   |  | | Doing a “Gore” on our health system | By Mike Magee, MD
If there was a Nobel Prize for “repositioning,” I'd give it to Al Gore -- even though he's already won the Nobel Prize for Peace. Why? Because, beyond his passion for the issue of global warming, and his dogged pursuit of the facts and unique ways of communicating those facts, Gore's true brilliance has been in knowing he would get nowhere unless he repositioned the issue.
Specifically, the global warming issue pre-Gore was owned by the environmentalists, and they had been positioned as "fringe" and "extreme."1 What Gore did was make global warming a mainstream issue.2 He did this by making it a health issue, a transportation issue, a human disaster and climate issue, an agricultural and food issue, and a global development issue.3 In short, his repositioning made it our issue.
As soon as it became our issue, human beings -- being who they are -- began to wonder what each of us could do. Most focused on their homes.4 Those with hefty resources could pay up to $500 for a full-fledged consultation.5 Others turned to free sites sponsored by organizations like the University of California Lawrence Berkeley National Laboratory for a check-up.6
What they found was not too surprising. There's much each of us can do. We’re clearly wasting water, overheating empty rooms, letting air leaks continue to leak, using old fashioned lighting, avoiding investing in energy efficient appliances and modern heating and air conditioning, and on and on.6 There's a great deal of low-hanging fruit. But, being overwhelmed by what needs to be done, or what could be done, often means nothing gets done. But now with oil well past $100 a barrel and pump prices reminding us that companion heating oil prices are also going through the roof, we have both moral and financial incentives to act.7
So where do we begin? Well, an ABC News poll of 1,004 Americans in 2007 said that 94% were ready to adjust their daily lives, but only 31% admitted to making much of an effort.8 According to a 2007 Gallup poll, 89% of us are recycling. 70% have purchased products in the past year specifically because they believe they are better for the environment. And 35% say they will support candidates because of their pro-environment stance. A majority in the same poll believe they should be using fluorescent bulbs, buying hybrid cars, using more mass transit, and adjusting their homes for energy efficiency.9
Of course, short of action, good thoughts and best wishes are just that. Part of the issue is that investing in home improvements has varying levels of payback. One audit of a 1,500 square-foot home in San Diego showed that switching over to fluorescent lights cost $35 and resulted in an annual energy cost saving of $87. That's a good deal. Installing a programmable thermostat on the other hand cost $162 and saved only $26 per year, meaning that it would take 6.2 years to recover the initial investment. Attic installation and draft reduction can cost close to $1000 and yield annual savings of $350 with cost covered by savings in just 2 1/2 years.4 And of course, if you're handy and look for sales opportunities on materials, the opportunity to tip the scale in your favor increases.
Should the government get more involved? The majority of the public now supports government-imposed caps on corporate carbon emissions with some reservations, namely the impact on their pocket books. Understanding that at least some of the cost of regulation is passed on to consumers, 75% say they would accept a mild bump, from $85 to $87 in their monthly fuel bills to clean up our air. Close to that number - 73% -- are still OK with a rise from $85 to $95 a month in fuel costs. But bump the figure to $155 a month or roughly double what they are now paying, and only 50% of Americans are willing to go along.10
Still, we're getting there. 71% of Americans now believe our own human activity has created global warming and our current climate mess. That's still 20 points behind other global citizens from diverse countries including South Korea, Italy and China.11 Historically, on these issues, the United States has rarely been the first to act. But once we reach a tipping point, we do have the capacity to flip on a dime with surprising speed. And looking at the sea wave change in our approach to global warming, mainly triggered by one aggressive leader, coming off of a demoralizing defeat in a highly contested Presidential Election in 2000, one has to wonder what would happen if a leader of similar skills and fortitude took on the transformation of our U.S. Health care System: First the facts, next the financial reckoning, and finally the quick flip in public opinion. Who might be the Al Gore to galvanize our nation in support of a 180-degree turn toward the creation of universal preventive health care for all Americans, and wouldn't that person rightly deserve the first Nobel Prize for Repositioning?
References:
1. Smith R. A consumer's guide to going green. Wall Street Journal. R1. 12 Nov. 2007.
2. Gore A. Earth in the Balance. Jan. 1993.
3. Gore A. An Inconvenient Truth. 2006.
4. Badal J. House Calls: Energy efficient audits can find savings in places where consumers might never think to look. Wall Street Journal. R6. 29 Oct. 2007.
5. TerraLogos Green Home Services Inc.
6. Lawrence Berkeley National Laboratory, University of Southern California and the Department of Enengy. Home Energy Saver.
7. Oil's $100-a-barrel question. Business Week. 18 July 2006.
8. ABC News/Washington Post/Stanford University Poll. Washington Post. April, 2007.
9. Gallup Poll 11-14 March 2007.
10. Athavaley A. What price green? Wall Street Journal. R6. 29 Oct. 2007.
11. Most Ready For Green Sacrifices. BBC Poll. July, 2007.
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