UNIDENTIFIED MALE: I'd be chomping narcotics. UNIDENTIFIED FEMALE: Hi. But, we have the ability to make huge changes in our patient's lives and we're not using that, because it's not reimbursed and frankly physicians are not taught how to do it. Now, thanks to both of you for joining us. And to me, that's not the only issue. And it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? It was with a huge amount of skepticism and resistance. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. Hold them accountable and then talk to them, you know, on a weekly basis. All of us live here and work here. In our model, the physician acts as a quarterback. Log in to your account. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. The small wire cage you see there is the actual step. Co-directed by Matthew Heineman and Academy Award-nominee Susan Froemke (Lalee's Kin: The Legacy of Cotton), Escape Fire looks at a U.S. healthcare system designed to profit on disease not. UNIDENTIFIED MALE: Bye. It doesn't always work. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. BROWNLEE: We spend $300 billion a year on pharmaceuticals. The really astonishing part about the fact that we spend more is we have worse health outcomes. NISSEN: Good morning. The fire overtook the crew, killing 13 men and burning 3,200 acres. But, that's not the whole story. How are you? I mean -- but you have to have the time to educate your patient. Let go of thinking, drop back in awareness and notice how a thought may show up, seemingly out of nowhere, or an image may show up and then disappear. And, you know, you kind of get busy. First Published 08/18/22 12:02. read transcript. When I had my first heart attack, did the cardiac catheterization, put the thing up there and put a stent in my heart, because I had a clogged artery. You just never get to the bottom of what's causing all of these problems that they are having. WEIL: In the year of for-profit medicine, the time allowed for patient visits has shrunk to a point where you've got seven minutes with a patient. The Issues. How to make a healthy choices. GUPTA: But, why are these causing hospitals so expensive? BROWNLEE: Almost every study says that the doctor that has the greatest impact on your health, in general, the greatest impact on the health of a population is primary care doctors. ORNISH: There's very little evidence that these conventional treatments make you live longer, but they cause many men to be impotent or incontinent or both. If you have cholesterol under control, a discount. UNIDENTIFIED MALE: Oh, yes. Why do so many children die so young here? Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). Let me get right to it, Erin. It's addictive. HEALTH DOCUMENTARIES FULL LENGTH: Escape Fire The Fight to Rescue American Healthcare - food world Food World 320 subscribers Subscribe 269 Share Save 31K views 6 years ago Escape Fire The. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. LT. GEN. DAVID FRIDOVICH, THREE STAR COMMANDER, U.S. SPECIAL FORCES: I can see why there's a link between opiates, dependency, misuse, and suicide. All Americans have accepted for 50 or more years in the automobile insurance industry that driving record dictates premium. So, we decided to give you a look at a typical operating room bill and that breaks down. OSBORN: I've started doing research about where in the United States do I have to go to get the best heart care. We do nothing about supporting the good, that the body can and wants to be healthy. NIEMTZOW: Normally you would? Thanks all of you for joining us. Fire Escape Transcript. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. UNIDENTIFIED MALE: What I'm arguing for is not to make things tough on industry, it's to make things safe for patients. I mean, the average price tag for a single hospital admission can be really eye-popping. We have that technology, it's right there. (COMMERCIAL BREAK) DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: If we really can't begin to change, from paying for volume, paying for how much you do, to paying for outcomes, paying for how well you do, how well the patient does, that will change the game, people will start to say, well, now the money is in health and well being and safety and vitality, not in more, more, more, more, more. So, if there's a concern someone has a tumor, they who use a needle like this. A different perspective that there's a different way of doing things, that it's possible. If you can delay treatment, then that man is not at risk for side effects during that period of time. It really does. UNIDENTIFIED MALE: Yes. That cost about 1,000You'll find examples like this all over a room. All Dogs Go to Heaven/Transcript. We're on track for that on Tuesday. If you're in the system, do you access of if you are insured, if you are living in a safe neighborhood, your outcomes are great in America. Look at the thinness. And from that point on I realized that I don't want to be on this. It's just a terrible tragedy for patients. Got to push through it. YATES: Meditation is scary sometimes. That also happened in the 1990s. They sent me home with them. On my way. All Dogs Go to Heaven 2/Transcript. The question was, can we relieve their pain and reduce the amount of medications that they are on so by the time they get back, they are not snowed under on multiple medications. Aladdin (1992)/Transcript. ROBERTSON: It's a financial necessity. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. They can pretty much get away with increasing the rates as much as they want to. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. He had -- he had Percocet then he has Marco which is Percocet. I never had a personal doctor, family doctor, nothing, all my life. I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. (LAUGHTER) Infinitely. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. Psychologically, you deal with a lot of these sorts of things. Transcript In Escape Fire: The Fight to Rescue American Healthcare", director Matthew Heineman exposes what he sees as flaws in the U.S. healthcare system, such as a doctor who can spend just. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. It was either come and get care there or not get care at all. UNIDENTIFIED MALE: A platoon of 23. They did not tell the FDA, and they did not tell patients. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. Do you understand? Six years ago before I became CEO, I stopped to think, I've never looked after a healthy person and maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. I think there's some very good drugs out there, I think drug treatment has its place. And they have to, these for-profit companies by law have to serve shareholders. The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. Did you have a good day today? You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. MARTIN: OK. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. BURD: All right. May everyone be well. If you get a bump on your head as a friend of mine had, and you go into the emergency department, in America, you get a cat scan. And the actual costs for care here is among the lowest in the country. It is so addictive. UNIDENTIFIED FEMALE: Oh, my god. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. It expands the artery to hold it open and allow the blood to flow. BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. BROWNLEE: If trends continue through 2020, up to one-fifth of health care spending or almost $1 trillion annually, will be devoted to treating the consequences of obesity. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. UNIDENTIFIED FEMALE: Now you pick your spot. WEIL: This is a problem with a lot of our suppressive treatments. ROBERT YATES, INFANTRY, U.S. ARMY: Medications I was on. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. There's nothing else I can do. If somebody has an infection, we give anti-infectious agents. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. (LAUGHTER) NIEMTZOW: Hi. MARTIN: I'm going to make a phone call and try and get some wheels in motion so that we can get you the help that you need. You can convert other formats (like Microsoft Word, HTML) into a plain text file or you can use native programs on your computer like Notepad. So he figured I was going to die because I was in such bad shape. The, you know, the food that we eat and the nutrition that we put in our body, that's been around since the beginning of time. MARTIN: Bye. BERWICK: It's really easy to find articles or speeches 30 years ago in which leaders were calling for change, unsustainable costs, problems and outcomes in quality. GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: As we've pushed medical innovation and capability to the leading edge of the battlefield where we can save their life, and we've got some guys who have had some horrific injuries and they're getting narcotics for a longer period of time, they certainly are at risk to develop dependency, and that's what we're trying to avoid. We don't have a healthcare system in this country. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: The problem is, if you have stable chest pain, we have very good studies dating back a number of years that show that getting a stint will not prevent a heart attack, and will not make you live longer. We take grains and we've turned them into products like this, which rapidly raise blood sugar, provoke insulin responses, cause insulin resistance, promote weight gain in genetically susceptible people, which is most of us. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. If you talk to the employees around here that have lost 35, 50, 60, 100 pounds, they will tell you without a doubt they have a better quality of life. Upload captions and transcripts. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. What do you say to people when they say look, pay Erin Martin a little more money, you guys are making $5 billion. It includes the mandate, the requirement that we all have to buy their coverage. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. Tell me what happened. ORNISH: The program increased the telomere length. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. And how to know if you're being prescribed unnecessary procedures. It's just so much more than money. A heart cath, get another stent. UNIDENTIFIED FEMALE: Oh. (END VIDEO CLIP) GUPTA: In fact to build on that, if you talk to some of the executives of these hospitals, they will say for every dollar that is actually billed they may collect just pennies. When you're injured they feed you, feed you, feed you all this stuff. UNIDENTIFIED FEMALE: OK, I need some help over here. Not very much, but a little. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. Power your marketing strategy with perfectly branded videos to drive better ROI. Our life span isn't even in the top 20. It's nice to know that I've got a long time to spend with my family and I'm going to get to see my son grow older and go to college and all that fun stuff. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. And I had a massive heart attack. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. Episode Number(s) 1 S03E01 03x01. BULLIS: Soldier know if they go to war and they get a leg blown off, your medic is going to take care of you and the same thing needs to apply that if you have post-traumatic stress. No soldier should have to go through this. That prevents tissues from renewing themselves in the body and diseases take hold. I felt like there's got to be something different, something better. These lifestyle changes cannot only work as well as drugs and surgery, but often even better at a fraction of the cost and the only side effects are good ones. It doesn't matter how complicated they are, how much time that we spend on them, it's just a number, one, two, three, four, five. We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. And interestingly, patients really respond to that. How are you feeling? This place actually gave me the tools to put in my tool bag so I can go back and still continue my process of healing, recovery. My energy level is up. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. We have underpaid on a chronic basis. And that is where the affordable care act can help which is bringing more competition to the bidding and pricing of these items. Until my doctor said to me, I don't know what else to do for you. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. If it's a radiologist, they get paid for each CT scan they deliver. I'm not changed, but I'm changing. Escape fire : the fight to rescue American healthcare Authors:Matthew Heineman(Director, Producer), Susan Froemke(Director, Producer), Donald M. Berwick(Commentator), Shannon Brownlee(Commentator), Wayne B. Jonas(Commentator), Steven E. Nissen(Commentator), Andrew Weil, Chad Kelly(Composer), Moby(Composer), Aisle C Productions(Production company) I'm Dr. Sanjay Gupta. CHO: I know, you look really good. Most diseases don't happen overnight. The Dartmouth study showed the patients in places like Miami were receiving more care. Are you incentivized to do more stents? He's taken 10 tablets. Next, click the three-dot menu icon underneath the title of the video. UNIDENTIFIED FEMALE: How are you? UNIDENTIFIED MALE: No. BERWICK: Everybody is doing what makes sense to them individually. GRUBER: Well, basically, Medicare actually - I don't have to tell - Medicare right on demonstration where they did bidding, where Medicare would pay -- would reimburse certain rates for medical devices and they had bidding across different manufacturers to be the low bidder, to brought that sources lower prices by 40 percent. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. How did -- what did think about that? Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). And water, they are saying, I'm going to have to give up to get there. They may be a member of a health plan for a year and maybe no longer. It's And we will say, it is important you request the appointment not only through a telephone call, but if you have an e- mail address, to try to do that. JONAS: Fifteen years ago, we did a consensus conference at the National Institutes of Health and we asked the question, do we have good evidence to show that acupuncture is safe and effective for any condition? NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. ORNISH: Dr. Peter Carroll and I collaborated with Dr. Elizabeth Blackburn, who won the Nobel Prize in medicine and she had done a study showing that stress creates shorter telomere, said as your telomeres get shorter, your life gets shorter. This is what he's got left. (COMMERCIAL BREAK). Rescue care is second to none. CARNES: I will be at your side should anything challenging come up for you. UNIDENTIFIED MALE: Not, not when I'm doing that. We need primary care doctors. And in some ways, I think of a lot of what's happening in health care is kind of dark matter. It has to do with the training of physicians. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. We want more tests. There's been a lot of change in me in that transition between La Clinica and here. Don't need you, don't need you. All right. Thank you so much. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. ROSS: When do you think it would be good to try it? He's got Lunesta and also has Valium. GUPTA: Sometimes the patients demand this stuff. Viewers will see this language when they . If you go out and buy heart healthy diet food, it's going to cost you more money than anything. They did not tell physicians. We spend one heck of a lot of money. But, the American people are going to want something like that and that is going to be their perception. So I decided to leave. I mean, give me a break. I was a bit surprised. But I'm doing it. You almost forget that what you're doing is providing healthcare. The first description that the play makes about the fire escapes is "The apartment faces an alley and is entered by a fire escape, a structure whose name is a . Format: DVD Edition: Widescreen. I tried to get him up, he just rolled himself out. There's a contradiction to what we do. I just had been ignoring it, because I thought, you know, I'm only 34 years old. I mean, give me a break. You also want to engage the billing representatives and the financial representatives of the hospital in that discussion and have them understand, I need an explanation of these charges. But we end up being this revolving door. The answers among us, and only by accepting the fact that the American healthcare system is badly broken and the status quo isn't working, is bankrupting our nation, will we be able to seek out the escape fires, the potential solutions, and create a sustainable and patient centered system for the future. RICHARD UMBDENSTOCK, PRESIDENT, AMERICAN HOSPITAL ASSOCIATION: I was almost as surprised as anybody to see the reports that I was the most frequent visitor to the White House during the health reform debate. MARTIN: Wow. GUPTA: I'm salaried too as a physician. May everyone be healthy. Did you indeed have four different blood transfusions, you and your family may only recall one or two. NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. But one evening, I sat straight up in bed with the worst chest pain. It's unseen, but it's there and it's very, very powerful. GUPTA: Erin, what did you think about that particular theme? And sometimes push the plate away. $300 billion on drugs. That's how embedded people get in the status quo. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. Let me just take a listen to you. If you ask the manufacturers a device like this, why so much money? You have the ability to reduce or raise the risk of many preventable diseases. We need a whole new kind of medicine. Just do something. Dodge survived, nearly unharmed. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. Jonas, Wayne B., commentator. And maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. They either couldn't afford it, or they worked for small employers that had been purged by big insurance companies. UNIDENTIFIED FEMALE: These are the costs of all of our drugs in order. And that being applied to health care just doesn't work. These calories are cheap only when you buy them, but when you look at the overall cost to society, these cheap calories are just so junky, they are really the most expensive. BROWNLEE: We spend a spectacular amount of money on healthcare. UNIDENTIFIED MALE: These are all one person's? BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. GRUBER: For everybody. That's not good medicine. Prevention is cost effective. I had difficulty sleeping at night. Obesity leads to heart disease and strokes and diabetes. DR. REED TUCKSON, EXECUTIVE VICE PRESIDENT, CHIEF OF MEDICAL AFFAIRS, UNITED HEALTH GROUP: There is no question that primary care doctors are underpaid, especially relative to their specialty counter parts, those who do procedures. But with regard to prevention, preventing disease, does that save us money? But when you're doing something that has never been done before, it's not universally accepted, to say the least. Sometimes when you go, go to bad places in your head. The check that I get back from the insurance company after that was billed is $40. Sometimes we're talking about them on a daily basis. So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." All my health issues have gone away. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. He overdosed. Who's next? RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. UNIDENTIFIED REPORTER: A new study finds a growing number of combat veterans are battling mental illness, but many are finding it difficult to get the help they need. Escape Fire Clip 14,141 views Oct 14, 2014 55 Dislike Share IHI Open School 9.49K subscribers *Note: You can purchase the full-length Escape Fire documentary on iTunes and Cinema Now, or you. NISSEN: If you look at health care in America, you're twice as likely to get your knee replaced as you are in Western countries with the same standard of living. Is that how you get paid? OK. Bend down. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. We could do 1,000 studies with a million patients, it would remain on the fringes, it's all about the Benjamins, as (INAUDIBLE) would say. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. MARTIN: I think what the American people need is, they need good health care. 4:00 Minute Teaser Video UPDATE: "In 2010, the US spent $2.5 trillion on healthcare." But now (in 2018) we are spending $3.65 trillion/year. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. GUPTA: You know, one can't help but walk away from the documentary, Doctor , frankly, they are scared of stents. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. They didn't want to have a new competitor. UNIDENTIFIED FEMALE: They don't say how much they gave him. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? MARTIN: Yes? UNIDENTIFIED MALE: I feel like I'm warming up a little bit. And abolitionists more broadly encouraged northerners to refuse to comply with the enforcement of fugitive slave laws and to disobey the Supreme Court's ignoble Dred Scott v. There's no crisis worker at lunchtime? JONAS: If the military is able to successfully integrate acupuncture, meditation, and mind body, yoga, then we'll find that the culture at large will learn how to adopt it, and it will have a transformative effect on our healthcare system. We need a whole new kind of medicine. And the company did nothing. Escape Fire: The Fight To Save American Health Care. That simply means they get paid for each office visit. The army sergeant general directed that we establish the pain management task force to take a look at alternatives to narcotics. One of the great contributions of America to world cuisine, you know, fake bread. BURD: I was a business guy and I thought if we could influence behavior of about 200,000-person workforce, we could have a material effect on healthcare costs. 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