To US healthcare executives: 

Today, September 20, UN Secretary-General António Guterres is convening the Climate Ambition Summit, calling upon leaders across government, finance, business and civil society to establish agreements on “immediate and deep reductions in fossil-fuel emissions…to limit global warming to 1.5°C degrees above pre-industrial levels and prevent the worst impacts,” including “accelerating the decarbonization of high-emitting sectors.” (More here).

We urge you, stewards of some of the most influential healthcare systems, to answer this call to leadership for cross-sector climate ambition by establishing fossil fuel divestment policies at the institutions under your management, and to collaborate with executive leadership across the health sector to achieve this sector-wide.

The decarbonization programs now emerging at many of your facilities are important, and we applaud them.  But they only address “operational” emissions, while billions of dollars invested in fossil fuels across the sector via pension, retirement, endowment, and other institutional investing continue, unabated.  

These ongoing investments have far greater emission impact than almost any other single source in the health sector, including direct production investments in Exxon, BP, Shell, etc., the largest fossil-fuel producers on Earth.  They must no longer be ignored by health sector leadership. 

Our April 2023 report details the fossil fuel investments of four major health institutions – Kaiser, Mayo Clinic, Ascension and HCA, as case-studies.  Based on federal reporting, these four health systems alone have over $4 billion invested in fossil fuel holdings. Extrapolated nationally, our private health system’s institutions are estimated to have hundreds of billions of dollars invested in fossil fuels. 

The global harm caused by this level of funding is hard to overstate: it provides the capital used by oil, gas and coal corporations to develop massive fossil fuel infrastructure – thousand-mile pipelines, deep sea oil platforms, Arctic drilling –  which literally ensures global emissions will increase, worsening the global climate crisis with profound global health and equity implications.  A more blatant contradiction to global climate goals, established under the Paris Accords would be hard to imagine.  

These investments are made by asset managers under your direction. 

We appeal to your leadership to redress this. 

There is ample precedent. Health systems divested from tobacco in the ‘90s. And, today, 1600 institutions already have fossil fuel divestment policies in place. (The database here.)

Even on strictly economic terms, investing in fossil fuels is no longer responsible, as detailed in this IAEE report.  $Billions have been lost by major US pension managers on fossil fuel investments.  

Finally, climate-change related costs add tremendous economic burden to the healthcare grid. The US Senate recently concluded “Healthcare costs related to combustion of fossil fuels are estimated to total nearly $820 billion in the U.S. annually.”  The catastrophic weather extremes fueled by climate change include hundreds of thousands of ER visits, hospital evacuations, and $Billions in healthcare costs attributed to record-shattering extreme heat, wildfires and catastrophic floods now suffered on every corner of Earth with increasing frequency – and predicted to accelerate unless fossil fuel emissions are reduced dramatically, and immediately.  

The National Academy of Medicine’s Action Collaborative on Decarbonizing Healthcare already works with many of your institutions on facility emission reductions.  Organizations such as the Institute for Healthcare Innovation and Healthcare Without Harm are well placed to provide collaboration with health industry stakeholders in achieving the next level of the health sector’s response to climate change: a full accounting of the climate impact of your institutional investments in fossil fuels. 

In 2021, CommonSpirit (addressed in this letter) issued a pledge to “evaluate investment portfolios for their climate impact”.  This is a laudable display of leadership and compassion from CS executives, and we urge all of you to similarly begin accounting for the climate impacts of your investments, as we await the results of CommonSpirit’s evaluation.

Secretary-General Guterres calls for an end to fossil fuel financing and for “governments, civil society, business and others working in partnership” to achieve this. It’s time for health sector leadership to establish such partnerships now, including working closely with your asset managers, such as TIAA and Vanguard, to set fossil fuel divestment & exclusion policies.  

We further note: there are no longer legal restrictions on climate considerations in private pension investment choices.  ERISA regulations, updated by the Department of Labor last year, now allow for climate-related risk considerations. 

Health sector institutional investments must no longer be ignored as if immune from their real-world consequences; maintaining huge  investments in fossil fuels contradicts today’s urgent, global call for climate ambition and represents nothing short of a betrayal of the fundamental ethos of healthcare. The health sector can do better, and now is the time for your leadership.

We look forward to your response.  We also welcome the chance to meet with any of you individually, outside of social media discourse, to discuss in greater detail privately.   

Sincerely,

• Don Lieber, He/Him, Campaign Director, First Do No Harm
• Amy Gray, She/Her, Senior Finance Campaign Strategist, Stand.earth, Climate Safe Pensions Network

To: CEOs, CFOs, Executive Leadership, US Healthcare & Hospital Systems

• Greg Adams, President and CEO, Kaiser Permanente 
• Steven J. Corwin, CEO  NY Presbyterian Hospital
• Gianrico Farrugia, CEO and President, The Mayo Clinic
• Robert I. Grossman, CEO, Tisch Hospital / NYU Langone Health
• Joseph Impicciche, CEO, Ascension Health
• Shelly Schlenker, EVP, CommonSpirit 
• Tomislav Mihaljevic, CEO, The Cleveland Clinic
• Pete November, CEO, Ochsner Health
• Peter Pisters, CEO, MD Anderson Cancer Center
• Kevin W. Sowers, President, Johns Hopkins Health System

CC:  

• Victor J. Dzau, President, National Academy of Medicine
• Deborah J. Bowen, President, American College of Healthcare Executives
• Jonathan Perlin, President, The Joint Commission