The Climate Impact Hiding in Plain Sight
Susan Parks, a retired librarian living in rural Montana, grew accustomed to driving nearly 80 miles whenever she needed to see her cardiologist. Pandemic-era changes nudged her care online. By 2023, those virtual check-ins became a routine facet of her life—and, as new research reveals, part of a sweeping shift with national environmental repercussions.
Telemedicine isn’t just a story of digital convenience or healthcare access. According to a UCLA-led study published in the American Journal of Managed Care, telemedicine in 2023 translated to monthly carbon dioxide reductions equivalent to eliminating up to 130,000 gas-powered cars from American roads. Researchers, leveraging de-identified data from nearly 1.5 million virtual visits, estimate that as many as 1.35 million of these replaced in-person appointments each month. The result: a monthly drop of up to 47.6 million kilograms of CO₂. For context, that’s like recycling up to four million trash bags—every single month.
Health care is responsible for around 9% of U.S. greenhouse gas emissions, a surprisingly outsized figure for a sector built on healing. A closer look reveals administrators and policymakers have often overlooked the environmental cost of routines such as appointments, diagnostics, and travel. This oversight is now impossible to ignore, as mounting evidence points to how modest changes in care delivery—like substituting a virtual visit for a car trip—can drive remarkable gains for public health and the planet.
Why Telemedicine’s Carbon Dividend Matters
Until recently, most climate policy discussions have skirted around the healthcare sector. That’s despite its massive climate footprint—from carbon-intensive hospital systems to the emissions racked up by millions of patient commutes. The UCLA study, under the guidance of Dr. John N. Mafi, quantified emissions savings using the Milliman MedInsight Emerging Experience database, factoring in contemporary realities like the growing share of electric vehicles—making their findings far more accurate and actionable than earlier, back-of-the-envelope calculations.
So why does this substitution effect really matter? The environmental savings come only when telemedicine swaps out, rather than adds to, in-person care. Simply tacking virtual visits on top of existing medical routines accomplishes little. The study highlighted that between 741,000 and 1.35 million telehealth visits each month functioned as true substitutes. There’s a lesson here for federal and state policymakers: the choices you make in terms of reimbursement, regulation, and infrastructure directly shape the carbon trajectory of the nation’s largest economic sector.
Is this carbon dividend merely a statistical fluke, or a replicable phenomenon? The numbers speak loudly. To frame the issue, Harvard public health expert Dr. Ashish Jha notes that if every U.S. health system adopted UCLA’s measured level of virtual substitution, “we’d see one of the most significant carbon declines ever attributed to a single, low-cost health care policy shift.”
“With Congress still deliberating the future of telehealth flexibilities, our findings offer crucial evidence that telemedicine can play a modest but meaningful role in lowering U.S. health care’s carbon footprint.” — Dr. John N. Mafi, lead author, UCLA
Beyond that, telemedicine’s green impact does not just benefit urbanites reluctant to face city traffic. The study underscored an especially strong effect in rural America, where doctor visits typically mean greater distances, more emissions, and—often—harsher barriers to care. Every saved trip is good for the atmosphere and, perhaps more pressingly, for the vulnerable populations at health care’s geographic margins.
The Policy Crossroads: Will Congress Embrace a Healthier, Greener Standard?
Renewed focus on the climate-health nexus lands just as Congress debates whether to make pandemic-era telehealth flexibilities permanent. Short-term extensions have given patients like Susan Parks a reprieve, but the future is uncertain—and so are the environmental gains. The threat is not technological, but political. The same lawmakers who tout an “all of the above” approach to climate now hesitate to enshrine a proven, bipartisan tool into law. What does this hesitation cost us?
International comparisons are instructive. The United Kingdom, Canada, and several EU nations moved quickly post-2020 to bake telemedicine into their standard of care, with targeted incentives designed both for access and for green dividends. In contrast, the U.S.—hamstrung by legal caution and industry lobbying—remains locked in limbo. According to Kaiser Family Foundation analysts, failure to institutionalize telemedicine on environmental grounds risks “throwing away the lowest-hanging fruit in the decarbonization of American health care.”
Telemedicine, of course, is not a cure-all. As pointed out by Dr. Mafi’s research team, the carbon benefits evaporate if virtual care leads doctors to order excessive, low-value diagnostic testing—something their data suggests has so far not occurred. The delicate policy challenge is ensuring that digital medicine remains a true replacement, not an add-on, and that payment structures do not incentivize unnecessary care. Any sound national telehealth strategy must therefore pair environmental incentives with quality safeguards.
Environmental justice advocates have also flagged that access to telemedicine is not equal. Households without broadband—disproportionately poor, elderly, or in communities of color—remain on the outside looking in. For the green dividend to reach everyone, infrastructure investment and targeted digital literacy programs need to be more than afterthoughts. Only with full digital inclusion will this innovation live up to its climate and equity promise.
Seizing the Opportunity: A Prescription for Policy and Progress
History shows that seemingly small policy choices can trigger massive ripple effects. Consider how Clean Air Act amendments in the 1990s accelerated emission reductions across sectors, sometimes in ways “nobody projected at the outset,” according to climate historian Dr. Leah Stokes. Telemedicine’s carbon dividend, though “modest” in the grand scale of U.S. emissions, is poised for similar outsized long-term impact—if we refuse to let inertia stand in the way.
As the nation charts its post-pandemic future, policy decisions around telemedicine offer a two-for-one opportunity: improved access for patients and a lighter load for the environment. For readers who demand pragmatic climate solutions that respect human dignity while advancing justice, the evidence is in. Telemedicine is not a silver bullet, but it’s an essential tool—one Congress, state lawmakers, and health system leaders would be wise to wield aggressively. The next chapter will tell whether American health care, so often a laggard in both cost and climate, can finally deliver healing without harm.
