The Fund supports networks of state health policy decision makers 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 to advance state health leadership, strong primary care, healthy aging, and sustainable 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 foundation that works to improve population health and health equity.
August 25, 2022
Back to The Milbank Quarterly Opinion
We have become so acclimated to bad news that when the Senate recently passed the Inflation Reduction Act (IRA) with its huge health and climate provisions many were skeptical. Could the reports of its progressive provisions be accurate? As we slowly emerged from the catatonia induced by years of Congressional inaction, we began to believe in its immense value. While not as ambitious as the ill-fated Build Back Better bill, the IRA makes enormous commitments aimed at promoting wind and solar energy production, the building of electric cars, incentives for households to move to energy efficiency, limitations on the use of coal, and incentives aimed at limiting greenhouse gases by up to 40% by 2030. In light of the cynicism in the public health community regarding the ability of Congressional Democrats to overcome resistance to any climate legislation, many are still wary of possible trap doors in this bill, which might portend a rocky future, particularly if Republicans regain control of either or both houses of Congress this coming fall. 1
Some of the provisions in the bill indicate the dangerous path we will need to navigate in the coming months and years. First, there are some significant concessions to the oil and gas lobby that suggest political resistance to it is far from over. Second, even if the IRA’s projections of 40% reduction in CO2 emissions by 2030 do come to pass, it will only get us part of the way to the goal of 50% we are committed to in the Paris Climate Accord.
We may take a deep breath right now, but we are far from exhaling too soon if we have to avoid the proverbial global warming “tipping point” when no effort to forestall the human costs of melting icebergs, rising seas, empty reservoirs, massive month-long floods, and continual droughts will be sufficient. The bill contains payoffs to the oil and gas industries that includes the right for oil and gas exploration in the Gulf of Mexico, Alaska, and other public lands. Also, it includes language allowing coal- and gas-powered power plants to continue to operate, albeit with certain constraints. Obviously, the fossil fuel industries — coal, gas, and oil — are not about to go out of business or abandon plans to increase their profits. Hence, we can expect renewal of old lobbying campaigns, political contributions to members of Congress, and reinvigorated misinformation campaigns aimed at undermining restrictions on new oil and gas pipelines, fracking, and port and refining facilities. The recent rise in gas prices has already energized calls for “energy independence” and increased drilling, despite the fact that global oil prices are independent of the amount of oil the country itself produces.
There are clear indications of the breadth of resistance to the Act itself as well as an emerging plan to undermine it. Fox News quickly began the counterattack, by deflecting attention from the content of the Act to its title, emphasizing that the Act “does not actually reduce inflation,” and characterizing it as merely a “marketing ploy” by the “radical left” to impose its liberal “anti-growth agenda.” The other major news outlets, while acknowledging its significance, quickly relegated it to the second or third news segment behind the FBI raid on Mar-a-Lago and the war in Ukraine. One week after President Biden signed the IRA into law, it was still unclear whether most Americans understood how it might alter their lives.
In a 2020 speech before the American Meteorological Society, Senator Sheldon Whitehouse (D-RI) issued a stark warning that today carries enormous weight as we contemplate a sustained effort to undermine the IRA or, at least, to forestall any future progress. Speaking before a meeting on scientific misinformation, he detailed how phony science propagated by a “science denying apparatus” of lobbying groups, institutes, and university researchers underwritten by the petrochemical industry, the Koch Brothers, and others had already mobilized to counter the enormous scientific consensus around global warming. Despite the growing evidence presented by heat waves across the globe, starvation caused by droughts, forest fires that ravage the American West and Europe, floods that destroy towns, sea levels that are engulfing coastal countries, record low reservoirs and a near-empty Lake Mead, and hurricanes and tornadoes swooping through communities, there are still those who argue that climate change is not real. Still others who accept its reality argue that it is a natural phenomenon over which we have little control, or that it can be controlled by the “free market,” or that we only need more time to develop adequate technological fixes. Whitehouse outlined the methodology the fossil fuel industry developed: Supporting fake science and its promotion by right-wing think tanks, donating to politicians, and selectively using scientists’ studies to give succor to news outlets to broadcast misinformation, thereby paralyzing meaningful policy action to limit carbon emissions. 2
Often, the very complexity of climate science is used to obscure the need for immediate action to curtail the burning of fossil fuels. The Cato Institute, once a haven for climate change deniers, declared in 2015 that the “decades-long climate kerfuffle is …over” and that “The U.N. should cancel its Paris meeting.”3 That position has slowly evolved to more nuanced efforts to acknowledge the overwhelming scientific evidence confirming global warming. They’ve now gone so far as to affirm that “human activity has been a contributor since 1975.” But, the Institute argues to go slow, that climate science is “a very complicated and difficult issue that can provoke very unwise policy in response to political pressure.” It argues that “there is no operational or tested suite of technologies that can accomplish the goals” of reducing CO2 emissions and that it best be left to the “free market” to solve the problem for “there is ample time to develop such technologies, which will require substantial capital investments by individuals.”4
Other groups have echoed this evolving limp-along strategy. According to Greenpeace, the Koch Family Foundation has contributed $145,555,197 to 90 groups promoting fake science and opposing legislation during the past three decades since the Kyoto Protocol, the 1997 agreement of industrialized nations to limit greenhouse gas emissions, was adopted.5 One of these “denial groups” presented before Congress last Fall, calling the effects of climate change “mild and manageable.”6 Until this past month this slow down and wait approach provided the intellectual rationale for Republican members of Congress to resist every effort to pass legislation to rein in the use of coal in power plants, the burning of fossil fuels, and the building of pipelines to ease the oil “shortage.” Those who were once climate change skeptics had assumed the mantle of “responsible policy wonks” – yes, climate change is real but we need more (and more and more) science and time to come up with technological and market-driven solutions to the problem. Let’s keep studying the problem, await some innovative technological fix, and amble on into the future. Their current position is: There’s so much doubt about the future that there is no reason to rush into action.7
While we can take heart from the extraordinary effort by the Democrats to pass this landmark piece of legislation in a divided Congress, we must not lose sight of the fact that the concessions to the fossil fuel industry as well as the institutional infrastructure of giant, well-funded organizations dedicated to slowing down and ending future efforts to build on this monumental success, will threaten its sustainability. The “web of denial” that Senator Whitehouse has often cited in Senate speeches is perhaps temporarily shaken, but it is already planning next moves. Perhaps the most haunting summary of the “plans” for the future of the fossil fuel industry is contained in a brief answer one natural gas industry mogul gave to a reporter. Inquiring about what we could expect if, in 40 years, fossil fuels were effectively replaced by wind, solar, and other renewables, the reporter asked: Wasn’t he worried that the huge natural gas “facilities he built would effectively be useless?” His answer: “I’ll be dead …. So it won’t matter.” 8
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.
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.