health costs among the poorest people are 10-20% higher than the least deprived. It seems likely that individual healthcare carbon footprints also follow a social gradient, with emissions highest amongst the worst-off.”

According to Dr Bhopal and his colleagues, healthcare carbon emissions represent almost a fifth of the per capita healthcare carbon footprint among the poorest people, compared with under a fiftieth among the richest.

The net zero agenda involves, in part, transforming how the NHS delivers care and changing the behaviour of individuals. Reducing carbon emissions within the healthcare system involves trade-offs, write the researchers, since a re-allocation of resources may displace spending from more cost-effective health interventions.

The researchers consider if those with the greatest means and total emissions caused outside the healthcare system should shoulder the responsibility to reduce their carbon footprint. They give the example of a return flight from London to New York which incurs four times the NHS’ per capita carbon footprint or almost the annual total emissions of an individual in the poorest decile.

“Those who depend on the public healthcare system, and who risk the most if health gains are sacrificed due to already existing health inequity, may find it doubly unfair to carry the burden of reducing carbon emissions,” added Dr Bhopal.

Estimated 98 million Americans skipped treatments, cut back on food, gas or utilities to pay for healthcare

 

 

IMAGE: HIGHER HEALTHCARE PRICES DROVE 38% OF AMERICAN ADULTS – REPRESENTING AN ESTIMATED 98 MILLION PEOPLE – TO EITHER DELAY OR SKIP TREATMENT, CUT BACK ON DRIVING, UTILITIES, AND FOOD, OR BORROW MONEY TO PAY MEDICAL BILLS IN THE LAST SIX MONTHS, ACCORDING TO A NEW SURVEY CONDUCTED BY WEST HEALTH AND GALLUP. view more 

CREDIT: WEST HEALTH - GALLUP HEALTHCARE AFFORDABILITY STUDY THE GALLUP PANEL: JUNE 2-16 2022. N=3.001

WASHINGTON, D.C. — Aug. 4, 2022 — Higher healthcare prices drove 38% of American adults – representing an estimated 98 million people – to either delay or skip treatment, cut back on driving, utilities, and food, or borrow money to pay medical bills in the last six months, according to a new survey conducted by West Health and Gallup. The survey was conducted in June 2022, the same month inflation reached 9.1%, a new 40-year high.

The percentage of people making these kinds of tradeoffs was higher in lower-income households, but higher earners were not immune. While more than half of households earning less than $48,000 a year made spending cuts, nearly 20% of households earning more than $180,000 a year were forced to cut back too. Women under the age of 50 also cut back on medical care and medicine at higher rates than their male counterparts (36% to 27%, respectively) and much higher than men generally (22%).

“People have been making tradeoffs to pay for healthcare for years. Inflation has only made things worse as people are also now struggling with the high price of gas, food, and electricity,” said Timothy A. Lash, President, West Health. “However, unlike those expenses, Congress has the power right now to reduce healthcare prices, particularly for prescription drugs. Legislation is on the table.”

 

Healthcare inflation, which stood at 4.5% in June 2022, was half the overall inflation rate, which spiked to 9.1% in June, primarily because of rising prices for gas, food, and rent.

Most Americans are not even thinking about how inflation may increase healthcare prices given the spikes in gas and food. When asked, “For which one of the following expenses do you expect costs to rise the most in the next six months?”, 43% of respondents cited gas, followed by food (34%). Healthcare was mentioned by only 3% of respondents.

Aside from the tradeoffs that Americans are making to afford healthcare in the current inflationary environment, one in four (26%) say they simply avoided medical care or purchasing prescription drugs altogether because of higher prices and were either unable or unwilling to divert funds from somewhere else to pay for it.

 

The future does not look bright for these Americans in terms of relief at the pharmacy counter. Overall, 39% report being “extremely concerned” or “concerned” about being unable to pay for care in the next six months, including 33% of Democrats, 44% of Republicans and 42% of independents.

In addition to focusing on the healthcare cost challenges Americans face, the survey looked at how inflation was changing consumer behaviors. Driving less and cutting back on utilities were the top ways Americans tried to cope with higher prices.

“Inflation is hollowing out consumer spending habits across an array of areas,” said Dan Witters, senior researcher at Gallup. “What is found just under the surface is that after gas and groceries, the role of inflation in reducing the pursuit of needed care is large and significant. And the rising cost of care itself, which is originating from an already elevated level, is having an outsized impact on lessening other forms of spending, compounding the problem.”

Little Confidence Exists in Federal and State Governments to Curtail Costs

Irrespective of race, gender, income or political identity, Americans hold little confidence in their elected representatives to Congress or their own state government to slow rising costs. Three in five adults (59%) are “not at all confident,” and another 35% are “not too confident” that their own members of Congress will take action to lower healthcare costs in the coming months. Only 6% are “somewhat” or “very confident.”

When viewed through a political lens, Republicans and independents report elevated levels of concern about future healthcare affordability, but Americans in all three political identity groups (more than nine in 10) are “not at all confident” or “not too confident” that members of Congress will take action.