Healthcare, Earthcare

As fate would have it, I’m writing this memo from a hospital, sitting bedside with my father as he prepares to undergo heart surgery. Like a lot of people, I didn’t used to think about health care all that often. Now, I realize that I was indulging in perhaps the ultimate privilege - I was “well.”  

Well, sort of. I was diagnosed with an (asymptomatic) heart murmur at age 14, and after I was no longer eligible for coverage under my mother’s policy, I was unable - simply denied any opportunity at any cost - to purchase a policy on the open market in the early 2000’s. But I was in my 20s, in good shape, and raised by my father to be an entrepreneur, so I accepted the risk and went without.

It frustrated me, at the time, to realize we live in a country where politicians pay never-ending lip-service to the virtue of small businesses, while at the same time making policy that in effect excludes the 25% of Americans who have been marked with the scarlet P of a pre-existing condition from participating in entrepreneurship. 

But like many political battles that are occupying our thoughts now, our health care debate is a false dichotomy. There is no inherent reason we need to literally risk our lives to start a business - but many Americans have been programmed to think that making employers responsible for our health care is the only way we can have health care, because that’s all we’ve ever tried.  

Now in my 40s, I am struck by the parallels between America’s approach to environmental policy and its healthcare woes. Again, we have been programmed to see a false dichotomy - we can either care about the environment or have jobs. But this argument ignores all of the Americans who are creating businesses that profit by finding environmentally sound ways of doing things.  

Moreover, we often talk about healthcare as if it is unrelated to the environment, when in fact the two are inextricably linked. Though I’m (selfishly) relieved that it is being devoted to helping my father, for example, I can’t help but feel distress about the enormous energy expenditure required to operate the equipment and HVAC system in this hospital, the by-product of which is in turn contributing to poisoning the environment and making us all sicker. In fact, a 2003 Commercial Building Energy Consumption Survey (CBECS) data showed that large hospitals, though containing only 2% of commercial floorspace, consumed 4.3% of the total delivered energy used by the commercial sector - and that share has increased in the years since. (Read more on this study at

Again, I am pondering a false dichotomy: my father’s well-being versus the health of planet earth. Ultimately, an emphasis overall wellness and prevention of health problems in the first place would lead to a better overall quality of life for people like my dad (who, like me, also had to forgo healthcare for nearly 30 years as a small business owner with a pre-existing condition), and would also lead to a reduction in the need for energy-intensive treatments and stays in the hospital, which would reduce the overall carbon footprint of our healthcare system.

The Earth Charter suggests that we “Ensure that decision making addresses the cumulative, long-term, indirect, long distance, and global consequences of human activities.”  We can say the same about healthcare system as our environment as a whole: anything we can do now to mitigate climate change will be exponentially easier than trying to triage the myriad symptoms that await us - and our children - in the future. 

- Andy Fry

Andy Fry