The Fund supports several networks of state health policymakers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis on topics important to state health policymakers, particularly on issues related to state leadership, primary care, aging, and health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a nonpartisan foundation focused on improving the health of communities and entire populations.
December 2, 2020
Building Back Better
Apr 13, 2021
Mar 10, 2021
Back to Building Back Better
For those who think elections don’t matter, take a look at the climate change discussion in the past few weeks. On a macro level, incoming President Biden has identified climate change as an existential threat to humanity; John Kerry, former Secretary of State, environmental activist, and oil industry critic, has been named as the Special Presidential Envoy for Climate, elevating climate change to the level of national security; the country is re-entering the Paris Agreement; and, at the EPA, science-oriented administrators are replacing climate change deniers and industry shills.
On a micro level, some company executives are voicing support for policies to reduce their carbon footprints and to promote clean energy. Some are touting efforts to replace inefficient energy sources with new green(er) systems. Even some of the biggest auto manufacturers whose gas-guzzling SUVS are at the heart of the problem are at least temporarily dropping their support for Trump’s effort to override California’s strict emissions standards, betting on the ultimate success of electric cars and efficient batteries that will power them. “President-elect Biden recently said, ‘I believe that we can own the 21st century car market again by moving to electric vehicles.’ We at General Motors couldn’t agree more,” a General Motors representative hypocritically wrote to the heads of various environmental groups. And Shell, British Petroleum, and Total have cynically joined the Oil and Gas Methane Partnership, a joint effort of the United Nations Environment Programme, the European Commission, and the Environmental Defense Fund, to track climate warming emissions.
But voluntary actions or statements are certainly not enough for even the most dynamic parts of the new “gig” economy that are largely ignoring or are unaware of the threat of climate change. TechNet, “the voice of the Innovation Economy,” is a consortium of many of the country’s largest tech companies. It recently issued a detailed map for the future. With the exception of General Motors, most of its members are technology companies like Google, Zoom, Apple, eBay, Amazon, Cisco, Facebook, and Accenture or are companies like Lyft, Visa, and Uber that depend on this new set of web technologies. Despite no apparent overriding self-interest in burning oil, their agenda for the country’s future does not even mention climate change or regulation of polluting industries. Rather, their agenda identifies future concerns of the tech industry—privacy through the creation of trade incentives, international trade, legal protections for patents, and the like. They call for the Federal Trade Commission to end “burdensome regulations” in the interest of promoting digital trade.
While the recent election has unleashed government and led to a torrent of words from industry, the fact that so much damage was done to government agencies during the Trump administration’s short period in power should give us pause, especially given that Republicans in Congress appear ready to stifle legislation that is at odds with powerful groups that support them. The oil and chemical industries that support so many legislators still see their profits and futures tied to drilling in the Arctic and the Gulf of Mexico, transporting shale oil by pipeline across the Midwest, promoting fracking, expanding natural gas exploration, and the like. In view of the apocalyptic possibilities of rising sea levels, increasingly powerful hurricanes, severe droughts, and longer seasons when forest fires can destroy huge areas of the country and the world, the idea that the Senate could continue what has amounted to 12 years of climate change denialism is truly haunting. If, as we hope, one election could dramatically change the nation’s agenda, another might be capable of undoing it just as fast. After all, there’s another election just down the road.
We can expect major corporations’ “dark money” to fuel a propaganda and political effort aimed at stifling regulatory programs. Senator Sheldon Whitehouse has shown how, in the past, unidentified donors poured hundreds of millions of dollars into the campaign coffers of senators and congressmen, and how foundations and think tanks have generated white papers, amicus briefs, and seemingly academic articles to support a variety of industrial policies. Groups like the Global Climate Coalition, the Heartland Institute, and the Competitive Enterprise Institute, along with trade associations like the American Petroleum Institute and the US Chamber of Commerce, will unleash advertising campaigns to convince the American people that we can trust the petrochemical industry to police itself and that clean energy is their goal. As Whitehouse has documented, “Giant fossil fuel corporations have spent billions—much of it anonymized through scores of front groups—during a decades-long campaign to attack climate science and obstruct climate action.”
There are numerous ways in which the Biden administration might counter some of the more egregious efforts that undoubtedly will take place.
First, it is essential to establish a body within government that focuses on the climate crisis, so that research and policy cannot be easily dismembered if a conservative majority once again controls the levers of government. In the same way that the US Commerce Department promotes trade and presents itself as a direct service to commercial interests, a department dedicated to climate change can be framed as protecting the agenda of those who seek to mitigate the threats to the climate. It would elevate the issue beyond the broader mandate of the Environmental Protection Agency. Recently, Howard Frumkin and Richard Jackson, former directors of the Centers for Disease Control and Prevention’s National Center for Environmental Health, issued a call in Scientific American for the creation within the National Institutes of Health of a division named the National Institute of Climate Change and Health. Such a division could track the scientific issues, conduct research, and provide training for a cadre of scientists who can center attention on climate change research.
Second, there needs to be a clear and broadly understood regulatory agenda that cannot easily be undone by a Senate that engages in another four years of inaction. This must include practical infrastructure changes that can be incorporated into other legislation that has the broad support of the American public. There should be a means of identifying more than just the lack of harm in any piece of legislation passed by Congress. New bills should contain an impact statement that explicitly identifies specific benefits to further the climate agenda. A highway bill, for example, should include affirmative discussions of the ways in which electric cars will be promoted through the establishment of charging stations in rest areas or the ways in which highspeed rail lines can be used as alternatives to dependence on the internal combustion engine.
Third, a sustained effort is needed to identify bad actors and polluters, as well as the covert sources of support that undermine public confidence in government regulatory actions. This might be done through the Climate Agency identified above. But, in addition to “outing” bad actors, there should be specific and significant penalties imposed, holding corporations financially responsible and their managers and Boards personally responsible for their actions. Some of the most important actions that have changed corporate behavior were not because of legislation, but because of the penalties imposed through court decisions that impacted companies’ bottom lines. Successful efforts to mitigate or correct the damage done to individuals and communities by asbestos, lead, polychlorinated biphenyls, and tobacco, for example, were accomplished in spite of regulatory inaction through court cases in front of juries and judges rather than through Congressional actions or agency-imposed penalties.
The enormous power that the Koch brothers, big oil, and the chemical industry have over regulatory bodies and elected officials should give us pause if we think that being reasonable will open the eyes of ravenous interests. We need to make sure we don’t let pass the enormous possibilities that the Biden presidency provides.
[i] The author thanks Senator Whitehouse for his insights and suggestions in the drafting of this essay.
David Rosner is the Ronald H. Lauterstein Professor of Sociomedical Sciences and professor of history at Columbia University and codirector of the Center for the History of Public Health at Columbia’s Mailman School of Public Health. He is also an elected member of the National Academy of Medicine. In addition to numerous grants, he has been a Guggenheim Fellow, a recipient of a Robert Wood Johnson Investigator Award, a National Endowment for the Humanities Fellow, and a Josiah Macy Fellow. He and Gerald Markowitz are coauthors on ten books, including Deceit and Denial: The Deadly Politics of Industrial Pollution (University of California Press/Milbank, 2002; 2013) and Lead Wars: The Politics of Science and the Fate of America’s Children (University of California Press/Milbank, 2013). He also testifies for plaintiffs in lawsuits on industrial pollution and occupational disease.
Back to The Milbank Quarterly Opinion
Get the Latest from the Milbank Memorial Fund
An endowed operating foundation that engages in nonpartisan analysis, collaboration, and communication, with an emphasis on state health policy.