Greening Health Care Josh Farley CDAE Outline of
Description: Greening Health Care Josh Farley CDAE Outline of Presentation Biophilia Toxic health care Market logic Requirements for efficient markets Green investments and health Biophilia Adding elements of Nature to living spaces can presumably
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slide1. Greening Health Care Josh Farley
CDAE<br>
slide2. Outline of Presentation Biophilia
Toxic health care
Market logic
Requirements for efficient markets
Green investments and health<br>
slide3. Biophilia “Adding elements of Nature to living spaces can presumably induce positively valued changes in cognition and emotion, which again may impact on stress level, health and well-being.”
Bjørn Grinde1* and Grete Grindal Patil2
Int J Environ Res Public Health. 2009 September; 6(9): 2332–2343. Biophilia: Does Visual Contact with Nature Impact on Health and Well-Being?<br>
slide4. Greening Hospitals High energy consumption
Hazardous chemicals
Phthalates, PVCs, dioxins
Reliance on disposables
Toxic waste streams
What level of waste emissions is sustainable?<br>
slide5. Greening Pharmaceuticals 10 prescriptions per American per year on average, 17 gr of antibiotics, 3x rate of European countries
Eighty percent of the U.S. streams / quarter of groundwater sampled contaminated with a variety of medications
Feminine fish, hermaphroditic frogs
Antibiotic resistance/sewage plants
Waste water recycling
Impacts on humans?<br>
slide6. Pharma and Ecosystem Services<br>
slide7. Why so much pollution? Who owns the sky? Who owns the ocean? Who pays for toxic waste?
The ‘tragedy of the commons’
Profit maximization: privatize benefits, socialize costs<br>
slide8. What is the Goal of a Private Sector Health System? Maximize profits?
Goal of private sector firms
Costs belong in the numerator<br>
slide9. Total Health Care Expenditures per Capita<br>
slide10. Doctor Consultations per Capita<br>
slide13. What is the Goal of a Public Health System? Achieve best health care outcomes (e.g. average years of healthy life)<br>
slide18. What is the Goal of a Public Health System? Achieve best health care outcomes (e.g. average years of healthy life) at lowest possible costs
Costs belong in the denominator<br>
slide19. Health Outcomes per Dollar Spent<br>
slide20. What is the Goal of a Public Health System? Access to some form of health care
We have decided it is unethical to simply leave the poor to die
What is the most cost effective way to provide health care?<br>
slide21. Prerequisites for efficient markets Large numbers of sellers and buyers
Price takers
Perfect information
No entry or exit barriers
No externalities
E.g. contagious disease<br>
slide22. Half of Americans Live Where
Population Is Too Low for Competition Source: NEJM 1993;328:148 A town’s only hospital will not compete with itself<br>
slide23. ‘Competition’ Increases Costs<br>
slide25. How do insurance companies maximize profits? Avoid insuring anyone who might get sick
Deny care when someone does get sick<br>
slide26. What are the most serious threats to human health today?<br>
slide27. Humans, like all species, depend on a healthy and well-functioning ecosystem<br>
slide28. Essential and Non-substitutable Services from Nature Food
Water
Disease regulation
Disturbance regulation<br>
slide30. Unsolvable problems? Marginal benefits of food systems<br>
slide31. New Technologies Agroecology
Agroecology croplands that generate more services, shifts ecological threshold to left
Agroforestry ecosystems that generate more food, shifts economic threshold to right
Requires public good investments
R&D: 80% annual return on investment
Extension: 80% annual return on investment
Infrastructure
No price rationing of non-rival resources<br>
slide34. New Institutions Economic systems that explicitly account for and promote ecosystem services
Requires collective, cooperative payments for public good benefits
Requires penalties for destruction of public goods
Common property rights<br>
CDAE<br>
slide2. Outline of Presentation Biophilia
Toxic health care
Market logic
Requirements for efficient markets
Green investments and health<br>
slide3. Biophilia “Adding elements of Nature to living spaces can presumably induce positively valued changes in cognition and emotion, which again may impact on stress level, health and well-being.”
Bjørn Grinde1* and Grete Grindal Patil2
Int J Environ Res Public Health. 2009 September; 6(9): 2332–2343. Biophilia: Does Visual Contact with Nature Impact on Health and Well-Being?<br>
slide4. Greening Hospitals High energy consumption
Hazardous chemicals
Phthalates, PVCs, dioxins
Reliance on disposables
Toxic waste streams
What level of waste emissions is sustainable?<br>
slide5. Greening Pharmaceuticals 10 prescriptions per American per year on average, 17 gr of antibiotics, 3x rate of European countries
Eighty percent of the U.S. streams / quarter of groundwater sampled contaminated with a variety of medications
Feminine fish, hermaphroditic frogs
Antibiotic resistance/sewage plants
Waste water recycling
Impacts on humans?<br>
slide6. Pharma and Ecosystem Services<br>
slide7. Why so much pollution? Who owns the sky? Who owns the ocean? Who pays for toxic waste?
The ‘tragedy of the commons’
Profit maximization: privatize benefits, socialize costs<br>
slide8. What is the Goal of a Private Sector Health System? Maximize profits?
Goal of private sector firms
Costs belong in the numerator<br>
slide9. Total Health Care Expenditures per Capita<br>
slide10. Doctor Consultations per Capita<br>
slide13. What is the Goal of a Public Health System? Achieve best health care outcomes (e.g. average years of healthy life)<br>
slide18. What is the Goal of a Public Health System? Achieve best health care outcomes (e.g. average years of healthy life) at lowest possible costs
Costs belong in the denominator<br>
slide19. Health Outcomes per Dollar Spent<br>
slide20. What is the Goal of a Public Health System? Access to some form of health care
We have decided it is unethical to simply leave the poor to die
What is the most cost effective way to provide health care?<br>
slide21. Prerequisites for efficient markets Large numbers of sellers and buyers
Price takers
Perfect information
No entry or exit barriers
No externalities
E.g. contagious disease<br>
slide22. Half of Americans Live Where
Population Is Too Low for Competition Source: NEJM 1993;328:148 A town’s only hospital will not compete with itself<br>
slide23. ‘Competition’ Increases Costs<br>
slide25. How do insurance companies maximize profits? Avoid insuring anyone who might get sick
Deny care when someone does get sick<br>
slide26. What are the most serious threats to human health today?<br>
slide27. Humans, like all species, depend on a healthy and well-functioning ecosystem<br>
slide28. Essential and Non-substitutable Services from Nature Food
Water
Disease regulation
Disturbance regulation<br>
slide30. Unsolvable problems? Marginal benefits of food systems<br>
slide31. New Technologies Agroecology
Agroecology croplands that generate more services, shifts ecological threshold to left
Agroforestry ecosystems that generate more food, shifts economic threshold to right
Requires public good investments
R&D: 80% annual return on investment
Extension: 80% annual return on investment
Infrastructure
No price rationing of non-rival resources<br>
slide34. New Institutions Economic systems that explicitly account for and promote ecosystem services
Requires collective, cooperative payments for public good benefits
Requires penalties for destruction of public goods
Common property rights<br>