I recently read an article in The New York Times — provocatively titled “Why we must ration healthcare” — that makes a reasonably cogent argument for health care reform, including some level of rationing, which is the hot button for both sides in the current discussions.

However tenuous, I believe that there are core concepts of health care in relation to our homes that are worth our consideration. One particular quote from the article provides some context for the connection between health reform and green buildings: “Dr. Art Kellermann, associate dean for public policy at Emory School of Medicine in Atlanta, recently wrote of a woman who came into his emergency room in critical condition because a blood vessel had burst in her brain. She was uninsured and had chosen to buy food for her children instead of spending money on her blood pressure medicine. In the emergency room, she received excellent high-tech medical care, but by the time she got there, it was too late to save her.”

So how does this relate to green building?

This woman became critically ill, requiring expensive critical care at the end of her life primarily because she did not have access to inexpensive preventive care early on. Similarly, many homeowners, and to a much greater extent renters, do no have access to healthy, efficient, and sustainable living spaces due to a combination of ignorance, lack of availability, and limited funding. In the short term, they waste energy and water and may have health problems related to their living conditions. Also, a general paucity of durable construction practices can lead to more frequent repair and replacement than is necessary. As a society, we are absorbing the future costs of these problems through the environmental impact of extra power generation, water scarcity, material extraction and disposal, and extra medical care for asthma and other illnesses related to poor indoor air quality.

Who pays for the free market?

We require emergency rooms to treat indigent people, which is often more expensive and less successful than preventive care in advance would have been. As a society, we are delaying and redistributing future costs by not requiring high-performance housing right now. As a capitalist society, there is a strong argument for everything to be voluntary and market-driven. One downside of adhering strictly to this point of view is that we are creating long-term resource and health problems in maintaining the status quo that will ultimately cost more money and lives down the road — costs that everyone will bear.