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Why we need a healthcare Hirsch report

Most peak oil studies to date have focussed on trying to predict when peaking might occur. There is one notable exception, however. In 2004 the US Department of Energy’s National Energy Technology Laboratory released their landmark Peaking of World Oil Production: Impacts, Mitigation and Risk Management.

Background (Apologies to those of you who already know this)

Unlike the others, this study (informally called The Hirsch Report after the lead author – who incidentally appeared on the recent ABC-TV Four Corners episode on peak oil) made no attempt to predict when a peak might occur.

After identifying that peak oil would cause a liquid fuels crisis, it looked at how long it would take to replace oil as a transport fuel. The authors calculated that it would take 20 years of “crash” programs to produce enough facilities to significantly replace oil with artificial fuels. In contrast, if the US waited until peaking was obvious, there would be 20 years of significant economic hardship (similar to, or worse than, the Great Depression).

Medical Hirsch Report

I contend that a study with a similar purpose would be a useful tool for each country’s health care system. It would provide useful information for planning and implementing mitigation programs, allowing us to manage the significant expected impacts of oil scarcity and energy descent.

Hirsch Report Methodology

The authors purposely kept the analysis simple. They did this so that their results would be transparent. They acknowledged that no study could infallibly predict the impacts, and used a semi-qualitative approach, rather than a rigidly quantitative one. In simple terms the approach was:

  1. Describe the current situation and identify the scope of the problem.
  2. Consider any examples or analogous situations that might shed light on the analysis (they used the peaking of US domestic natural gas supply).
  3. Only consider commercial or near-commercial processes (to maintain realism).
  4. Calculate the timeframes and capacities of the necessary number of fuel-production plants.
  5. Repeat the process for each technology (eg coal-to-liquids; vehicle energy efficiency).

Applying Hirsch to health care

In order to think about how this process might be applied to the health care system, I chose the hypothetical example of plastic syringes (with a proposal to replace them with glass ones):

  1. How many single-use plastic syringes are used each year? What sizes? Where are they used (eg hospital versus community)? What are they used for? Who makes them? Which countries do they come from?
  1. What happened in Cuba when their oil supplies were cut off? How about Zimbabwe (a country that has been called the “first casualty” of peak oil)? How do NGO aid-agencies like MSF currently handle this issue in third-world countries? The idea is to try to distil some generalized lessons. For example: What alternatives are there? If glass syringes will be used, how can they be made, packaged and shipped safely? How might they be cleaned, sterilized and reused? What are the infection control issues? And so on.
  1. What viable processes currently exist to manufacture precision glass instruments in our country? Who might do it (eg consider scientific instrument makers but also manufacturers of glass bottles and jars)? What is their current capacity? Do they have the technology or would it need to be bought from overseas and adapted here?
  1. Educated guesses about how long it would take to build and tool up enough factories to make them (in the format of “Complete X factories per year, each producing Y syringes per year, Z years lead time until the first one is operational then 1 per year thereafter”).
  1. Repeat this process for each important oil-based component of the current health-care system. Such a study would be much harder to do than the original one, because Hirsch et al only considered one output; we need to consider many.

One would also need to try and predict the increased sterilizing load (both in staff and equipment terms), infection control issues, financial costs and benefits, patterns of use, etc.


The possible outcomes of such a study include:

  • A reasonable idea of the enormity of the problem and the scale of mitigation required.
  • An estimate of the number of years needed to significantly reduce our current dependence on oil-based materials, allowing timeframes for implementation to be developed.
  • Identification of the critical areas of the current healthcare system that need urgent attention.
  • The realisation that perhaps a stockpiling strategy might be favoured over developing domestic manufacturing capacity.
  • A complete redesign of the current system (really a paradigm shift to the new ways of delivering satisfactory health care discussed n this report).
Editorial Notes: Paul Roth is a family doctor practising in an Australian city. He has postgraduate qualifications in acupuncture and integrative medicine, a diploma of medical hypnosis, and has practised reiki for several years. He is interested in peak oil and what it might mean for health care. He hopes to raise awareness in the community of these issues, and create a dialogue about possible futures for peak oil medicine. Check out Paul's blog, Peak Oil Medicine, for some thoughts on health care options for a scarce oil future. -AF

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