There are several reasons why environmental costs should be considered explicitly in the ethical discussions regarding limiting the costs of health care.
Health care is a major sector of the U.S. economy.
If the U.S. is to limit environmental costs generally, it must limit health care environmental costs. There is reason to think that high levels of public health can be maintained while dramatically reducing the environmental impact of health care. Limiting cost considerations only to monetary costs truncates the moral conversation by ignoring a wide range of social and environmental costs. Society has an obligation to minimize its environmental impact in order to protect the health and welfare of present and future human generations and show respect for non-human creatures. Because the health of earth's ecosystem is a necessary basis for human well-being, our pursuit of health should not undermine its viability.