REPORT: Major health institutions $4.6 billion fossil fuel holdings contradict Hippocratic oath

Groundbreaking report – The Biggest Malpractice – exposes 4 U.S. hospital networks’ fossil fuel holdings, which contradict climate pledges and betray public health impacts of the climate crisis


Indigenous lands of the Munsee Lenape Peoples (colonially called New York, NY) – Today, the First, Do No Harm campaign and the Climate Safe Pensions Network released a first-of-its-kind report revealing disturbing levels of fossil fuel investments at major US healthcare institutions. The report – “The Biggest Malpractice: How Hospitals Betray the Public Trust with Billions in Fossil Fuel Pension Investments”– finds pension funds of four major hospital networks including the Mayo Clinic, Kaiser Permanente, Ascension Health System, and the nation’s largest health system HCA Healthcare have over $4.6 billion invested in fossil fuels.

“The health sector divested from tobacco in the 90s, now it’s time we do it with fossil fuels,” said Don Lieber, a surgical technologist and organizer of First, Do No Harm. “Fossil fuel investments directly contradict the Hippocratic Oath – First, Do No Harm – at the heart of the healthcare profession. It’s not that complicated: we’ve mapped the human genome; we conduct micro-surgery; we certainly can – and must – divest from fossil fuels. ”

The report focuses on fossil fuel investments in direct contradiction to the health sector leadership’s calls for decarbonizing the health sector, including a well-publicized “Call to Action” by the President of the National Academy of Medicine; to, widespread ‘sustainability’ commitments made across the sector’s 1,200 private hospital systems; and, to the voluminous body of research confirming a range of serious threats to public health from fossil fuel pollution and climate change. 

The full report is available here.

Key findings include:

  • Mayo Clinic – $1,453,738,165 in fossil fuel holdings and investments
  • Kaiser Permanente – $2,527,025,402 in fossil fuel holdings and investments
  • HCA Healthcare (The nation’s largest health system) – $351,434,652 in fossil fuel holdings and investments
  • Ascension Health System – $258,753,175 in fossil fuel holdings and investments

These investments are directly tied to some of the worst climate-polluting projects in the world, such as tar sands extraction in Canada, and Arctic drilling, with profound impacts for climate change and global human health.

These four hospitals alone have at least $774 million of pension funds invested in fossil fuel producers, companies like ConocoPhillips and ExxonMobil dedicated to extracting and selling oil, coal, and gas. When analysis is expanded to include holdings across the entire fossil fuel economy—including fossil fuel service companies, fuel transport companies, pipeline operators, fossil-fuel powered utilities, and additional investments in these companies embedded within index investment funds— these four hospitals alone have invested at least $4.6 billion in fossil fuels.

Nationwide, it is likely that private US hospitals have well over $10 billion invested in the fossil fuel economy. 

Taken as ‘case studies’, the report features four institutions accounting for a massive amount of fossil fuel investments. The report has over 60 endorsements, including from, Physicians for Social Responsibility, Giniw Collective, and many more.

There are 1,228 private (for profit) hospitals in the U.S., according to the American Hospital Association. A review of publicly available records indicates a wide range of fossil fuel investment levels among these institutions – from Kaiser Permanente’s estimated $2.8 billion, to Sloan-Kettering’s $1 billion (mostly indirect fossil fuel exposure through climate funders such as JP Morgan).  

As part of the Climate Safe Pensions Network, the First, Do No Harm campaign launched in March 2022 through a publication in the New England Journal of Medicine. The campaign targets the healthcare sector, and calls on key high-profile private, large scale institutions such as the HCA Health, Mayo Clinic, Kaiser Permanente, Sloan Kettering, and NYU Langone to divest massive employee pension and retirement funds from fossil fuels. 

Amy Gray, Senior Climate Finance Strategist with and coordinator of the Climate Safe Pensions Network, added: “It’s absurd, and hypocritical to the ethos of healthcare, that large corporate-run institutions continue to make these harmful investment choices. Climate change represents a massive health crisis. Healthcare pensions can and must divest from fossil fuels to protect our health and our frontline communities disproportionately harmed by the fossil fuel industry.”

To date, more than 1550 institutions representing more than $40 trillion in assets have already committed to fossil fuel divestment. The health sector is loudly absent from the growing list of fossil fuel divestment commitments.

Hospitals divested from tobacco in the ‘90s, and the First, Do No Harm campaign calls for the sector to divest from fossil fuels now.