Doctors.They can be climate activists too.“Green jobs now” has become the rallying cry for environmental activists over the last few years as they have worked to build political support for climate action by tying it to economic growth — a powerful message in a world rocked by the worst recession in decades. Politicians have responded to this message, making sure to underline the jobs message. The climate bill passed in June by the House was officially titled the “American Clean Energy and Security Act.” Its Senate counterpart is the “Clean Energy Jobs and America’s Power Act.”

But the jobs-and-security argument is just one part of why the United States needs to transition its economy away from coal and oil. A growing body of medical research suggests a strong link between increased public health and reduced dependence on fossil fuels.  Green groups and the Obama administration should adjust their campaign for climate legislation to tout the potential health benefits.

Over the last decade, as environmental organizations in the United States felt themselves besieged by a hostile political climate, they developed arguments for climate regulation centered around job creation, economic development, national security concerns, and the protection of iconic wildlife, like the polar bear. The health impacts of pollution were largely left by the wayside. As the Obama administration and Congress moved forward this year with health-care reform and climate legislation, environmental organizations remained mostly silent in the health-care debate. In the House-passed Waxman-Markey climate bill, a search for the phrase “health care” turns up only allocations to reduce carbon emissions from hospitals and clinics.

The oversight is stunning. The health-care implications of climate policy are enormous, as shown by recent ground-breaking studies from the U.S. National Academy of Sciences and The Lancet, Britain’s leading medical journal. The National Academy of Sciences study, “Hidden Costs of Energy,” calculated that burning fossil fuels cost the American public $120 billion a year in health-care costs and premature mortality, measured in asthma, lung cancer, and cardiovascular disease. If the health burden of fossil fuels were scored like legislation, they would cost us $1.2 trillion dollars over the next 10 years — enough money to pay for health-care reform and leave hundreds of billions of dollars left over.

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Coal power plants alone impose over $62 billion in health costs annually, according to the National Academy of Sciences, yet almost half of their impact on human health comes from the dirtiest 10 percent of plants. Those dirty coal plants together only supply about 5 percent of the nation’s electricity; replacing them with renewable energy sources could save almost $27 billion dollars a year in health costs. The type of carbon cap envisioned by Congress, however, evaluates only the cost to emit greenhouse gases, not the co-pollutants sickening millions of American children and killing thousands every year. Under the legislation now being considered, the dirtiest, cheapest coal plants could be kept open indefinitely, with only nominal reductions in emissions, as they produce enough profit to purchase the offsets and permits needed to keep them open.

In fact, the health costs of coal pollution completely dispel the myth that coal power is cheap. The dirtiest coal plants are more than twice as expensive to operate as wind power, with health costs weighing in at a prohibitively expensive 12 cents per kilowatt-hour. A carbon market would have to require a price of $120 per ton of carbon to raise the price of coal power to its true cost to the communities downwind of its smokestacks. If a carbon cap is enacted, it’s unlikely that it will push carbon prices even close to that anytime in the near future.

The Lancet‘s recent study found that climate policy written without bearing health costs in mind was far more expensive, far less beneficial to communities, and left potential savings of tens of billions of dollars on the table. It found that “the measures needed to make the necessary reductions in greenhouse-gas emissions are those needed to protect and improve global health. Overall, what is good for tackling climate change is good for health.”

Politicians, listen up!

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Yet, debates over climate legislation have revolved around climate targets and policies such as emissions allowances, offsets, and the design of a cap-and-trade system. In fact, the very design of the House-passed climate bill would likely do little to improve public health. The bill relies primarily on offsets and a carbon market to reduce greenhouse gases. The tools may rate highly in economics scoring by the Congressional Budget Office, but their scoring entirely neglects the health savings from climate policy. The inclusion of international offsets into a final bill actually erodes the domestic health benefits of climate legislation, as carbon financing is outsourced, with tens of billions in health-care savings not being realized to avoid relatively low costs to industry.

In the absence of coalition-building between climate and health-reform activists, Obama administration officials have started taking up the issue, particularly EPA Adminstrator Lisa Jackson and Secretary of Health and Human Services Kathleen Sebelius. Their biographies lend themselves to leadership on this issue. Secretary Sebelius had been hailed as an environmental hero for her work in blocking the construction of coal plants during her tenure as governor of Kansas. Lisa Jackson is an African-American mother with an asthmatic son, and she has made the point that families that look like her own are bearing the burden of America’s energy policy, saying “23 million American children suffer from asthma, and African Americans have twice the national rate of asthma and the highest cancer rates in the country.”

The two leaders headlined a Nov. 20 White House event about the public-health benefits of clean-energy reform. The White House invited many leaders of the environmental-justice movement, and Sebelius laid out the public-health case for climate action, arguing for climate policy as an exercise in preventative care. “As greenhouse gases go down, so do deaths from respiratory illness and disease,” she said.

But there was little discussion at the event of what’s actually in climate legislation — no hard questions about whether the bills in Congress would actually benefit those who bear the burden of our dirty-energy economy, the minority and working-class communities clustered around power plants, ports, and highways.  That was a missed opportunity.

The Obama administration has existing regulatory authority to seek real emissions reductions from the electricity and transportation sectors. Energy-efficiency standards, federal permitting rules, regulation of health-endangering pollutants like diesel emissions of particulate matter, and many more agency-level actions or executive orders could both reduce carbon emissions and provide substantial health savings.  Administrative action by the president, the EPA, and the Department of Energy could save U.S. taxpayers tens of billions of dollars a year in health-care costs, protect vulnerable communities, and restore credibility to U.S. efforts to tackle climate change in the eyes of the world.

The benefits of these actions would accrue to some of Obama’s strongest supporters, including African Americans, the mothers of the 23 million asthmatic children in the United States, and the young people worried about climate change and America’s leadership role in the world. Last but not least, this is a moral issue, for how do we calculate the human misery embodied in $1.2 trillion dollars in health costs from respiratory and cardiovascular illness, cancer, and premature death?

Whether for fiscal, social-justice, or moral reasons, the intersection of health and climate policy needs to come to the forefront as the Obama administration and the activist community push toward climate legislation in the spring of 2010.

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