Insurance companies have always been able to regulate the rates they charge. UNIDENTIFIED MALE: What are you going to do at work? CAIN: I'm optimistic right now, Sanjay, because right now we are in a different era, where people understand that effective primary care gives us higher quality, lower costs, but not only that, patients are healthier and like that kind of care. A heart cath, get another stent. And they have a hard time believing that these simple choices that we make in our lives each day can make such a powerful difference. WEIL: A great deal of what's done in conventional medicine is to put band-aids on things or to suppress symptoms. (END VIDEO CLIP) NISSEN: I was doing a Google search, and what I found was a Web site in the United Kingdom where the clinical trials done with Avandia were actually partially disclosed. But we're going to talk to them about it still, you know? It's the same challenge. I lost a lot of good men. These for- profit companies by law have to serve shareholders. We're all salaried so the decision on what we do for a patient is dependent upon what the patient needs not on our financial incentives. Brownlee, Shannon, commentator. And some people even that are getting stents don't have symptoms. It's been a wild ride. GUPTA: So you're salaried. We want more tests. 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. 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. So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. I felt like there's got to be something different, something better. Look at our results, our life span isn't even in the top 20. ROSS: We've become a culture where you drive up, you get what you want, you get it fast, you get it right away, and you drive off. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. I mean, I can't think of a single negative in doing this. I think many of her cardiac catheterizations instead would not have been necessary. 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. I'm Dr. Sanjay Gupta. To get people to eat different, to eat, you know, to lose weight, to exercise regularly, those are hard things to get people to do, and we need to be better at it. One of the ways to think about saving money in health care is to focus our energies on that 20 percent of patients and think about treating those people in a more effective way. Little did I know that it was followed by years of the same thing over and over and over again. Is that how you get paid? BERWICK: The healthcare system is unsustainable. BROWNLEE: There's a saying in health care policy that 20 percent of the patients account for 80 percent of the costs, and the majority of those costs are when they are repeatedly hospitalized. DR. PETER CARROLL, CHAIR, DEPARTMENT OF UROLOGY, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: My path crossed with Dean's because we both wanted to bring rigorous clinical trial testing to this hypothesis that lifestyle intervention could have a impact on men with early stage prostate cancer. Even if I lose 30 more pounds, which probably is my ultimate target, I'm not going to stop doing this. I'm not interested in getting my productivity up. And that model has continued until today. And how to know if you're being prescribed unnecessary procedures. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. She joins us now. Rescue care is second to none. Good. Our forefathers in medicine were really about patients. I can't be having heart problems. If it's a radiologist, they get paid for each CT scan they deliver. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. We're not talking about a handful of people here. Can't wait to be there. It's not whole food as nature produces it. Did you have a good day today? 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. 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. A lot of unnecessary stents? 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. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. She ended up having another open heart operation, another bypass operation. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. But I think the economic imperatives are much stronger now. And I think we're in a great deal of trouble because of that. It is an IV like this, about $280 just for the IV bag. UNIDENTIFIED MALE: Nine months. If you select our human service, your transcript will be ready within 24 hours. NIEMTZOW: Because of that? These are techniques that should be used to relieve symptoms. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). All right. But I'm doing it. I'd rather be shot again than go through withdrawals of coming off that medicine. 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. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. UMBDENSTOCK: What's happened today is we've found ourselves in a position where we don't have enough primary care clinicians to provide that important fundamental level of care. GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: This is a national problem for us, you know, we're seeing the military just being a microcosm, I think, of the problems society is having. How long were you there? THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. This is what you do for a living. RICE: And I was surprised about this, particularly the data. UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. Doctor , let me start with you. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. The documents are coming out in these court suits, it looks worse and worse. Compared to having your chest cut open? GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. 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. It's an expensive world to live in in terms of getting your voice heard in D.C., but that's the whole function of advocacy. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. It's just a terrible tragedy for patients. Now we're kind of dealing with the consequences. I am back in the chest pain center with a pretty sick patient, and I'm going to need you to call attending phone, too. Do you understand? The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. 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. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. We have a -- we have a motto in medicine. DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. A different perspective that there's a different way of doing things, that it's possible. detail. So, a hospital like the one you just saw there. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . That's not good medicine. And I hope our new generation of health professionals will catalyze this social movement that's necessary and enough people get aroused enough about the situation and see it for what it is and then start some kind of grassroots movement to change the political balance of power. Something like that. JONAS: There's very large randomized trials done at multiple centers that have demonstrated that acupuncture works, so we put together a study to see if we can actually insert this simple acupuncture technique during the aerovacs of wounded soldiers into Walter Reed and other medical centers in the United States. They can pretty much get away with increasing the rates as much as they want to. I was so dependent on my pain medication. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. You know? Up next, CNN Films presents "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." I was taking 64 pills a day of combinations of Roxaset and Oxycotin. It's here, right in the center of your chest. 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. But I decided to give it a shot. And the problem is, some of those procedures will lead to bad outcomes. And water, they are saying, I'm going to have to give up to get there. 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. GUPTA: How big a problem is this then? It's still not over, but it's better from Germany, I promise you that. GUPTA: Can you actually get a-hold of those people? I mean, what is that, boy? And it wasn't because procedures were more expensive in Miami than in Minneapolis. 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. We need a whole new kind of medicine. UNIDENTIFIED MALE: Yes. We don't know what they are. Physical Desc: All right? Let me just take a listen to you. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. So, if there's a concern someone has a tumor, they who use a needle like this. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. UNIDENTIFIED MALE: A platoon of 23. I took care of them and I was responsible for them and just worrying about if somebody else is going to do for them what they need. If we can prevent that and even reverse it, that's how we're going to make true health care, not just sick care available. In fact, more soldiers died last year from non-combat injuries than during war. When I was at U.S. News and World Report, I wrote cover stories about how great the newest and greatest treatment and pill and procedure was. And healthcare doesn't need to be immune to that. There's the cost of covering people who simply don't have insurance or can't pay. In the dialog that appears, select the language of the file you're uploading. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. How are you? Or at least we think we do. UNIDENTIFIED FEMALE: Right. UNIDENTIFIED MALE: No. If they are surgeons, they get paid for each procedure. I was head of corporate communications, which means I was the top public relations officer for the company. I was on Trizadon. I mean, an obvious one is nutrition, which is almost omitted from medical education. Never needed you. Where I'm at right now, patients are in desperate need of care. Got approved very quickly. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. GUPTA: A lot of these stents are unnecessary? GUPTA: But, why are these causing hospitals so expensive? UNIDENTIFIED MALE: Once I found out what was really wrong with me. Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? This is what he's got left. . You're doing this radical intervention, you know, I say radical? But, you know, we have the means to decrease disease. OK? (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: In the last few years, a profound change has begun in American medicine. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. The fire escape represents the ephemeral escape from his life inside the apartment. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. I've spent more than 30 years of doing studies showing that heart disease can be reversed by changing what we eat, how we respond to stress, how much we exercise, and how much love and support we have in our lives. But this program has just inspired me to press forward. STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. Now, thanks to both of you for joining us. UNIDENTIFIED MALE: I feel like I'm warming up a little bit. UNIDENTIFIED MALE: I love you, too! But I think, to be honest, when you add more people to the system; that raises costs. But so what, right? It would empower patients. This suture costs about $200. He asked for pain medication. What is really striking is how little they have written the last few years. SGT. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. I was on anti-depressants. We pay doctors to see patients, so they see a lot of patients. 27 cardiac catheterization and well over seven stents. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. They can't recognize an invention when it's among them and they can't give up their old habits. We need to change the nature of medicine. That may strike people as very high. What would happen? You know, they'll actually fix it. UNIDENTIFIED MALE: Without the financial incentives, there's no way I could have gotten to the point that I am now in saving literally thousands of dollars over the past few years by being healthier. GUPTA: Erin, what did you think about that particular theme? (LAUGHTER) NIEMTZOW: Hi. On my way. 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. We are second to none in this country for those things. American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. 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. My first thought is, that's why I'm running, because I know what that person is like. UNIDENTIFIED FEMALE: If there is a 50-minute queue, I'm sure we can probably squeeze them into the schedule. Escape Fire escape fire University Central Michigan University Course Introduction to Health Service Organizations and Systems (HSC 507) Academic year 2021/2022 Helpful?00 Share Comments Please sign inor registerto post comments. 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. We have a disease management system. PROTESTERS: Healthcare. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. He is also a president of the society for interventional and geography in intervention. I came to Walter Reed. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. Half. It's still a struggle. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? 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. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. All right. I mean, look at our results. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. 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. Escape Fire: The Fight to Rescue American Healthcare is a 2012 feature-length documentary directed by Matthew Heineman and Susan Froemke and released by Roadside Attractions. May everyone be healthy. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. Ten allotted. 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. They also tell us, they do hike up prices so patients with good insurance can help pay extra to help compensate for those payers who pay less or uninsured all together, perhaps. UNIDENTIFIED FEMALE: Hello, Mr. Fields. UNIDENTIFIED MALE: Yes. You know, the ads always end with the same phrase, ask your doctor. OK, so let's go into our meditation practice. UNIDENTIFIED FEMALE: These are all name brand. UNIDENTIFIED FEMALE: Because he's real sleepy? Carry a lot of weight because I'm infantry. The power lies with corporations and corporate interests and the lobbyists that they buy. UNIDENTIFIED MALE: Six and over. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. UNIDENTIFIED MALE: Not, not when I'm doing that. 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. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. Who should get a stent? I can act more as a guide for patients, taking the time to educate them and having them understand that there are choices that they have the power to make for themselves. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. 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. UNIDENTIFIED MALE: But Mommy, what are you going to do? And welcome home. We have a model that works simply by making changes in diet and lifestyles. Hello, how are you? They become more productive. I mean, the average price tag for a single hospital admission can be really eye-popping. Then all of a sudden I started getting chest pains. BROWNLEE: We spend a spectacular amount of money on healthcare. Aladdin (2019)/Transcript. Fire Escape Transcript. MARTIN: How are you today? So here I am going in and out of the hospital to find out what's going on. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. There's nothing else I can do. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. OK? It is the largest health insurance company in the country. I'm two and a half months out of combat. 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 MALE: People often think it has to be a new drug or a new laser or something really high-tech and expensive for it to be powerful. So he figured I was going to die because I was in such bad shape. Going back home. 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. Transcripts Dragons: The Nine Realms Fire Escape Script view. (COMMERCIAL BREAK). One of the great contributions of America to world cuisine, you know, fake bread. Our health care system. NIEMTZOW: Any pain? I mean, the impression I think was a little misleading there, don't you think Nissen? Also remember this. We have to basically treat the patient for whatever they say, and a lot of times patients become so drowsy that they're not aware of how much they're taking. Thank you so much. 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. It's much better to try to work at a deeper level. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. UNIDENTIFIED MALE: It was OK. Kind of gave me more idea on what to eat. GUPTA: So, tell me how that would work? I lost him. UNIDENTIFIED MALE: When do we want it? MARTIN: Because of the bottom line, because of the cuts that are coming through the government, if it came to the point where they couldn't pay me anymore, that would suck, but I'm not afraid. I know you're heading home and you're excited. UNIDENTIFIED MALE: I feel different. ROSS: How long ago was that? It includes the mandate, the requirement that we all have to buy their coverage. I have an acutely suicidal patient in my office that I need help with. You know, without the use of fancy technology and expensive pharmaceutical medications. It really does. It goes back to Teddy Roosevelt. BURD: All we did was facilitate smart choices for people and develop this culture of health and fitness. We are more likely to get a knee replacement or have a cat scanner, have an MRI. CARNES: Release the breath in a smooth, even stream out. WARD: For a long period of time I was hiding. Yes, this is Dr. Martin over at La Clinica. Who's next? You just look different. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. (COMMERCIAL BREAK) DR. WAYNE JONAS, PRESIDENT, SAMUELI INSTITUTE, MILITARY MEDICAL RESEARCH: If our civilian healthcare system is smoldering and we see it's going to catch on fire and burn pretty soon, it is going to be unsustainable because of the costs, the military system is already on fire. 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