 Good afternoon, everyone. I'm Dan Quinlan, I'm the Chair of the Vermont Climate and Health Alliance. We are Vermont physicians, nurses, therapists, veterinarians, researchers, aides, and other medical and health professionals who share a deep concern about the impacts of climate change on our patients, our children, and our communities. We're joined together in a collective recognition that the track we're on is not good enough. Unless we all work together to change that, climate change will utterly upend the lives of our children and all who follow us. Last night, the 2023 UN Global Meeting on Climate Change ended. Today, Vermont's Bill McKibbin sent out an email summarizing his thoughts. He ended with the following statement. Today's agreement is literally meaningless and potentially meaningful. The diplomats are done now. The rest of us are going to have to supply that meeting. I'm joined here today by three wonderful colleagues and friends, Dr. David Rand, Dr. Megan Melgarie, and Dr. Beth Zygman. Our goal today is to describe why we believe that Vermont's should support the Make Big Oil Pay campaign. We believe this idea is exactly the major, the kind of major step that Bill McKibbin and so many other leading voices are asking us to support. Dr. Melgarie. Hello, thank you for having me. My name is Megan Melgarie, and I'm a primary care doctor in the community, and also a clinical associate professor at the Larner College of Medicine. I think Katherine Hayhoe summarized this nicely in her book, Saving Us, and I'm paraphrasing here, but she said fossil fuels have done a lot for us. They've advanced our society. They've accelerated our growth and our wealth. So there's definitely acknowledgement that fossil fuel in our country and in the world have led to advancements. There's no denying that, and none of us want to go backwards and be living in a society pre-industrial. But at this time, we have technology and we have advancements to allow us to move forward from such a polluting and unhealthy form of energy. And so fossil fuel combustion globally causes 10.2 million premature deaths and pollutes our air and it's dangerous to human health. So I'm a clinician in Vermont, so locally I've noticed climate change related health impacts in my clinic for the past 11 years that I've practiced and over time I've noticed more frequent impacts and more intense impacts for patients and their health. This summer was particularly salient in terms of the impacts that were noted that I noticed in clinic. For example, my patients with lung disease are really impacted by climate change related impacts. So with the extreme heat of the summer combined with the wildfire smoke coming from the Quebec fires, increased allergens in the air, all of these factors can exacerbate people who have COPD, asthma, and people who are definitely coming in more with exacerbations of their illnesses. I have one particular case that I found poignant and I had a patient with COPD. She was hospitalized this summer right around the time when the wildfire smoke was the most intense and I think in New York City they said it was the highest levels on record of air pollution. She was hospitalized, she was just at home with oxygen and I visited her two weeks later because it was clear that she was not able to make it into the clinic. And she told me she had not literally stepped outside her home from the time that she was hospitalized until now. So she hadn't gone outside and breathed in outdoor air. She hadn't been to her pool that was right in her back porch. She hadn't visited her neighbors or gone to her mailbox because her disease was so exacerbated still and because the air quality was still poor. And so people are really being impacted by the impacts of climate change in their health our most marginalized and most vulnerable patients who have illnesses are the most impacted but everyone is impacted. All of us have been impacted by climate change related health impacts whether we know it or not. So and fossil fuel companies continue to make tremendous profits at the expense of our health. So again, they had a role and now we need to move forward from that. And fossil fuel companies are still subsidized when their actions, the combustion of fossil fuels are causing death and disability and illnesses in our community. So I hope we're encouraging legislators to support the fair share idea when it comes into legislation coming up in January. Thank you very much. Sure, thanks Megan. My name is Dr. David Rand. I'm an internal medicine doctor. I teach medical students in residence at the University of Vermont, where I also practice. In addition to being a doctor, I'm also a father. Many us in Vermont thought that we were safe from the devastating impacts of climate change and then came the floods and the wildfire smoke and the algae blooms choking our lakes and the heat. Climate change impacts the health of my patients and also of my family. It boggles my mind that I can't let my daughter go outside some days because the wildfire smoke will damage her lungs and that I have to warn my patients about being exposed to the air because they will increase their risk of having a heart attack or needing to come into the hospital for breathing problems. I worry most about my patients who can't afford to stay inside and turn their HEPA filters on. The people who need to work outside, whether they work on a farm or delivering packages or in construction. Climate change affects people's health differently and a lot depends on how rich or poor you are. In the floods, many people's lives were devastated, emotionally, financially and physically, but the people most impacted were those who couldn't afford to rebuild on their own, who couldn't afford to work, sorry, who couldn't work because where they worked was flooded. Climate changes multiplies inequality. Meanwhile, we have known what causes climate change for a very long time. As early as 1977, in fact, scientists at big oil companies predicted that continued use of their very own products, fossil fuels, would cause major changes in the climate and yet they kept it a secret and then they lied about it. As a doctor and as a vermonter, I'm calling for fossil fuel companies to pay their fair share. To help vermonters and my patients adapt to the devastating changes to our climate that their products have caused. But it can't stop there. We must elect politicians who will do whatever it takes to stop this runway train. Our leaders must stand up to big oil and transform our economy from one dependent on burning fossil fuels to one that uses clean energy. And we must all do whatever we can individually to minimize our own climate emissions. We don't have a minute to waste. Thank you. Hello and thank you for inviting me to this event. I'm Dr. Beth Ziegman. I'm an associate professor of radiology with a sub-specialty in cardiothoracic radiology. That means I'm a specialist in the imaging diagnosis and surveillance of diseases of the heart and lungs. But it doesn't take a heart and lung specialist to point out the horrible health impacts of climate disruption. This past summer we were plagued by weeks worth of wildfire smoke from Canada, smoke that's highly toxic to the lungs and heart, as well as numerous other organ systems. And then there were the catastrophic floods in our state and all the resulting tragic cost to the mental and physical health and well-being of Vermonters. Not to mention the astronomical financial cost to our state, not only to rebuild communities and lives, but to pay for the escalating cost to our already struggling healthcare system. We know with certainty that these terrible events and their health impacts can be traced to the burning of fossil fuels, primarily oil and natural gas and coal. How? Because it is indisputable that weather disruption is caused by climate change. And make no mistake, big oil companies like ExxonMobil and Shell have known for decades. In fact, the first address by the American Petroleum Institute President on this topic to his industry leaders was in the 1960s. And he pointed out where we were headed. Based on amazingly accurate research by their own scientists, they knew what was coming. That the continued burning of fossil fuels would lead directly to this crisis and the ballooning costs that we're now facing. People throughout the world, including in Vermont, suffer worse and more frequent health impacts and there are so many impacts. Increases in lung disease, mental health conditions, skin infections, in our region, Lyme disease, direct physical injuries from climate events, heat-related illness, water contamination, the list goes on and on. What's truly astounding is that despite this, the oil and gas industry continues to blatantly lie about their intentions to help the transition to clean energy. And we've seen this recently at the climate conference in Dubai. They continue to pretend that they're going to help the transition to clean energy. Instead, they do everything possible not just to delay, but to derail the energy transition. They must be held accountable for the mounting costs of their lives, the costs to your health, to our health, to the health of our children and our grandchildren and all future generations. Just like the pharmaceutical and tobacco industries, the fossil fuel industry has to pay for this mess. Thank you. Hi. I would like to start by thanking the healthcare professionals from the Vermont Climate and Health Alliance for taking time out of very busy care schedules to be here and to speak about the varying costs of climate change, particularly among colleagues and patients. My name is Jordan Hyden. I use she, her pronouns and I'm B. Perg's Keep Vermont Cool campaign manager. And I'm here to tell you a little bit about B. Perg's newest climate campaign, Make Big Oil Pay. The Make Big Oil Pay campaign is rooted in a value that most of us learned in kindergarten. That is, if you make a mess, you should help clean it up. But unfortunately, big oil and gas companies like ExxonMobil and Shell are not doing that and have not been doing that for decades. Instead, they've raked in unprecedented profits, over $200 billion last year alone. And in the process, they've left an enormous path of environmental destruction behind. So we believe it's time for Big Oil to pay its fair share to combat the climate crisis, redirecting a portion of profits to create climate solutions through the implementation of a Vermont Climate Superfund. This concept is wildly popular. And a recent survey conducted by Data for Progress found that the idea enjoys broad support from Democrats, independents and Republicans. So what we've found locally, that is the case as well. After knocking on thousands of doors through VPurg Summer Canvas and hosting community action events in every single county in the state, and with support from local legislators and organizations like the Vermont Climate and Health Alliance, we look forward to watching this important concept evolve in the State House. So if you'd like to learn more about the campaign to make big oil pay, please visit makebigoilpay.org and stay tuned for details about a day of action taking place at the State House in the second week of January. Thank you so much for being here and we're happy to take any questions if you have them. Hi, so logistically, how do you see the oil companies contributing to the Superfund? Yeah, that's a great question. I will take that. So this is something that is being developed that is based on information we have from other states. So just to be clear, Massachusetts, Maryland and New York have already set this tone. They have bills in motion as we speak. And this is something, again, that is developed off of the EPA Environmental Protection Agency Superfund Program. So it's something that is a work in progress. We're working closely with lawyers and experts in determining how we can get those funds. But it is something that will be required of them. It's based off the amount of climate emissions that each individual entity produces. And it's just based on their own individual responsibility. So those funds will be redirected towards the state in a way where we can use them for a variety of things that's to be determined. But it could be infrastructure reconfigurations. It could be renewable energy projects, things of that nature. That remains to be seen at this point. The bill is being drafted. So we'll have more information about that in the coming weeks. Are you thinking like a tax or like a certain kind of regulation or like a lawsuit? It's definitely not a lawsuit. And I don't believe it's a tax. But there will be more information as we continue to work with legislators on exactly how that comes to fruition. What is your message to legislators as they head into this session of January? Does anyone want to take that? Maybe from all perspectives. Yeah. Does anyone want to start from? Want to share? Not from the perspective. The health perspective takes us from the health perspective. My message to legislators would be that our health care costs continue to climb. We've lurched so far recently from crisis to crisis. The COVID-19 pandemic was the prime example. And this crisis is analogous. We need to hold accountable the companies who knew what they were doing, who knew what the impacts would be, and who basically spent decades trying to obfuscate and pretend that this wasn't happening and confuse the public about the science. The science is clear. So the message to legislators would be we need to do everything in our power to hold these folks accountable. The same way that we did with the opioid crisis. Thank you. Can I take a shot at that as well? So I think for us, thinking from a medical perspective, what's gone on here is very similar to what happened with the tobacco debate. So that information was hidden from the public. And that's absolutely what's going on here. And we're not unique in the sense of there are groups like this in 23 states now. There's also a national organization. There's international organizations. In 2018, there was a letter that went out from the Global Climate Summit that was signed by 117 health organizations across the planet, representing 17,000 hospitals and 6 million healthcare employees. That was 2018. And this whole thing has only grown since then. So that's another part of the message to legislators. We are really trying to get them and the public to see that the medical profession is incredibly concerned about this for a very good reason. Again, based on very solid science and what the physicians and others are seeing in their clinics. And I would also just like to add that we believe Vermonters have been footing the bill for the climate crisis for far too long. And Vermont is actually the seventh highest number of federally declared disasters over the last decade and also has the fifth highest per capita spending on climate disasters since 2011. So it's really critical that we start to make these changes now. And have you gained support from Vermont residents and the people who are paying for those consequences? Absolutely. Yeah, we actually just wrapped up a 14 county statewide tour where we hosted 17 community action workshops across the state, really trying to mobilize for this campaign and coming soon, Bill. But we have received a lot of support. A lot of folks are taking action writing to their legislators, sharing on social media and getting involved in many different ways. So we are seeing that support. Megan. What's your last name, Megan? It's Maljuri. And it's Barbara. Emma's in Mary, A-L-G-E-R-I. So sorry, let me turn the camera on you. Actually, would you mind checking in front of the podium please? So it kind of went through a little bit of a laundry list of the sort of health impacts that happen upon people who are exposed to climate change. Could you just go over one more time, sort of what you're seeing in a primary care office from climate change? Yeah, thank you. Good question. So from my perspective, climate change related health impacts range from people coming in or calling pretty much daily from spring until the end of the fall with tick concerns, whether it's tick on them, they're concerned about Lyme disease, they're concerned about anaplasmosis. I've diagnosed both of those concerns for people in the office or through the lab. And in addition, exacerbations, pretty much anyone with a chronic medical issue can be susceptible to exacerbation of that disease in the setting of the strains of climate change. So the extreme heat can lead to people with hypertension becoming dehydrated. The extreme heat and humidity can lead to exacerbations of Lyme disease. So my asthmatic patients can have trouble breathing, COPD patients have trouble breathing, they come into the clinic, sometimes need a steroid, sometimes as I mentioned, they need to be hospitalized for that. And so there's a lot of impacts for that population, people with congestive heart failure also are exacerbated by the extreme heat and other stressors from climate-related impacts to their health, and they can have trouble breathing and come into the clinic with concerns. I also, there was a study by National Academy of Sciences indicating that there's a 21% increase in allergies over the past 20 years. And I definitely see that in the clinic too. So people are coming in with these prolonged colds and saying, what can be done? Can I, do I need antibiotics? And really what they have is allergies and they never have had these before. More extreme cases of allergies where people need to take allergy medicine year round now where they didn't before, because we have such a delayed frost and there's more carbon dioxide in the air. So those are some of the impacts that I see in the clinic. Yeah, so a lot falling on the shoulders of primary care physicians because of climate change. And given the fact in Vermont that we have such a shortage, are you concerned at all? I mean, certainly I think that in Vermont we have an aging population to begin with. So as I said, climate change impacts everyone but it also impacts our older patients. You know, the very young, the very old, people who are pregnant, people who are marginalized, who have been provost. So when we think about our aging population, people have chronic illnesses and these are exacerbated. We already have a shortage of primary care providers. So I am concerned about being able to adapt, being able to respond to the needs of Vermonters. Are you concerned that everybody who has negative impacts exacerbated by climate change will be able to see primary care physicians? Do you think that that might not even be able to happen? I, yeah, I mean, we see that now where people can't get in to see their doctor. They have prolonged waits and end up in the hospital because of that. So I am concerned about that. And because people are gonna end up in the hospital and emergency medicine costs so much more. Do you guys have like a ballpark figure of how much the cost is gonna be because we're not able to meet these demands? Sort of what the supplement from the Superfund would be? Like just like a ballpark estimate of how much money you think is gonna go. Yeah, we could be seeing costs upwards of $5 billion over the course of the next 25 years but those are estimates and could be much higher. So what we're hoping to see is a 50% contribution from those big oil and gas entities. So $2.5 billion over the course of the next 25 years. Thank you. If there are no other questions, I think we'll wrap it up here but a few of us will be hanging around, floating around if you wanna continue the conversation but thank you so much for your time and we appreciate your attendance today. All right, hello, my name is Josh Ferguson and I am a climate and energy organizing fellow at the Vermont Public Interest Research Group and this past fall I was blessed to have the opportunity to visit every county in the state and bring this conversation on climate change to every corner of Vermont and I found in that tour is that there are a lot of shared feelings about climate change and the damages of climate change in Vermont and we really are trying to bring that conversation to the forefront, you know. A lot of tax-paying citizens in Vermont are seeing rises in their taxes and their healthcare and in their housing needs, they spend a lot of thousands of dollars out of pocket every year to update their facilities so that they can continue to operate as normal and in fact, across the state, we found that operating as normal has come at a higher cost and we feel that the time for Vermonters to carry that burden is over and that it is time for big oil companies, big energy companies who have created at least 70% of the damage associated with climate change, that it is time for them to pay a fair share.