One of the things I think that people are going to remember from that documentary is that when you talk about our life expectancy, we are 50th in the world, last in terms of the richest countries. People eat what's cheap and what's available. MARTIN: What I do every day, buddy. So, you compare us to those other nations, you have to understand that we come to the table with the bigger burden of disease. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: In the last few years, a profound change has begun in American medicine. A flower for you. On my way. Everybody is doing their job, we just design the jobs wrong. What that means is, the money we spend on prevention improves our health greatly per dollar spent. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. If we get Medicare to cover it, then everyone else will cover it and if everyone covers it then it becomes a standard of care. UNIDENTIFIED MALE: What do we want? Hold them accountable and then talk to them, you know, on a weekly basis. MARTIN: I think what the American people need is, they need good health care. It's not just we know it, we actually can go and visit it. Aladdin and the King of Thieves/Transcript. But this program has just inspired me to press forward. UNIDENTIFIED REPORTER: Safeway's healthcare costs have remained flat compared to a 40 percent jump for most other companies. So, if you have a patient comes in, you get paid a certain amount because you do a stent. Viewers will see this language when they . The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. I mean, couple weeks, I felt like I was okay. (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. He or she assembles a team of five other people to work with, a nurse, a yoga teacher, an exercise physiologist, a registered dietitian, and a clinical psychologist. Alvin and the Chipmunks/Transcript. GUPTA: You know, one can't help but walk away from the documentary, Doctor , frankly, they are scared of stents. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: I don't recall any time telling a lie, but I know that there are many times that I didn't disclose full information, and I was the company's chief spokesman. It was with a huge amount of skepticism and resistance. The average per capita cost of healthcare in the developed world is about $3,000. It's about saving the health of a nation. Healthcare, it's headed for really, really bad trouble. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. It's just a terrible tragedy for patients. UNIDENTIFIED FEMALE: Just take a couple of minutes to kind of arrive. more . UNIDENTIFIED MALE: The healthcare reform bill that was enacted achieved two of the insurance industry's major objectives. Sometimes we're talking about them on a daily basis. UNIDENTIFIED FEMALE: Because he's real sleepy? There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: There's the assumption that people who run government, elected officials, members of Congress, but it's not true in many cases. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. Rescue care is second to none. UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? I feel like I'm changing. SHANNON BROWNLEE, MEDICAL JOURNALIST: How powerful are lobbyists in the healthcare system? DR. RICHARD NIEMTZOW, DIRECTOR, ANDREWS AIR FORCE ACUPUNCTURE CENTER: Right there. DEAN MICHAEL ORNISH, PREVENTIVE MEDICINE RESEARCH INSTITUTE: When you're doing something that has never been done before, it's not universally accepted, to say the least. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. You know, the ads always end with the same phrase, ask your doctor. Committed to her living longer and better. UNIDENTIFIED FEMALE: Right. People come in and you try to fix one thing and they come back for the same thing over and over and over. ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. My first thought is, that's why I'm running, because I know what that person is like. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. UNIDENTIFIED FEMALE: No. I mean -- but you have to have the time to educate your patient. MARSHALL: So, anybody that's having a heart attack should get a stent. If you ask the manufacturers a device like this, why so much money? Anybody else would laugh, you know? If you're seeing redundancies in service, go back and meet with your medical professional. UNIDENTIFIED MALE: We moved you over here. UNIDENTIFIED FEMALE: These are all name brand. . I'm not sure what is what. If they are confirmed non-smoker, we give them a discount. Exhale. What do you think? Even if I lose 30 more pounds, which probably is my ultimate target, I'm not going to stop doing this. What does that do? What do you say when someone calls you? But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. But one evening, I sat straight up in bed with the worst chest pain. I'm optimistic about the future. That Medicare bidding demonstration. Escape fire: the fight to rescue American healthcare (DVD) Contributors: Heineman, Matthew, director, Froemke, Susan, director, Berwick, Donald M. 1946- commentator. But so what, right? Click on "Export" and choose your preferred file format. May everyone be well. If insurance companies don't deliver value, they won't be in business very long. WEIL: Right. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. 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. But then Dean Ornish was starting his program to see if you can reverse heart disease through a lifestyle change, and he went to my doctor and asked if he could approach me. It's a happy time in my life right now. A lot of unnecessary stents? BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. Blood pressure under control, a discount. BULLIS: Catching it very, very early after their exposure and allowing them to process that is so critical in the long-term recovery. And in some ways, I think of a lot of what's happening in health care is kind of dark matter. WEIL: Most of this huge effort of the healthcare industry is devoted to intervention in established disease and the majority of that disease is lifestyle related and preventable. UNIDENTIFIED MALE: Bye. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. We have a lot more power over how healthy we are than we are willing to take credit for or willing to take responsibility for. Why do so many children die so young here? You just never get to the bottom of what's causing all of these problems that they are having. It's addictive. At some point he's going to stop breathing if he's taken too much narcotics. YATES: That's a healing process because you're not bottling up, it's going to a different section in your mind to where you can start processing it. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. UNIDENTIFIED FEMALE: Oh. What the insurance industry's objective is, is to try to weaken those consumer protections over time and to try to influence how the law is being implemented. For me to spend 45 minutes on an established visit with a patient to make sure they are doing their exercise, make sure their diabetes is going okay, and to try to figure out what their true problem is, probably get paid $15. It's not true in France and Germany. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. I lost him. The only other country, by the way, is New Zealand. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. People come in and you try and fix one thing and they come back for the same thing over and over and over. It is important to keep in mind. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. MARSHALL: Yes, sir. Because they're not using health care now. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. The film interweaves personal stories with the efforts of leaders battling to transform it. GUPTA: A lot of these stents are unnecessary? Little did I know that it was followed by years of the same thing over and over and over again. The Escape fire Video demonstrates human stories and leaders in the fight to transform Medicare at the level of medicine, the US military, industry, and government. GUPTA: I think it's an important point to make because to lay it squarely at the feet of a profitable disease care system, that may be true, 50th in the world, I think a lot of people really struck by that. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. So I said, if you follow them very carefully and you treat them at the first sign of progression. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? So we provide incentives for people to engage in healthier behavior. MARTIN: Can you feel this? So, we decided to give you a look at a typical operating room bill and that breaks down. As Berwick says in the film, "We're in Mann Gulch. That's good. It's hard to say good-bye to the patients. But it's more than cost. UNIDENTIFIED MALE: These are all one person's? DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. They may be a member of a health plan for a year and maybe no longer. UNIDENTIFIED MALE: A day, for 25 years. You know? We are going to take a short break. We want more specialists. And the company did nothing. So tired of it. Got approved very quickly. And it wasn't because procedures were more expensive in Miami than in Minneapolis. It just doesn't work out financially. BERWICK: The healthcare system is unsustainable. You don't necessarily make a lot of investments in preventive care for someone who's not going to be a part of your health plan for a long period of time. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. And from that point on I realized that I don't want to be on this. 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. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . MARSHALL: It doesn't matter if I do one stent or five or ten stents. UNIDENTIFIED FEMALE: Hi. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. 1. s03e01 - Fire Escape Tran script. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. GUPTA: I mean, both physically and mentally. So inhale. This is going to caused about %800 dollars. GRUBER: For everybody. 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. Cost about $1200. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. You are going to hear from many different voices with varying opinions and backgrounds tonight. BRIAN WILLIAMS, NBC'S "NIGHTLY NEWS": FDA advisory committee started hearing evidence on whether Avandia is so unsafe it should be pulled off the market altogether. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. The fire overtook the crew, killing 13 men and burning 3,200 acres. I was in the hospital for two weeks. UNIDENTIFIED FEMALE: They are all combined. This is a chest tube. Until my doctor said to me, I don't know what else to do for you. Can't wait to be there. And people do. They didn't want to have a new competitor. People eat what's cheap and what's available. And now I'm -- 25 years later and I'm in pretty good shape. The film is about finding a way out. UNIDENTIFIED FEMALE: Take them away from him. YATES: I was on Parazasin just for nightmares. Aladdin (1992)/Transcript. Do you understand? Not just the health, but healthcare, the health of a nation. This is Prazosin. UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. This is major reason why we see kids getting fat in this country. (BEGIN VIDEO CLIP) DR. ERIN MARTIN, PRIMARY CARE: As a primary care physician, we are supposed to be the people that are making sure the patients don't get sick and they have everything they need to maintain health. He overdosed. UNIDENTIFIED MALE: I do it again on Friday. 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. Let me just take a listen to you. MARSHALL: Me, personally, I'm on a salary. When you're injured they feed you, feed you, feed you all this stuff. What we do with waste in healthcare. And that's parts of what a really great healthcare system would do. But I think, to be honest, when you add more people to the system; that raises costs. The costs are going through the roof and the ability to help these service members and their families recover and repair and come back to a functional life is getting less and less. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. About a 30 percent increase in the risk of heart attack and related complications. You bike to work today? I never had a personal doctor, family doctor, nothing, all my life. BROWNLEE: We spend $300 billion a year on pharmaceuticals. OK? 0. (CROSSTALK) UNIDENTIFIED MALE: That's not -- yes. These are techniques that should be used to relieve symptoms. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. There's a contradiction to what we do. And I say that as doctor. 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. WEIL: Where are you from? They couldn't get insurance. POTTER: We have been trying to reform the health care system for a hundred years. A documentary highlighting the shortcomings of the American healthcare system. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? OSBORN: Oh, it's so beautiful! Escape Fire Worksheet Escape Fire: The Fight to Rescue American Healthcare HSC 507 Introduction to Health Service Systems & Organizations Central Michigan University - Spring 2020 Print your name: _Kya Churchill _____ The video has been placed on reserve in the CMU Library. BURD: All right. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. You can't have a cafeteria that doesn't have calorie counts on it. CHO: I know, you look really good. A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. UNIDENTIFIED FEMALE: How are you? And Doctor Jeff Cain. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? Expand the Transcripts and captions section if closed, then select Upload. People say you're doing this radical intervention. It is so addictive. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. NISSEN: We're not saying that people are doing these procedures for profit. I was taking 64 pills a day of combinations of Roxaset and Oxycotin. Michelle? Treated for sciatic nerve, back, L-3, L-4, L-5, swelling left side of my brain, and extreme PTSD. ROBIN CARNES, WALTER REED ARMY MEDICAL ENTER MEDITATION INSTRUCTOR: The first thing I'd like to do is teach you a breathing exercise with a targeted effect on post-traumatic stress. OK. And you say that you can help negotiate the price of these bills down, what do you tell people? Fire Escape Transcript. 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. The film examines the powerful forces trying to . CHO: I was trying to figure out how much Yvonne's care would have been over the years, and I think it's well over $1.5 million. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. So he figured I was going to die because I was in such bad shape. When medicine became a business, we lost our moral compass. UNIDENTIFIED FEMALE: When I was a kid. So we took the men with prostate cancer. All right. He lit a match and he lit a fire at his own feet. Let me get right to it, Erin. It doesn't reward them for keeping their patients healthy. GUPTA: United health care makes a lot of money. There's been a lot of change in me in that transition between La Clinica and here. Dodge survived, nearly unharmed. GUPTA: Why not just pay them more money? 2. MARTIN: Bye. Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health catastrophe and the company didn't tell anybody. So we're going to open up some chi? DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. UNIDENTIFIED MALE: I feel like I'm warming up a little bit. Now you're going to get the scissors. Healthcare reform was a good place to start, but it will do little to address the root problems. 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? 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