Published: Santa Monica, Calif. : Lionsgate, [2013]. Impressive. That is how many medications I was on. Or at least we think we do. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. PROTESTERS: Now. 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. They may be a member of a health plan for a year and maybe no longer. Escape Fire: The Fight To Save American Health Care Aired March 10, 2013 - 20:00 ET THIS IS A RUSH TRANSCRIPT. Afghanistan? It's been a wild ride. BURD: All right. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. In our model, the physician acts as a quarterback. Escape Fire: The Fight To Save American Health Care. UNIDENTIFIED MALE: Yes. You say there's a lot of Yvonnes (ph) out there, the patient we just met. UNIDENTIFIED MALE: I have no health insurance. An Entrenched System. Are you incentivized to do more stents? Your company becomes more competitive. 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. You have all these stents, and these stents, once they go in, they never come out and are part of you. (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. You didn't have to be a statistician or in the words of my old friend Bob Dylan, you don't have to be a weatherman to know which way the wind blows. Got approved very quickly. Incentivizing them to be healthy or not charging them as much if they're healthy. I mean, I can't think of a single negative in doing this. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. People eat what's cheap and what's available. It only reduces symptoms. Do you think that will make a difference? People go in and out of health plans. Play the video for which you need a transcript and click on the three horizontal dots below the video. It's not just we know it, we actually can go and visit it. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. Open your favorite browser and launch YouTube. Ten allotted. I came to Walter Reed. 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. People with chronic disease who come in and out of hospitals, bouncing in and out of ERs, that's what they need, someone to really take an interest. Until my doctor said to me, I don't know what else to do for you. (BEGIN VIDEO CLIP) COMMERCIAL ANNOUNCER: Managing Type 2 diabetes can be hard. You can you visit a hospital that's stopped infections, you can visit a hospital that's ending wastes slowly but doing it, you can visit systems that coordinate care nearly perfectly. BROWNLEE: Fee for service rewards physicians for doing more. He is also a president of the society for interventional and geography in intervention. All my health issues have gone away. But it's more than cost. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. Log in to your account. 0. And I thought, once I get this, I won't have the blockages anymore. Obesity leads to heart disease and strokes and diabetes. That isn't true in Canada. 1 hr 39 min PG-13 Documentary A powerful and thought-provoking documentary that exposes the U.S. healthcare system as one designed to profit on disease rather than health. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. 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) We want that. YATES: OK. (MUSIC & CREDITS) GUPTA: We can't leave the conversation right there. We see a lot of the chronic conditions that affect many Americans that have gone untreated for sometimes months, but sometimes years. 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. And the disease care system actually -- I mean, if it really was honest with itself, it doesn't want you to die and it doesn't want you to get well. NISSEN: Yes, but we have to educate patients. GUPTA: So, tell me how that would work? Simply the same way the hospitals and physicians. On my way. NISSEN: Now, the leading cause of death in diabetes is heart disease. CARNES: Release the breath in a smooth, even stream out. Don't need you, don't need you. UNIDENTIFIED FEMALE: Loratab, Naproxen. Am I going to be paying more? Physical Desc: It's all about the reimbursement. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. I mean, look at our results. If you're seeing redundancies in service, go back and meet with your medical professional. Prevention is cost effective. GUPTA: Stay with us. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. I was 35 at the time and was scheduled for open-heart surgery. And is it still traveling into your neck? One of the great contributions of America to world cuisine, you know, fake bread. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. I mean, the average price tag for a single hospital admission can be really eye-popping. UNIDENTIFIED MALE: Nine months. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. And interestingly, patients really respond to that. We have made all of this unhealthy food the cheapest and most available food. It's very hard for us as nurses to treat for pain because there's no thermometer we can stick in and say oh, it's seven out of 10 pain. 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. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. WGRZ reported that crews encountered heavy fire and thick smoke coming from the building at 747 Main St., after they got the call at 10:08 a.m. A Mayday was called early in the operation. But, the American people are going to want something like that and that is going to be their perception. DR. WAYNE JONAS, PRESIDENT, SAMUELI INSTITUTE, MILITARY MEDICAL RESEARCH: With 10 years of ongoing wars, the amount of suffering that's going on in the military right now is tremendous. MARTIN: Thyroid is a little bit big. BERWICK: The healthcare system is unsustainable. YATES: The pain, it's hard, you know, it's really hard. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). There's no crisis worker at lunchtime? ROBERTSON: Right. And I think that's a good place to start. As Berwick says in the film, "We're in Mann Gulch. I'll look up and I'll see a person who's overweight across the street. And to me, that's not the only issue. That's built in these costs as well. There's saving money and there's cost effective. GUPTA: Sometimes the patients demand this stuff. And if they have a relationship with you, feeling truncated. And the fire spread around him. GUPTA: I mean, both physically and mentally. We need a whole new kind of medicine. GlaxoSmithKline worked very hard to keep these numbers from the public. You didn't think you could take care of patients and get reimbursed enough to do the work you need to do. 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. I think many of her cardiac catheterizations instead would not have been necessary. I mean, give me a break. So at this point, we will administer the medication. That's my routine. One of the three men who survived the Montana fire did so through an ingenious solution and a leap of faith by making an escape fire. It argues that American medical treatment is largely focused on getting people into hospitals and giving them drugs, two profit centers that are hugely expensive and supported by massive lobbying campaigns. Maybe even a provider service. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. I was so dependent on my pain medication. UNIDENTIFIED MALE: Yes. UNIDENTIFIED MALE: McDonald's put salads on the menu, but turns out the salad is $6, the burger is 99 cents. 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. NISSEN: Finally, the FDA put severe restrictions on the drug. They promised me that I could make the practice whatever I wanted it to be, and if I don't want to see six patients an hour, I don't have to see six patients an hour. NISSEN: You know, DVT and pulmonary emboli. It's hard to say good-bye to the patients. GUPTA: So you're salaried. UNIDENTIFIED FEMALE: I just want to see what they've given him. Where does that money come from? . But we end up being this revolving door. Dodge survived, nearly unharmed. I mean, an obvious one is nutrition, which is almost omitted from medical education. And Doctor Nissen is in salaried as well. Dr. Berwick suggests that the current state of healthcare. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. They may keep the disease process going and they may strengthen it over time. It doesn't reward them for keeping their patients healthy. That is chest pain that is actually currently damaging the heart in patients. Anybody else would laugh, you know? As an overall system, no, we're not anywhere near the best in the world. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? About a 30 percent increase in the risk of heart attack and related complications. Just sore. DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Dr. Dean Ornish has studied and written about diet and heart disease for decades. And sometimes push the plate away. Can adding Avandia help you? The present system doesn't work and it's going to take us down. (END VIDEO CLIP) NISSEN: There was a drug on the market, Avandia. Sometimes they are related to lifestyle habits. Alice in Wonderland (1951)/Transcript. It turns out lots and lots of men who had a cancer that didn't need to be treated, but they got treated anyway and it was causing a lot of harm. Probably put him on the bottom on the other side. Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. How to Get YouTube Transcripts on Desktop On a desktop or laptop, head on over to YouTube.com in a web browser such as Google Chrome and open a video to watch. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. Does it make a difference? That we really have historically the low growth over the last three years, actually about the rate of our economy which is actually pretty historically low. Some would say overrewarded specialty and subspecialties. NIEMTZOW: If you didn't have the acupuncture needles, how do you think you'd be feeling? May everyone be happy. UNIDENTIFIED FEMALE: OK, I need some help over here. Do you understand? And then, being paid, on top of that, a bonus if they can demonstrate, if they have improve the quality of care and have also may cause saving. There's nothing else I can do. This is a lot worse. Not just the health, but healthcare, the health of a nation. GUPTA: I'm salaried too as a physician. My very best friend from war, he was on narcotics. To feel that way when you come home is demoralizing. UNIDENTIFIED MALE: What do we want? UNIDENTIFIED FEMALE: Do you want to do a pill count with me? If someone had talked to her -- I think someone had really teased out her chest pain and shortness of breath, I think many of her cardiac catheterization and stents would not be necessary. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. UNIDENTIFIED FEMALE: Where are you coming from? I'm interested in helping patients. UNIDENTIFIED FEMALE: You need to get up and pee? The psychological trauma of every one of those multiple catheterizations, every time she had a chest pain coming into the E.R., and unfortunately, there are lots of Yvonnes out there. That also happened in the 1990s. I said, there's got to be a better way. You're doing this radical intervention, you know, I say radical? And those are surprising. I was a walking dead man. Because they're not using health care now. This is what he's got left. What is really striking is how little they have written the last few years. MARTIN: At a community healthcare center like where I work, you see chronic illness, people that aren't able to afford their medications, lots of psychiatric illnesses. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. You just look different. 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. It's not true in France and Germany. She got her cholesterol under control, her weight under control and things were great for her after that. Click on "Export" and choose your preferred file format. And the actual costs for care here is among the lowest in the country. UNIDENTIFIED MALE: I love you, too! Joining me to talk more about this is doctor Steven Nissen, he is the man in the documentary, the chairman of cardiology at the Cleveland clinic. We're 50 percent more likely to have a stent than we wait and say, countries in western Europe where they have similar disease rates. That simply means they get paid for each office visit. MARTIN: A day? It's wonderful. Original Airdate 08/17/2022. It is the largest health insurance company in the country. Episode Number(s) 1 S03E01 03x01. So that's rewarding for me. With the infantry division. They can pretty much get away with increasing the rates as much as they want to. UNIDENTIFIED FEMALE: Take them away from him. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. You're your options might be, if there is a doctor surgeon on hometown. WEIL: It could get worse. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. UNIDENTIFIED MALE: I've been to the emergency department a few times before, and the last time I was having chest pains, not like this. The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. Here you go. TUCKSON: Primary care doctors are being cared more. The fire raged past Wag Dodge and overtook the crew, killing thirteen men and burning 3,200 acres. Do you want to tell me about some of those that you lost? And that's the problem. GUPTA: I want to point out something. Expand the Transcripts and captions section if closed, then select Upload. MARTIN: Good. The problem is not that it doesn't work, the problem is that we haven't figured out how to get it into the system so that we can make it widely available to the population. Tell me what happened. BERWICK: The healthcare system isn't affordable anymore. Event marketing. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. It was either come and get care there or not get care at all. As an overall system, no, we're not anywhere near at the best in the world. The power lies with corporations and corporate interests and the lobbyists that they buy. But when you're doing something that has never been done before, it's not universally accepted, to say the least. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. It's a completely irrational system. Unless you're in the middle of having a heart attack, which 95 percent of people who get them are not, they don't prolong your life, they don't even prevent heart attacks. So inhale. 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. Description: In this clip* from the award-winning documentary, Escape Fire: A Fight to Rescue American Healthcare, you will hear about two patients trying to navigate the US health care system. Tom's Escape In The Fire Escape. OSBORNE: I have lost -- since last year I've lost 21 pounds. We want more specialists. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. Entitled Escape Fire, Dr. Berwick's speech took its audience back to the year 1949, when a wildfire broke out on a Montana hillside, taking the lives of 13 young men and changing the way firefighting was managed in the United States. We're talking about a $3 or $4 billion a year drug. It's generating rivers of money that are flowing into very few pockets. NISSEN: Yes. Now you're going to get the scissors. Link 'n' Share. Rescue care is second to none. NIEMTZOW: That means we're getting the needles in the right -- in the right place. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. BURD: Thirty percent of our smokers have quit, 21 percent of our obese population are no longer obese, and Safeway employees will be less of a burden on the Medicare of the future because they have adopted to this culture of health and fitness. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. Literally, 30 patients an hour. I'm sorry, it's going to get pretty tight. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. 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. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. There were even times, honestly, that I looked in the mirror and said, how did you get here? MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. What's wrong with medical education is that it simply doesn't address whole subject areas that are absolutely essential to understanding human beings, health, illness, and treatment. So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." Look at our results, our life span isn't even in the top 20. UNIDENTIFIED MALE: I feel different. I was a bit surprised. We've just created a completely different system here. I take a pharmaceutical drug myself, but if there's one thing that I would love to see you begin to implement in your own practice and teach others about, it's to try to change this mindset that has so completely taken hold in our culture on the part of both doctors and patients that drugs are the only legitimate way to treat disease. Video: This tiny shape-shifting robot can melt its way out of a cage . Healthcare, it's headed for really, really bad trouble. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. In fact, more soldiers died last year from non-combat injuries than during war. UNIDENTIFIED MALE: What I'm arguing for is not to make things tough on industry, it's to make things safe for patients. JONAS: What it first seems like strange bedfellows, healing oriented mind/body practices and sort of the hardcore military actually is an opportunity that they jumped at because of the pragmatic need and nature that the wars had driven them to respond to. It used to be me. YATES: I'm a red neck south Louisiana boy, just old Hill Billy, you know? I do it in my clinic all the time. 2. Maintaining my pain. Aladdin (2019)/Transcript. UNIDENTIFIED FEMALE: No. Eight IEDs through this deployment. Why do we care about covering the uninsured? BURD: All right. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. They sent me home with them. When medicine became a business, we lost our moral compass. Committed to her living longer and better. Thanks for watching. They can't recognize an invention when it's among them and they can't give up their old habits. Our health care system. We even found that when you change your lifestyle, over 500 genes were changed. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. And then clearly we have social and economic issues that impact people's ability to access if you look at our percentage of un-insurers. OK. The fire escape represents the ephemeral escape from his life inside the apartment. (LAUGHTER) NIEMTZOW: Hi. And that model has continued until today. You almost forget that what you're doing is providing health insurance. DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. The drug get away with increasing the rates as much if they have written the last one in open-heart.., faster than most people could ever run fact, more soldiers died last year non-combat! People are going to cover the heart disease program, the health but! Watching tonight probably say, look, what does this mean for me most directly into doing more the... Care: I mean, the physician acts as a quarterback the only issue video settings in the health. 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