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The scale and subtlety of our country's dependency on oil and natural gas cannot be overstated. Nowhere is this truer than in our medical system.
Petrochemicals are used to manufacture analgesics, antihistamines, antibiotics, antibacterials, rectal suppositories, cough syrups, lubricants, creams, ointments, salves, and many gels. Processed plastics made with oil are used in heart valves and other esoteric medical equipment.
Petrochemicals are used in radiological dyes and films, intravenous tubing, syringes, and oxygen masks. In all but rare instances, fossil fuels heat and cool buildings and supply electricity. Ambulances and helicopter "life flights" depend on petroleum, as do personnel who travel to and from medical workplaces in motor vehicles. Supplies and equipment are shipped -- often from overseas -- in petroleum-powered carriers. In addition there are the subtle consequences of fossil fuel reliance.
A recently retired doctor informs me, "In orthopedics we used to set fractures mostly by feel and knowing the mechanics of how the fractures were created. I doubt that many of the present orthopedists could do a good job if you took away their [energy-powered] fluoroscope or X-ray."
|This article appears in the May/June 2007 issue of Orion magazine, 187 Main Street, Great Barrington, MA 01230, 888/909-6568, ($35/year for 6 issues). Subscriptions are available online: www.orionmagazine.org.|
Despite this enormous vulnerability, public discussions of health care routinely ignore the prospect of peak oil. The proposed reforms, which seek to cover more people while holding down escalating costs, amount to little more than fiscal maneuvers. They take no notice of ecological resource constraints that will set limits on our ability to give people access to medical care.
The coming scarcity of fossil fuels, on top of inflationary costs in medicine (the prices of oil and natural gas are approximately four times what they were in 1999 and rising) and the expenses of treating Baby Boomers (a cohort twice the size of its predecessor), could overwhelm a medical system already in crisis.
We can avoid collapse, however, by reducing medicine's present consumption of energy and creating a health-care system that reflects our actual relationship to resources. Ironically, peak oil can be a catalyst for creating a health-care system that is cost-effective, ecologically sustainable, and congruent with a democratic social ethos.
At present we have a tiered health-care system. At the top is a Ferrari model of care that reflects our affluence, fascination with technology, and extravagance. Ferrari care has made possible the treatment of rare life-threatening diseases and expensive procedures like organ transplants, but it has also been used for esoteric and often redundant testing and vanity procedures such as botox injections. At the bottom is a jalopy model serving over 50 million un- and underinsured Americans who very often receive no treatment, defer treatment until their condition cannot be ignored, or face economic ruin when they seek adequate care.
If the two tiers persist after peak oil, they will eventually be preserved by force -- armed guards at gated medical facilities -- for the few able to pay, while the rest of Americans are relegated to the jalopy and faced with overt rationing, triage, and curtailment of medical care. Such an outcome would be an overt contravention of democratic values -- most Americans tell pollsters they believe that health care is a human right, not a privilege awarded those with higher income.
What then should we do? The best democratic option is to replace both the Ferrari and the jalopy with a Honda. The post-peak Honda health-care model will of necessity operate with fewer overall resources and less energy than today's health-care system, and at lower cost. But it need not result in poorer quality of care.
Dan Bednarz is a health-care consultant in Pittsburgh. He is working to build a broad-based consortium on energy, climate, and the future of health care.