Do American health care violates the recent advice of CIJ climate advice? – The health care blog
By David Introcaso
At the end of July, the United Nations International Court of Justice (ICJ) announced its long -awaited and highly anticipated climate advice. The ICJ decision represents a historic moment in climate responsibility.
“States’ obligations in terms of climate change”
In a rare unanimous decision, the opinion of the CIJ concluded “a clean, healthy and lasting environment” is partly a prerequisite for the enjoyment of human rights, including the right to life and the right to health. Consequently, the states judged of the CIJ, including their private actors, are forced to ensure that the climate is protected from anthropogenic greenhouse gas emissions (GHG) and can be legally detained by other states, groups and individuals unharmed or unharmed not to protect the climate.
The 140 -page opinion is the result of a UN resolution in 2023 which asked the CIJ to produce an advisory opinion answering two questions: what are the obligations of the States under international law to ensure climate protection; And what are the legal consequences to cause significant climate damage? In an unsuccessful attempt, the US State Department opposed the resolution arguing that the CIJ can only consider applicable climatic treaties such as the 2015 Paris Agreement and the exclusion of other rules of international law.
In short, the CIJ noted that states have substantial, urgent and enforceable obligations under United Nations climatic treaties – and international laws in order to prevent significant damage to the GHG emissions which include those resulting from the use of fossil fuels. The court has largely defined the use of fossil fuels such as the adoption of laws, regulatory policies and programs which promote the production and consumption of fossil fuels via leases, licenses and subsidies.
States must act using “all the means at their disposal” which include the adoption of appropriate legal and regulatory measures, the acquisition and analysis of scientific and technological information and risk and impact assessments, by fulfilling a duty of cessation; And, acting in good faith who understands the duty to cooperate and collaborate internationally. The decision also allows legal action to protect future generations. The court rejected the argument assigning damage to a case -by -case basis is incompetent by declaring that it is “scientifically possible” to determine the current and historical emissions of each State. Without appointing the United States, the CIJ has confirmed that states that are not part of UN treaties must always respond to their equivalent responsibilities under international law. (The blog of the Law on Climate Change of the Sabin Center in Columbia has long examined the opinion of the ICJ.)
Contribution of American health care to anthropogenic warming
Given that the CIJ recognizes an inherent link between anthropogenic warming and human rights, opinion implies that the right to health cannot be guaranteed without tackling the own climatic obligations of American health care. Answer these putting a substantial challenge for the industry for several reasons.
American health care contributes significantly to anthropic warming. According to Professor Northeastern Matthew Eckelman, the industry represents an increasing amount of GHG emissions currently at more than 600 million metric tonnes of carbon dioxide equivalents (CO2E) or 9 to 10% of the total American American emissions and 25% of world health care emissions. If American health care was his own country, he will probably rank 9thLess than Saudi Arabia but more than Germany.
Two reasons largely explain the carbon footprint of US Healthcare. The industry is immense. Despite the service of 4% of the world’s population, last year, it was a market of $ 5.3 billion or about half of world health spending. The industry wastes a huge amount of energy. Despite the expenses of more than $ 5 billion per year in energy, which is equivalent to at least 15% of profits, hospitals are considerably ineffective, as they continue to consume fossil fuels to generate heat first to produce electricity which is considerably less effective than the use of renewable resources which directly produce electricity or demand for work. The energy ineffectiveness of the final use increases the problem. For example, only a trivial number of hospitals is EPA Energy Star certified for energy efficiency. For the ten -year period ending in 2024, 85 or 1.4% of more than 6,000 hospitals were on average certified.
With regard to state obligations, the Congress has not yet adopted legislation or an administration promulgating a regulatory rule to mitigate health emissions. Despite the efforts of the Biden administration to “fight against the climate crisis”, the Centers for Medicare and Medicaid Services (CMS) did not end with a single regulation. Like the 2015 Paris Agreement, CIJ’s opinion emphasizes climate action “respect” and “promote” the rights of “children, people with disabilities and people in vulnerable situations”. Nevertheless, decision-makers have examined beyond the fact that the children of Medicaid and the seniors of health insurance pay the greatest climate penalty-which becomes more and more serious as the stock or the supply of carbon dioxide and other GES continue to accumulate in the atmosphere. American decision-makers also know that as Meta-Problem, or a deep cause of all the others, in the absence of GHG emissions from health care, they cannot claim that health care is improving or that health care provides does not impose iatrogenic damage.
As for the industry, clinically health care has not yet developed diagnostic and procedural codes linked to the climate and quality measures, a factor in the adjustment of patient risks and in performance remuneration programming. Operationally, Lancet’s countdown on health and climate change reminds readers every year health care has made trivial progress in divestment in fossil fuels. Last November, the Office of Climate Change and Equity in Health was forced to admit the United States Ministry of Health and Social Services (DHHS) did not know how much health care organizations simply reported their GHG emissions. Because the National Academy of Medicine Climate Collaborative has made no measurable progress over three years, the former CMS administrator last October, Dr Don Berwick, felt obliged to reprimand his colleagues by declaring: “Trus … must be done now, not later, now, to complain about the excuses concerning the terms and the costs and the costs of commerce could not complain. The trade in health care and American professional associations, in particular those dedicated to hospital care, infectious diseases, pediatrics and public health, have not discussed or recognized the resolution of the CIJ of 2023 and now the opinion of the CIJ despite the fact of knowing, for example, more than half of the known human pathogens may be aggravated by climatic risks.
Add to this, that American health care contributes to both and is affected by anthropogenic warming means that industry effectively constitutes a prejudice cycle – treating – damage which exposes it more and more at systemic financial risk. Simply explained, if or more likely when anthropogenic warming or climate degradation leaves us unable to absorb or transfer its own risk of insurance, credit market freezing, health assets are reproduced quickly and mercilessly and market failure is obtained. The American health care industry becomes a victim of its own contradiction, a victim of its own moral risk.
Although the CIJ carries the highest legal, moral and political weight, what effect the advisory opinion will have is uncertain. What is certain is that climate -related costs will continue to increase and the ability to scientifically assign emissions will continue to improve. The CIJ opinion will affirm the complaints of applicants in 3,000 current climatic cases in more than 60 countries and will provide the courts with a “panoply of legal consequences” from which to choose, in particular repairs, the repeal of laws and apparently advanced regulations of the GHG, in particular the cessation, non-compliance and continuous compliance guaranteed.
David Introcaso is a research consultant and health policy based in Washington, DC
