We suppose it had to happen eventually in a nation fixated on winning -- and losing.

Everybody knows that a warmer planet in the aggregate will require costly adjustments. And coastal cities are particularly at risk from rising oceans caused by melting ice caps.

Now we have a county-by-county analysis of the winners and losers in climate change, and as we reported Coconino County is among the former.

The data, however, is mainly economic and relative. If Phoenix overheats and its mortality rate goes up along with more energy use for air conditioning, then relatively cool and healthy Flagstaff comes off looking better.

So on a map, there is Coconino County colored light green amid a sea of reds and yellows – the only other green Arizona county is Apache, presumably because of its higher elevation.


Is there a local silver lining, then, in global warming? Should a phenomenon with such dire consequences for the “losers” even be evaluated on such terms?

There’s really little choice. Sorting out relative impacts of all kinds of social and physical changes is as old as cost-benefit analyses, only using bigger data sets: 15 different economic variables applied to 29,000 possible future states of the world across each of 3,143 American counties.

Recently, the Congressional Budget Office has performed a similar analysis of various Republican health care bills that seek to repeal and replace Obamacare. In those cases, the CBO has applied the coverage options, premiums and taxes in the bills to a variety of demographic profiles based on age, income and health conditions. The winners are the wealthy, who receive the biggest tax cuts, and the healthy, who are free of mandates and could purchase insurance at minimal costs. The losers include older, poorer, less healthy adults not yet eligible for Medicare and some of the very poor who might be kicked off Medicaid rolls if the states cannot afford to pick up the declining federal share. Rural hospitals also would struggle financially and the insurance industry has said some of the revised Senate provisions would send the private market into a tailspin.


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Broken down by counties, that analysis, as with climate change, would no doubt show geographical net winners and losers. (Coconino County, with its higher poverty rate, rural hospitals and dearth of multimillionaires, would likely be among the latter under the current Senate proposals). The health insurance exchanges already sign up enrollees by county and assign coverage to insurors by county, so there is precedent.

But are counties, with their arbitrary boundaries, really a fair and meaningful way to judge either the effectiveness of statewide insurance markets or the impacts of planetary warming? In the former, insurance that is meant to be comprehensive and portable ought to be able to draw from the biggest pool that can feasibly be managed. Small counties unable to spread risk as broadly are at an immediate disadvantage. There doesn’t have to be a single-payer national health care system to recognize that the broader and deeper the risk pool, the more affordable will policy premiums become. Counties just don’t cut it.

In climate change, there are similarly broader considerations than whether summers are relatively cooler and wetter in Flagstaff than Phoenix. Even a small rise in temperature is likely to destabilize local plant and animal species, with wildfire and drought more of a risk, too. The study also assumed a stable population, despite a country where mobility is ingrained in the culture. At some point, the heat zone emigres would overwhelm Flagstaff’s carrying capacity, resulting in not only higher infrastructure, education and social welfare costs but a likely decrease in the quality of life that studies can’t quantify.


In the end, climate change and health care insurance both require a social responsibility to the common good that far outrun county borders. It’s an interesting exercise, but shortsighted -- if the Southwest in general cannot surmount climate change, neither can Flagstaff. We might be a sky island, but we are no island unto ourselves when our health and that of the planet are at stake.

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