The issues challenges facing modern medical environments

Anne Ringgaard We may live longer but we also get more ill than ever -- and then there's the threat of antibiotic resistant bacteria.

The issues challenges facing modern medical environments

Introduction to the Series Phil SharpPresident, Resources for the Future This new series is meant to provide an easy way to learn about important policy issues related to environmental, energy, urban, and public health problems and builds on RFF's long tradition of fostering serious public discourse.

Today's selected stories

Our objective over the next few years is to build up an extensive archive of readily accessible commentaries by invited experts on a diverse range of policy issues. For example, in upcoming months some of the topics will include: But today I am delighted that Paul Portney, Dean of the Eller College of Management at the University of Arizona, and my predecessor as President of RFF, is kicking off the series with his views on important environmental challenges facing the nation.

Portney We can pick to conveniently mark the beginning of the modern environmental era in the United States. After all, that was the year that EPA was created, and with it significant federalization of environmental protection efforts that had until then been the province of individual states.

The issues challenges facing modern medical environments

And that same year saw the passage of the amendments to the Clean Air Act, the first really dramatic assertion of power by the federal government in the environmental arena.

Two years later, Congress passed what we now refer to as the Clean Water Act, and, in the decade or so to follow, a handful of other federal laws were passed dealing with pesticides, solid and hazardous wastes, and drinking water.

So, where do we stand 37 years later? It's simply beyond dispute that air and water quality have improved in The issues challenges facing modern medical environments every part of the United States, no matter which pollutants we consider or how we choose to measure them.

Moreover, in most parts of the United States today, we treat solid waste--garbage, that is--with about as much care as we handled nuclear wastes back then--a pretty low bar, I realize, though progress has been great.

Not only are truly hazardous wastes today treated with even greater care, but their use has been significantly reduced, in part because of the expense of dealing with them in the modern regulatory system.

The issues challenges facing modern medical environments

This progress is all the more remarkable because our population has exactly doubled since and real GDP has more than tripled.

I know, I know, air quality was improving in at least some U. And well beforeCalifornia took on the auto industry and required cars sold there to meet the first vehicle emissions standards in the country.

Some analysts have used this to argue that we would have made the same environmental progress had we left matters to the states and not created EPA, nor passed the statutes of the s. It strains credulity to suggest that individual metropolitan areas, or even states, could have mounted as effective a campaign to control air and water pollution from industrial facilities like electric power plants, petroleum refineries, steel mills, paper mills, and cement kilns, among others, as the new EPA did.

And it's painful to imagine 50 different sets of standards governing tailpipe emissions from new cars, trucks, and SUVs.

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Rather than having at least one foot on a banana peel, Detroit's carmakers would have both feet in the grave by now. Before we bruise our backs patting ourselves too hard, let's remember two things. First, while we have made terrific environmental progress in the United States, we could have accomplished as much, at much less cost we're talking hundreds of billions here had we built our federal regulatory apparatus using the kinds of incentive-based approaches that have become the default approach to environmental regulation today.

No one likes to hear "I-told-you-so. The success of the sulfur dioxide emissions trading program established in the amendments to the Clean Air Act has proved they were right on the money. Second, while we've done an exceptionally good if also overly expensive job of dealing with the environmental problems at which the laws of the s were aimed, we neglected two problems that ought to concern us the most as we look forward in this new century.

First, no federal law or regulation has required emissions reductions for carbon dioxide CO2 or other greenhouse gases with the exception of chlorofluorocarbons or CFCs, which were controlled out of concern for their ozone-depleting potential.

While I think there is more uncertainty about the causes and likely consequences of global warming than most scientists suggest, we're nuts not to have instituted gradually increasing controls on CO2 and other greenhouse gases.

The worst-case scenario, especially for future generations, is too scary not to be taking some preventative measures now. The second environmental problem we face lends itself less to federal control and is not the province of the EPA, namely the steady conversion of wilderness and open space to developed uses as our population grows and spreads out.

In many respects we're lucky we're a growing country, both demographically and economically. But as we expand, the wilderness areas and open spaces we enjoy, which are the home to a host of species, are getting chewed up in the process.

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Forget recreation and habitat for a minute. Who doesn't find it pleasing to drive from one place to the next while looking out at forest, fields, or even desert, rather than still another subdivision or shopping mall, however attractive the latter might be? We have never regulated land use very much at the federal level in the United States, and that's not all bad--the thought of social planners in Washington telling communities who can do what and when, not to mention what it ought to look like, gives me the willies.

But leaving the protection of a prototypic public good like open space solely to locals surely has its own set of problems. We have to do better at preserving some natural beauty while still accommodating our growing numbers.

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The essential elements of the suggested model include decentralized governing of hazardous environments, and the least informed about threats to health.

It is the poor who

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