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Sustainability, the Complete Concept

Environment and Healthcare

by Hunter Lewis

Most of us would agree that the principal difference between children and real adults is that the latter look ahead, consider consequences, act responsibly and sustainably.
Sustainability is not, however, just the essence of maturity. It is also the essence of morality.

In his book, Moral Foundations, the ornithologist, naturalist, and philosopher Alexander Skutch observed that:

People . . . might tell us that . . . morality . . . is not lying, not stealing, not killing, not coveting, not cheating, [not] . . . injuring one’s neighbor. If asked what common feature unites all these interdicted activities, they would find it difficult to answer. They might say that all these forbidden activities cause people pain… This is true enough, but . . . competition in trade or the professions brings much loss and sorrow to those who fail in it; . . . the punishment of children makes them unhappy; and the practice of medicine and dentistry are abundant sources of pain even to those who ultimately benefit… The common feature which unites the activities most consistently forbidden by the moral codes of civilized peoples is that by their very nature they cannot be both habitual and enduring, because they tend to destroy the conditions which make them possible.

Sustainability is therefore the essence of both maturity and morality. It is also the foundation for human happiness. As the ancient Greek philosopher Epicurus wrote:

The . . . chief good is care in avoiding undesired consequences. Such prudence is more pre cious than philosophy itself, for all the other virtues spring from it. It teaches that it is impossible to live pleasurably without also living prudently, honestly, and justly; [nor is it possible to lead a life of prudence, honor, and justice] and not live pleasantly. For the virtues are closely associated with the pleasant life, and the pleasant life cannot be sepa rated from them.

Environmental Sustainability

In today’s world, the ethic of sustainability is usually voiced by environmentalists. They constantly remind us, in the words of the 1987 Brundtland Commission, that we cannot meet our own needs by making it impossible for future generations to meet theirs. To live prudently, honorably, justly, and happily, we must:

  • Consume more intelligently, taking special care with our use of non-renewable resources;
  • Protect the earth from man-made poisons, toxins, and waste;
  • Conserve our air, fresh water, oceans, forests, wetlands, farmland, wildlands, wildlife, and all the other natural systems that sustain us and give us so much pleasure and beauty;
  • Develop green technologies, business practices, and personal habits that will help us to become genuine guardians and stewards of nature.

Environmentalism is often dismissed as impractical or even utopian. But the opposite is true. Once the Chinese and other people living in emerging economies reach the same income level as Americans, can we imagine that they would all be able to consume as much or throw away as much as Americans today? At that point, as Lester Brown has pointed out, it would take all the paper the world produces today just to meet Chinese demand. Would there be any trees left?

To return to Alexander Skutch’s point, an anti-environmental stance “cannot be both habitual and enduring, because [it will] tend to destroy the conditions which make [it] possible.” To reject an ethic of sustainability is not consistent with maturity, morality, logic, or happiness.

Environmentalism is pointing us in the right direction. Yet, oddly, even environmentalists do not always apply the ethic of sustainability to other aspects of their lives, both individual and social. Consider, for example, healthcare.

Sustainable Healthcare

The term “sustainable healthcare” was first used by Dr. Robert Verkerk, a PhD food scientist who founded the Alliance for Natural Health ( in 2002. Dr. Verkerk defined it as:

A complex system of interacting approaches to the restoration, management and optimization of human health that have an ecological base, that are environmentally, economically, and socially viable indefinitely, that work harmoniously both with the human body and the non-human environment. . .

It will be immediately apparent that much of healthcare today is not sustainable. In the first place, and most obviously, it is not financially sustainable. In the United States especially, health costs that in 1970 consumed 7% of gross domestic product now consume 18%, and, on their present trajectory, could easily reach 25% or more as the aging postwar baby boomers enter old age.

Why are medical care costs soaring? In purely financial terms, it is quite simple. Since government began subsidizing medical care in the 1960s, demand has steadily increased. Guaranteed universal health coverage would of course increase demand further. Supply, on the other hand, has not in creased, partly because of government rules and regulations. Even the most elementary economics tells us that steadily rising demand along with restricted supply will lead to higher and higher costs.

How then does government restrict the supply of healthcare? Some of the ways are quite obvious. Only doctors are allowed to do work which nurses and other healthcare professionals could do just as well. Starting new medical schools on US soil is made almost impossible. Doctors who step outside the approved mainstream of synthetic drugs and surgery too often lose their licenses. Only synthetic, patentable, and therefore hugely expensive drugs are approved and paid for by Medicare, Medicaid, and the Veteran’s Administration. Natural (and inexpensive) nutraceuticals that might serve as well (or better) than drugs are very rarely approved or paid for.

The almost complete reliance on synthetic and expensive drugs is the great “catch 22” of American medicine. It costs so much to gain FDA approval that only synthetic drugs new to planet earth and the human body, and therefore patentable, are submitted to the FDA. But, precisely because they lack FDA approval, effective and inexpensive natural medicines are barred from the system.

For example, when cherry growers tried to cite research from Harvard and elsewhere about the health benefits of cherries, they were immediately enjoined by the FDA. The agency took the position that even an accurate recital of valid science was “false advertising” if it involved health “claims,” and that the only way for cherry growers to make health “claims” would be to take cherries through the drug approval process. If cherries made it through this process, they would thenceforth be regulated by the FDA not as foods, but as a drug.

Partly because, unlike cherries, drugs are non-natural, they are often very toxic. Adverse drug reactions are the fourth ranking cause of death in the US according to the FDA itself []. (Medical errors in general are either the third or first ranking cause of death, according to different studies. Gary Null, et al, argue for the first ranking in a groundbreaking book, Death by Medicine, to be published by Praktikos Books in January 2010.)

Both the drug industry and exponents of a more economical, natural, and sustainable healthcare agree on the importance of preventive medicine. But for the drug industry (and it seems most of the current medical establishment), preventive medicine means using high tech and often invasive tests to diagnose conditions (conditions, not illnesses) that must be treated with more and more drugs at an earlier and earlier age.

One of the greatest ironies of healthcare is that many environmentalists pursue healthy lifestyles, eat carefully, exercise, use dietary supplements, shop at health food stores—yet also support the US Food and Drug Administration, an agency that is aligned with drug companies and appears determined to suppress more natural and sustainable forms of healthcare. This is probably because environmentalists are accustomed to thinking of government regulation as a “good thing” and government regulators such as the Environmental Protection Agency as necessary watchdogs of industry. What these particular environmentalists fail to see is that the FDA is no EPA, that it has been captured by a particular industry, and that it is a foe rather than a supporter of the broader ethic to protect nature and live as naturally and sustainably as we can.

Whether one looks at our ailing planet or our ever less affordable healthcare, we see the same underlying problem: a rejection of maturity in favor of a childish refusal to look ahead. What we need instead is a more complete and all-encompassing concept of sustainability. Once we have that, all of us, but especially we environmentalists, need to embrace this broader concept as our guiding principle.

About the Author

Hunter Lewis is the author of numerous magazine, newspaper, and online articles as well as six books in the related fields of economics and values, including his most recent publication, Where Keynes Went Wrong: And Why World Governments Keep Creating Inflation, Bubbles, and Busts. His much-praised book Are the Rich Necessary? was called “highly provocative and highly pleasurable” by the New York Times, “great reading” by Publishers Weekly, and “worth reading aloud on a family vacation” by Barrons.

A graduate of Harvard University, Lewis co-founded Cambridge Associates, LLC, a global investment firm whose clients include leading research universities, charitable organizations, and families. He has served on boards and committees of fifteen not-for-profit organizations, including environmental, teaching, research, and cultural organizations, as well as the World Bank.