How the oil shortage will affect hospitals and healthcare

I believe in the peak oil theory.

Think about it, in a closed system nothing is infinite. Since oil is a product of millions of years of decay, unless we use it at the same rate that is it produced, we will run out. I do not have a crystal ball any more than anyone else I know, so I will not hang my hat on when, but will commit to whether: yes, it will happen. And while a lot of people have conjectured about what the world will look like post-peak oil, there is a surprising paucity of hypotheses or suggestions about healthcare. So, I will try to use my imagination to start to fill this gap.

First, a few facts.

Fact 1: The world, including the healthcare system, runs on cheap oil. The world’s daily use is 80 million barrels, 20 million barrels of which is used in the US, and 70% of those 20 million goes to the transportation sector.

Fact 2: The healthcare sector is a super-user of energy. The US Department of Energy estimates that, “hospitals use 836 trillion BTUs of energy annually and have more than 2.5 times the energy intensity and carbon dioxide emissions of commercial office buildings, producing more than 30 pounds of CO2 emissions per square foot.”

As we know, hospitals are incredibly technology-heavy institutions. In addition, literally tons of medicines and plastic disposables made from petroleum are the cornerstone of our healthcare model.

Fact 3: There is no imminent technological solution for the impending oil shortage.

Now, why should you take my predictions of such doom and gloom seriously? Well, for one I am not prophesying doom and gloom. Rather, since forewarned is forearmed, I am reiterating a warning still with time enough for us to start preparing for a different way of life. You don’t believe me that it is coming? Do you believe the US military? Their recent report clearly points to a drop in production and impending shortages of oil. They ought to know, being the biggest global consumer of this resource.

But back to medicine. What will it look like post-peak oil? I am happy to say that you still do not have to trust me, but perhaps Howard Frumkin’s of the CDC thoughts on this topic in JAMA can make you scratch your heads a bit:

Petroleum scarcity will affect the health system in at least 4 ways: through effects on medical supplies and equipment, transportation, energy generation, and food production.

It is worth reading the entire editorial to get the flavor for what is likely to come. At the same time, one can easily engage one’s not too wild imagination to start visualizing the situation. Taking it item by item, medical supplies and equipment are not only manufactured from or with petroleum, but they need oil to get to our hospitals and to run. Transportation needs very little explanation, given our reliance on emergency transportation by such modalities as ambulances and helicopters, as well as the need for regional and national referral centers based on expertise and availability of services.

Frumkin does a nice job talking about energy generation, and the concern here is an increased reliance on coal with its propensity for green house gas emissions, and so on, and so on. Finally, our industrial food production, having moved away from local integrated traditional farming to monocultures supported by automation which runs on oil, relies on additional oil for pesticides and fertilizers and transportation from the farm to the table.

So, what will medicine be like under these circumstances? The reality is that, if we as communities fail to prepare for this change gradually, we will be hit with it abruptly, and you have to admit that sudden and unplanned changes are tougher to deal with than anticipated ones.

I myself do not have all the answers, but I would like to challenge everyone, clinicians, administrators, patients and public alike, to begin this conversation. It would behoove us all to keep this idea in the backs of our minds as we move through our days, so that we can mindfully note what changes have to be made and what infrastructures need to be built to optimize our collective future.

Marya Zilberberg is founder and CEO of EviMed Research Group and blogs at Healthcare, etc.

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  • imdoc

    As with many problems, economics rules the day. Better to transition to a system with less petroleum dependency than face a crisis. Perhaps healthcare needs to be less dependent on large brick-and-mortar institutions stuffed full of technology, and more community based and minimalist. There are some lessons to be learned from places in the world in which such facilities do not exist. At present, the financial incentive preserves expansion of expensive energy intensive technology. As the article mentions, ag “monoculture” result in large corporate farms dedicated to large scale production. This is predicated on cheap fuel to grow and transport a tomato 2000 miles inland from California to a grocery store in the midwest during the summer. Mass grain production with government price supports and cheap processing and transportation makes high carbohydrate, high fat food inordinately inexpensive, contributing to obesity. In my opinion, increasing cost by taxation of carbon-based fuels is the best market signal to get alternative energy advanced.

  • http://hematopoiesis.info/ Alexey

    First of all each american have to start from themselves and change the way of consumption. Sell your cars, get a bike, move close to community and working place, stop buying stuff in plastic bottles, run your house/apt on power that you make yourself by sun or wind ect.
    Reduction of hospitals consumptions will come after that. it’s more centralized then your own. After you change yourself, you can show case for others and then hospitals will change.

    You have to start from yourself, change your mentality first. Everyone should be prepared for survival in oil-depleted world. When I go outside and look around I wonder why americans still not realize that?

    There is only one way for this country to survive the crash – reduce your consumption rate 100 times!

  • Tom

    Have to say that your reasoning is flawed in at least two ways. First, it appears that you believe that oil prices have risen due to decreased supply. Rather, oil production is higher than it has ever been, and rising prices are a reflection of increased demand from new consumers, notably China. Second, you seem to see energy as tied exclusively to oil, which puzzles me. To wit, your assertion:

    “Fact 3: There is no imminent technological solution for the impending oil shortage.”

    You may not be aware that, due to new extraction techniques, The US has recently become the biggest producer of natural gas. Certainly it serves as an admirable substitute for oil in energy generation, which in health care is usually in the form of electrical power. Thus, one technological solution for the “impending oil shortage”. Second, atomic energy is also a viable and cheap form of power generation that could also provide power, another technological solution.

    If we were serious about addressing oil shortages or oil prices, we would allow drilling in readily accessible areas, rather than pushing oil rigs to deeper and deeper water. The fact that we have not suggests that the oil shortages you warn of are simply not being taken seriously by those in charge of our national resources.

    Finally, “Peak Oil” has been predicted since the 50s, with no evidence of it occurring yet. You would do better to make your argument without reference to a theory that has a long history of failure tied to it. The US military report you cite is at best controversial, and much disputed.

    • ron

      To Tom,
      Oil peaked in the U.S in the early 70′s ,there’s your evidence that Peak Oil can and will occur globally one day! Better to be prepared! My advise to you, do some research.

      • Tom

        I find this assertion hilariously uniformed. Here is a link for you, so you can check the numbers for oil production from 1960 to 2008.
        http://www.eia.doe.gov/aer/txt/ptb1105.html

        Please do your own research, especially on such an easily proven assertion. Failure to do so reflects poorly on you. Your claim was absolutely representative of the “peak oil” crowd, however… In the 1970s. Times have moved on, and oil production has NOT yet peaked.

  • Vox Rusticus

    I have to agree. Healthcare is in the vulnerable position of being extremely resource dependent, both through the facility energy requirements (having to be constantly “on”), manpower-dependent, which requires significant energy and particularly petroleum inputs, and materials -dependent, through nearly every product used in medical care.

    We have seen brief periods where crude oil prices exceeded $150/barrel, gasoline priced jumped above $4.00 per gallon and the economic and behavioral changes were noticeable. Imagine a sustained period where prices were $6.00 or $8.00 per gallon, with no expectation of returning to any previous level. This country has already experienced one period where retail gasoline prices tripled, the oil embargo of 1973. That was an artificial and political shortage that resulted in nationwide shortages, gas lines and a market shift and ultimate collapse in the domestic automotive industry, the effects of which played out for over three decades, even after prices stabilized.

    We have many assumptions about healthcare, particularly ones about access and quality. It seems an affront to many when access that is expected is denied or quality is less than we have come to expect. The unsaid notion is that care should be available and cost should be secondary. But these expectations, like many in our society, are resting on a foundation that assumes certain facts about resources, and that those resources are available if not to individuals then to the governments and organizations charged with the public welfare. There are, of course, places where these assumptions do not apply, but we regard such places as under-developed or worse, degraded.

    Our wealth as a nation has been borne of many things, but one fact is that we enjoyed a long period or relative prosperity and a powerful currency and economy without the burden of having to repair war damage following WW2. That prosperity allowed us to build a society that enjoyed expansion with low-cost and high-quality fuels, and the form of that society was built with availability of cheap fuel as an assumption, in fact, as a requirement. Our cities developed not to accommodate oxcarts or even trams or railways, but to use inexpensively fueled personally-owned automobiles, and to provide people with individually-owned houses that were serviced by inexpensive electricity, natural gas and oil.

    Where in that model does oil at $150 or $200 per barrel have a place? Nowhere, I’m afraid.

    Healthcare, as we know it, cannot continue to deliver to our expectations without cheap fuel.

  • eRobin

    Would hemp be a plausible alternative? I’ve heard that anything made from oil can be made from hemp.

    • Vox Rusticus

      No. Sorry to disappoint you. Hemp would not be a plausible alternative.

  • Doc99

    “I believe in peak oil.”

    So if that premise is false, then everything that follows I might view as false as well.

  • http://Drackies@blogspot.com Frank Drackman

    Oil’s not gonna run out, any more than the oceans or the atmosphere. We’ll probably stop using it so much in a few hundred years, or whenever they figure out how to make fusion work. Oil was formed billions of years, or maybe 5,000 years ago, who cares? Hundreds, maybe thousands of miles below the Earth’s surface, and makes it’s way upward through cracks in the mantel, thats why the Saudi Oil Field Reserves keep going up despite the billions of barrels they pump out every year.

    Frank, “I’m not a Petroleum Engineer, but neither are you” Drackman

  • Leena Neyaz

    Couple of questions should be answered or at least be taken in consideration before the deadline- and when I’m saying deadline I mean: “before we face this problem as a real dilemma.” Are we really facing an oil shortage? If yes, is such an issue going to affect the humanity, including healthcare sector? Is there a solution? If yes, What is the best replacement for such an energy supplement?
    According to a whistleblower at the International Energy Agency, The world is much closer to running out of oil than official estimates admit. This is only one source from numerous sources estimate this oil shortage, such as the association for the study of peak oil & gas (ASPO). So, I do believe too in peak oil theory.
    And yes, this is a big deal because petrochemicals are key components to much more than just the fuel for my car. All food productions, transportations and healthcare industries are powered by petroleum. Can you imagine that there is a mix between medicine and oil? From small health industry- such as: pharmaceuticals, catheters and syringes- into big health technology- such as heavy equipments and machines- are running by petroleum and oil. It is true that “Oil watchers say that medicine in the U.S. is unsustainable in its current state” regarding oil shortage, but that does not mean that we have to just watch without taking an action, but better to start think and plan for the future.