The Health-Climate Nexus

Brad Plumer writes:

A friend was half-joking to me the other day that you could do far more for public health by passing a carbon cap-and-trade bill than by pushing for universal health care. Maybe that's right (see also this recent study showing that increases in CO2 can worsen the adverse respiratory effects of ozone and other air pollutants.) Especially if a climate bill provided incentives for, say, people to move to urban areas and walk and take public transit.

Maybe I'm Brad's friend or maybe the friend reads my blog, but as I've written "if Hillary Clinton's entire agenda were enacted, her climate change proposals would wind up doing more to improve public health than would her health care proposals." My assumption here is, of course, that under an auctioned cap and trade regime it's basically inevitable that people would drive less and do more walking or bike riding.

Relatively small changes could make a big difference in this regard. Even though all us yuppies have our gym members, most Americans are almost entirely sedentary, neither exercising nor walking much. At the same time, tons of people just die in car wrecks directly. There are good reasons to reform the health care syste, beyond the direct public health benefits (it'd be fairer, give people peace of mind, probably enhance economic opportunities and efficiency, etc.) but public health is important too and lifestyle issues are of paramount importance there.

Comments

This might be so, but isn't this one of those cases where, since the two proposals are in no way in conflict with each other, it's a bit silly to play them off each other this way? What would be better than doing either one would be doing them both! (I sort of vaguely recall you saying something like this a while ago, though maybe it was someone else. But it is funny to place two policies in semi-opposition when, you know, they don't conflict in any way.)

Posted by Matt (not the famous one) | March 8, 2008 10:25 AM

Re: My assumption here is, of course, that under an auctioned cap and trade regime it's basically inevitable that people would drive less and do more walking or bike riding.

Probably not. Most places people drive to it's not practical to bike or walk to, for a variety of reasons. True, they could bike or walk to the corner convenience store (assuming there is one) but will that really improve their health that much or decrease in any significant way the amount of CO2 going into the atmosphere?

Posted by JonF | March 8, 2008 10:25 AM

Want to fix our healthcare system overnight? Simply apply a tax to unhealthy food. Use that tax money to subsidize healthy food.

Raise the price of fast food, of items in the frozen food isle of the grocery story, of candies and cookies. Consequently lower the price of whole grain baked goods, of vegetables, and of fruits.

This would have a far bigger impact on US health outcomes than any legislation proposed by any politician. Best of all? It would be free. Actually, applying it would be free. But we'd end up saving craploads of money later on as cancer and diabetes rates plummeted.

Posted by Nick | March 8, 2008 10:48 AM

The "walk and bike more" thesis may apply in major cities. They tend to have neighborhood stores, etc. But for the hordes that live in the suburbs, driving is the only feasible way to get to anything. Sorry, but nobody is going to walk or bike 4-5 miles to the grocery store -- even if they didn't have to haul a bunch of bags of groceries home again. And most other stores are even further away.

More likely, people would do a whole lot more on-line shopping, and so cease getting in even whatever walking they do around the mall. In short, counterproductive (counterintuitive as it may seem to a city dweller).

Posted by wj | March 8, 2008 10:52 AM

It would really be a drag if this thread degenerated into the Argument Clinic of "it's just impossible for most Americans to make even small health-related changes in their lifestyle!" vs. "no, it isn't!" the way several previous threads on this blog, on this topic, have done.

Posted by James Gary | March 8, 2008 10:57 AM

At the same time, tons of people just die in car wrecks directly.

And tons MORE will die if we implement cap-and-trade. Or are you not aware that increases in fuel efficiency standards are often the result of making cars lighter, and lighter cars are more deadly?

In addition, cold temperatures cause many more health problems than warm.

Really, this is a pretty dumb post. There may be reasons why we should decrease CO2 emmissions, but health likely ain't one of them.

I wonder why people think that a policy implemented for one reason just must have all kinds of other benefits? If we reduce CO2 emissions, we'll increase health, make people smarter and prettier, and cause the Wizards to win more games. I mean, come on.

Posted by Al | March 8, 2008 11:02 AM

Go for synergy here! Any sane renovation of health policy in this country should involve a massive reinvestment in public physical education. Mens sana in corpore sano! The school athletic programs have become a sad joke in many parts of the country, a mere vestige of what they were a generation ago. More than that, if we could see our way clear to build vast new gym and athetic facilities in communities across the country, the health benefits would have a measurable impact on the national health bill. Most likely, though, any such notions will be met with a yawning chorus (whining): "We just can't do it. Everything's too expensive." Our national sclerosis and senility rules all.

Posted by elle loco | March 8, 2008 11:03 AM

And tons MORE will die if we implement cap-and-trade. Or are you not aware that increases in fuel efficiency standards are often the result of making cars lighter, and lighter cars are more deadly?

Of all the moronic right-wing talking points that Al has sprayed across the internet, this is surely the stupidest. I'm amazed to see him talking it out for a walk.

Posted by 23456 | March 8, 2008 11:23 AM

hey wj-

Liberals like Matt would like nothing better than to enact policies that render the suburbs obsolete. In fact, I think that abstract goals like global warming are of second tier significance to the real substantive achievement of ending the suburban-commuter-complex (if I may) that has existed in this country for 50 years.

Having said that, it might be that the suburbs will prove to be unsustainable with or without these policies due to rising gas prices and so on (I believe that will be the case), but I find it interesting that liberals misdirect nonetheless.

Posted by Derek Sutton | March 8, 2008 11:28 AM

Although cap and trade will cause less driving, at least pushing people on the margins of deciding between city and exurb to live urban, and therefore under normal circumstances obviously work exactly as Matt Y describes, duh, I wonder about black swan events like nuclear attack or, more likely, epidemic.

Posted by Consumatopia | March 8, 2008 11:33 AM

Of course, one of the benefits of universal, taxpayer funded health care is that incentives can be built into the system to encourage changes in lifestyle. And public health activities can be coordinated with those incentives.

But, more to the point, these two things are not competitive. Neither universal taxpayer health care nor a cap and trade system cost anything more, net, than the US is paying now.

Posted by jayackroyd | March 8, 2008 11:36 AM

This idea that a carbon trading scheme will make people walk more is the most screwball idea I've ever heard of.

People drive to work because where they work is too far to walk to.

People in cities walk more, not because they are more virtuous, but because driving is an expensive pain in the ass in cities.

Screwing with the cost of energy won't make office or industrial parks any closer to housing developments.

To walk or bike to the store is actually very bad for your health in most of non-urban America, because there are no sidewalks and you are walking in a ditch next to speeding cars.

Raising the cost of gas etc. will just be a giant tax on those who are unlucky enough not to live in cities. And it won't induce them to move to cities, because there are now so many virtuous hipsters living there that the cost of moving in is prohibitively high.

If you want people to exercise more, you need to put more sidewalks in residential neighborhoods all across the country. Or change the zoning laws to allow more mom 'n pop corner stores to be put in suburban developments.

Or pass a law requiring everyone to own a dog and to walk it at least twice a day.

Posted by lampwick | March 8, 2008 11:36 AM

Don't underestimate the value of peace of mind.

Posted by John McCain: More of the Same | March 8, 2008 11:37 AM

Cap and trade plans or any other plan to reduce CO2 emissions are really only designed to reduce the slope of increase in those emissions. The impact of that is surely going to be negligible on the climate for the next generation. In other words it will have almost no impact on pubic health.

It's funny how all logic goes out the window. The climate is warming significantly because of the current greenhouse gas content of the atmosphere. That means the trend would continue for some time if greenhouse emissions stopped totally tomorrow. Which won't happen unless a significant portion of humans die soon. Everything about plans to reduce greenhouse gas production, even ones hopeing to eliminate annual increases and forsee decreased output over the next generation or two still guarantee increases as far as the eye can see. We are talking about things at the very margin.

To take discussion of these factors at the margin of climate change and extrapolate them into any public health benefit is silly, to put it kindly.

Posted by rapier | March 8, 2008 11:40 AM

I'm with James Gary on this. There's some truth in the middle here.

I think there's a tendency to overstate the importance of driving in resolving the CO2 issue -- because, as Derek hints, it's a lifestyle issue that really rankles urban liberals. In fact, there are a lot of less well-publicized changes, from fluorescent lighting to wind energy to industrial efficiency, that will do more to reduce CO2.

That being said, building better mass transit, and planning more walkable suburbs, are obviously good things on the public-health grounds that Matt is stressing.

Perhaps, instead of arguing for or against the suburbs, the way to put this would be: there's a public-health rationale for better urban planning that is at least as important as the ecological rationale for it.

But contra lampwick and some other recent posters: you've got to think a couple of steps ahead, and not think about "the price of gas" strictly from a retail perspective. A cap-and-trade CO2 system could help create durable incentives for better urban planning, so that it's not just a fad, but something whose pocketbook benefits remain visible to municipalities and developers.

Posted by Ted | March 8, 2008 11:44 AM

There's an important distinction between the two policies. Climate-directed policies will have a statistical affect, but universal health care will have an, er, universal affect.

Only part of the moral imperative of universal health care is to statistically improve the national health and hygiene (which is important). The bigger part has to do with the right for everyone to have medical care and education. Cap and trade can't do that.

And like jayackroyd says, why not have both?

Posted by Chris Schoen | March 8, 2008 11:51 AM

To clarify that post: Getting rid of absurdly overweight vehicles would definitely help reduce CO2 (and make life safer for the rest of us). When I say that "there's a tendency to overstate the importance of driving" I mean that *after* we make the easy changes in fuel efficiency (trimming the bottom of the bell curve) we may start to reach a point of diminishing returns on the driving front.

Posted by Ted | March 8, 2008 11:53 AM

Urbans like Boston, NY, Chicago, Seattle and San Fran are already pretty well planned, and remarkably energy efficient, what with all the public transportation and the people living in apartment buildings.

The problem lies in the big southern cities like LA, Phoenix, Dallas, Atlanta, and Miami, and their suburban belts, all of which are haze and automobile-exhaust and energy inefficiency nightmares.

When you have some good ideas for changing the local culture in those cities, give me a call.

Posted by lampwick | March 8, 2008 11:58 AM

Lampwick: here's one idea for changing culture: cap and trade CO2! Then let prices do our talking for us.

Another idea: those of us on the left should pay attention to local politics and insist on smart zoning all around the country. It's not impossible.

I grew up in Atlanta, and found that I could get where I needed to go by taking MARTA. Didn't learn to drive till I was 27. Now, I lived in Decatur. There are places in NW Atlanta where you have to drive to get to your kitchen. But it doesn't have to be that way.

I'm now living in a small midwestern city (Champaign), in a classic suburb with big garages. But because it's zoned intelligently, I can walk to the gym, the coffee shop, or the drugstore, and take the bus to work.

It's never going to be Boston. But changes on the margin can make a difference.

Posted by Ted | March 8, 2008 12:14 PM

most Americans are almost entirely sedentary

Speak for yourself, dude.

Posted by Klug | March 8, 2008 12:22 PM

The problem with this meme of having nearly everyone move to ultra high density (aka cities) as the means of combatting global warming and health care -- and everything else that ails us --- is that it forgets that it is imposing upon millions of people the right not to have to live in such environments. I for one only like visiting cities, I would never want to live in one for more than a few years. I love the less dense suburb, smaller town and countryside as human dwelling space. Urbanites have been waging a war on the countryside since the dawn of cities.

We need other solutions that can accommodate this fundamental diversity in where and how people prefer to spend their lifetime on our good earth.

Posted by sampler | March 8, 2008 12:50 PM

sampler, noone is seriously suggesting forcing people to move to cities. However, if the federal government were to invest as much in American cities right now as they invested in American suburbs post WW2, we would probably see tremendous external benefits from such a move. People would still be able to live outside of cities - it just doesn't make sense for all or even most people to live that way.

Posted by yoyoyo | March 8, 2008 1:28 PM

Derek,
Actually, there is hope for the suburbs: telecommuting. As we move on from being a manufacturing economy, more and more jobs really don't require you to physically commute to get the work done. With the result that the only need for commuting is the insecurity of managers that they can actually keep track of what their people were doing if they can see them.

But as more and more companies end up merging and reorganizing, lots of managers are discovering that they are responsible for people scattered all over the map. And, if you manage by results rather than by time present or visible effort, it's not actually all that hard to cope. I know a lot of people who live in different state from where their manager is. Some still go in to an office, but many just log in from home and work away. I even know several who are physically in a different country. (And no, we're not talking about outsourcing here. Just employees who moved for reasons unrelated to their job.)

Get enough of that working remotely going, and the energy/polution costs from commuting plummet.

Posted by wj | March 8, 2008 1:41 PM

Nice to see the creative class walking back that universal health care nonsense; I'm sure it will go over big with Moody's. And why not extend the out-of-box thinking here to troubling programs like welfare and human services generally? Sure, the "deserving poor" should get what they need, but the undeserving? I don't think so.

Of course, if Blackberries caused brain cancer, there'd be a crash program to find the cause and help the victims....

Posted by lambert strether | March 8, 2008 2:09 PM

Over 400 World Wide Prominent Scientists Disputed Man-Made Global Warming Claims in 2007. See http://tinyurl.com/2dv6nz

Posted by Dr Coles | March 8, 2008 5:07 PM

wj-

Telecommuting will only work for a small fraction of the workforce and besides, that still doesn't answer how folks will grocery shop, go to church, or do whatever else they might want to do away from their home. Also, this is just my opinion, but the vast majority of people just can't mentally tele-work. Not only do they get lonely and feel isolated, but the comforts and distractions of home are too great, TV, phone calls to friends, laundry, etc.

Several people in my office have tried telecommuting and eventually gave it up for the reasons above. The only person that telecommuting has worked for is a batty old lady that hates people.

Look, we are all going to be packed into coastal cities at some point, it's just a matter of time. Whether it's a result of bureaucracy from Washington or peak oil, is an open question.

Posted by Derek Sutton | March 8, 2008 9:09 PM

Re: it just doesn't make sense for all or even most people to live that way.

As long as most people don't have long commutes to their jobs, why wouldn't it make sense for most people to live outside of large, dense cities? Most of humankind lived in non-urban (or small urban) environments for millenia.

Re: Telecommuting will only work for a small fraction of the workforce and besides, that still doesn't answer how folks will grocery shop, go to church, or do whatever else they might want to do away from their home.

How did people do these things before there were cars? Again, you don't have to live in the heart of NYC to have a short trip to the grocery store, church etc.

Re: Look, we are all going to be packed into coastal cities at some point, it's just a matter of time.

Nope. Too many people just won't be willing to live that way. Only a minority of people have ever lived in truly large cities. It may however come about that most of us will be living in small and mid-sized cities where most of the amenities are not too greatly distant, limiting the need for extreme amounts of driving (with better public transportation available for mid-range commutes). We actually had this situation for much of the 20th century and I see no reason why we could not go back to it, given better designed cities and improved technologies (inlcuding cars that do not run on fossil fuels)

Posted by JonF | March 9, 2008 1:35 AM