OPINION: The Inflation Reduction Act is a win for healthcare, but it needs to go further

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The classic heart attack patient in medical textbooks is someone who collapsed while shoveling snow. For one 72-year-old metro Detroit resident, it was a flood. The stress of watching flood waters overtake her home, and moving possessions up from the basement, led to a heart attack. 

This is one example of how climate change is impacting our health. In addition, flood water exposes people to pathogens and toxins that make people sick, especially children. Increased heat and humidity can result in premature deliveries and sudden deaths in the elderly and young athletes. Warmer temperatures mean worsening air quality and more frequent ER visits for those with breathing conditions.  

While all people are vulnerable, some communities suffer disproportionately, often those with the least resources. This is why the medical community recognizes climate change as a health emergency and why equity must be at the center of all solutions.

Michigan Clinicians for Climate Action  (MiCCA) applauds Congress for passing the most robust climate provisions to date in the Inflation Reduction Act (IRA) while also recognizing that there is still much more that needs to do to ensure climate justice. 

This $366 billion investment will take steps to decarbonize our economy and is projected to reduce greenhouse gas emissions to 40% below 2005 levels. The IRA will extend production and investment tax credits for clean electricity efforts, ensuring the continued growth of wind and solar energy, and provide tax incentives for electric vehicles. It will also place a fee on industrial methane leakage, invest in natural forms of carbon sequestration (e.g., community and urban forestry), and create incentives for homeowners and contractors to build energy-smart homes.  

Reducing emissions will have far-reaching immediate health benefits from improved air quality and mitigation of climate impacts such as the increased spread of infectious disease, deaths and injuries from natural disasters and heat events and mental health effects. 

While all populations will benefit from these measures, those communities closest to heavy traffic and polluting industries stand to gain the most. Robust emission reduction measures such as those seen in the IRA are projected to save lives, improve productivity in the workplace, and save hundreds of billions of healthcare dollars each year in the US

Unfortunately, climate justice provisions in the IRA fall short. While the IRA does provide funds for various community-led projects, invests in home efficiency for low-income households and schools, and reinstates the Superfund tax on oil and petroleum companies, much more is needed to protect communities whose health has been impacted disproportionately by fossil fuel pollution and climate change.

Access to affordable healthcare is critical to these communities. Fortunately, the IRA provides healthcare access to an additional 10 million Americans by extending premium tax credits for purchasing Affordable Care Act plans.

Furthermore, it will allow Medicare to directly negotiate with pharmaceutical companies to reduce the costs of prescription medications, and it caps out-of-pocket prescription drug costs for Medicare subscribers, who will also receive free vaccinations. All are excellent initial steps toward a more equitable healthcare system.

As health practitioners, we commit to “first do no harm,” yet the healthcare sector accounts for 8.5% of the US greenhouse gas emissions. By expanding access to affordable health coverage and prescription drugs, the IRA will encourage preventative health measures while avoiding unnecessary, complex, costly medical interventions that would otherwise increase emissions of heat-trapping gases. 

Healthcare providers working for climate justice in Michigan understand that while there is much to celebrate in the IRA, our work is far from done. This is just the first step, of many, toward a healthy, equitable climate future in which all can thrive.


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