In Latin, it means, above all, do no harm. Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. And every year they have to turn people away. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. Rescue care is second to none. They have talked about a child between age of one and four, having the third most common causes of homicide. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. Impressive. And you know, our grandparents did not eat stuff like this. If they are surgeons, they get paid for each procedure. Wag Dodge survived, nearly unharmed, in his escape fire. And I say that as doctor. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. ORNISH: In medical school, I was learning to do bypass surgery with Michael DeBakey, the heart surgeon. You just never get to the bottom of what's causing all of these problems that they are having. And I thought, once I get this, I won't have the blockages anymore. I mean, an obvious one is nutrition, which is almost omitted from medical education. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: All I hear is how we're going to give more people access to the present system and how we're going to pay for it. You will learn if your health care costs are going to go down any time soon. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. WARD: For a long period of time I was hiding. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. UNIDENTIFIED FEMALE: Do you have any pain right now? When I'm running and it's a hot day and I feel like giving up, it never fails. And the company did nothing. And that was the first study showing that heart disease was reversible. A flower for you. Everybody is doing their job, we just design the jobs wrong. It is a burning platform and they see this. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. That may strike people as very high. GUPTA: Why not just pay them more money? MARTIN: OK? So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. Click on "Export" and choose your preferred file format. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? Thanks for watching. UNIDENTIFIED MALE: Yes. 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. Ten allotted. I have an acutely suicidal patient in my office that I need help with. So that's rewarding for me. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. NISSEN: I do. 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. A different perspective that there's a different way of doing things, that it's possible. In the dialog that appears, select the language of the file you're uploading. Have you -- UNIDENTIFIED FEMALE: 2008. We've just created a completely different system here. So diabetics, (INAUDIBLE) costs. And welcome home. They can't recognize an invention when it's among them and they can't give up their old habits. That is ridiculous. YATES: Wow. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. (LAUGHTER) Infinitely. So I went into the hospital and they told me I had had a heart attack. So tired of it. Where I'm at right now, patients are in desperate need of care. I mean, give me a break. Let me take a listen to you. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. Because what we think is best for us often isn't. UNIDENTIFIED MALE: I do it again on Friday. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. UNIDENTIFIED MALE: I feel like I'm warming up a little bit. What we don't know, is that a fundamental change? Committed to her living longer and better. 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. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. No soldier should have to go through this. Well, it drives demand. But I think, to be honest, when you add more people to the system; that raises costs. 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. Published: Santa Monica, Calif. : Lionsgate, [2013]. Wag Dodge had an idea. GUPTA: A lot of these stents are unnecessary? Hello, how are you? Tell me what happened. You know, Nancy, we talked a lot about these bills. And I had a massive heart attack. Most diseases don't happen overnight. Right? UNIDENTIFIED FEMALE: OK. OK, so let's go into our meditation practice. And water, they are saying, I'm going to have to give up to get there. JOE BIDEN, VICE PRESIDENT: Good morning, folks, how are you? 0. 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. Psychologically, you deal with a lot of these sorts of things. GUPTA: How big a problem is this then? They are going to healthcare. GUPTA: I'm salaried too as a physician. It just wants you to keep coming back for your care of your chronic disease. But he can have anywhere between five and 10 milligrams of morphine. 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. I have an insurance now perhaps. I lost a lot of good men. We are going to take a short break. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? 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. 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. . Going to go look for it. UNIDENTIFIED MALE: What do we want? That isn't true in Canada. more . The next group of people are people that have tried medical therapy, that are on medical therapy and failing. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. DR. TIERAONA LOW DOG, FELLOWSHIP DIRECTOR, ARIZONA CENTER FOR INTEGRATIVE MEDICINE: We want to expose clinicians to a broader way of seeing the patient a deeper understanding of healing and a larger toolbox from which to choose for therapies. So putting more money into innovations and all of these things, yes, they're need in certain instances, especially emergency care, and things like that. CARNES: I will be at your side should anything challenging come up for you. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. BROWNLEE: We have a disease care system, and we have a very profitable disease care system. 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. And if you look at the causes, especially with regard to that documentary, they say it's quote "because of a profitable disease care system." If I'm frustrated by anything, it's that more of the nation hasn't adopted this. Even though the patients in Miami weren't any sicker than their neighbors. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. GUPTA: You feel better when you're healthier too. I mean, where did that idea come from? 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. detail. TUCKSON: Primary care doctors are being cared more. 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. If you account for that, we do much better. We even found that when you change your lifestyle, over 500 genes were changed. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. UNIDENTIFIED MALE: But Mommy, what are you going to do? UNIDENTIFIED FEMALE: Hi. Dodge survived, nearly unharmed. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. Cost about $1200. They did not tell the FDA, and they did not tell patients. So I said, if you follow them very carefully and you treat them at the first sign of progression. 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: What gives lobbyists power is the amount of money they have for campaign contributions. Because I've gotten a lot of inspiration from the fellowship. All my health issues have gone away. I tried to get him up, he just rolled himself out. UNIDENTIFIED MALE: Bye. SGT. And when we come back, just how much does profit play a role in all these treatment decisions. Aladdin and the King of Thieves/Transcript. He was featured in the film. That's good. And so 15 firefighters were trapped. Because they're not using health care now. UNIDENTIFIED MALE: Six and over. MARTIN: How much were you drinking before? NISSEN: Finally, the FDA put severe restrictions on the drug. Treated for sciatic nerve, back, L-3, L-4, L-5, swelling left side of my brain, and extreme PTSD. That's it. 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. NISSEN: Now, the leading cause of death in diabetes is heart disease. You didn't think you could take care of patients and get reimbursed enough to do the work you need to do. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. 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. Firefighters said they received about 12 calls . Aladdin (1992)/Transcript. Thank you all. The balloon is inflated to widen the blocked areas. I don't believe in that stuff. And we're going to be doing CPR on a patient. (END VIDEO CLIP) GUPTA: And Yvonne I the patient in that video. Alexander/Transcript. GUPTA: So it doesn't matter. 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. PROTESTERS: Healthcare. The easiest starting point was in the 30,000 non-union workforce, and I believe that within four years all of our employees will get this kind of healthcare plan. 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. It just doesn't work out financially. Log in to your account. 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. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. All right, so take a breath. If you're on a fixed income, what are you going to do for your family? NIEMTZOW: Normally you would? Physical Desc: ROSS: When do you think it would be good to try it? UNIDENTIFIED MALE: I quit drinking, too. I'm Dr. Sanjay Gupta. And it's just the last thing that you're really concerned about. To get the best results, use these formatting tips: To force the start of a new caption . NIEMTZOW: If you didn't have the acupuncture needles, how do you think you'd be feeling? That was job number one for them. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. (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. But, in fact, the more I looked, the more I found that there's all this stuff in medicine that we don't think about that is actually harmful. Got to push through it. There's the cost of covering people who simply don't have insurance or can't pay. YATES: That's every single signature that says that you're good to go to get out of Walter Reed and move on with my travel right there. You get paid for the service that you're doing as opposed to for the overall care of the patient. It expands the artery to hold it open and allow the blood to flow. NISSEN: You know, DVT and pulmonary emboli. And is it still traveling into your neck? I'm Dr. Sanjay Gupta. GUPTA: Erin, do you want to respond to that? Hold my beer while I shoot this gator, you know? that is going to raise cause. UNIDENTIFIED FEMALE: You need to get up and pee? I stopped taking my medicine months ago. MARSHALL: Yes, sir. My job is to provide the right care for the right patient at the right time. YATES: I was on Parazasin just for nightmares. I'm really, really pleased. I lost him. And for the large majority of people we help, they often don't understand what many of the charges are. Mountains of Afghanistan are not easy to climb, so pain in my back. ROSS: All right. ESCAPE FIRE: The Fight to Rescue American Healthcare tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system? WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. The army sergeant general directed that we establish the pain management task force to take a look at alternatives to narcotics. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. Who's next? There's the bright blue slush. We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. I was head of corporate communications, which means I was the top public relations officer for the company. Come back in a month or so? NISSEN: Yes, but we have to educate patients. Incentivizing them to be healthy or not charging them as much if they're healthy. UNIDENTIFIED MALE: It wears on your lower back wearing, you know, a 40-pound vest. BROWNLEE: We spend a spectacular amount of money on healthcare. GUPTA: Are you optimistic about the future when it am could to family care, and when it comes to our health care overall? MARTIN: I had to do the fellowship because it was kind of my little ray of hope that things could be better, things can be done differently. It was important to keep expressing the hospital's position. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. 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. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. We need primary care doctors. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. If it happened to me, it happens to a whole lot more people that are almost invisible to the system. (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. 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. PROTESTERS: Now. DAVENPORT-ENNIS: So, I think with some patients it clearly will. 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. 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. Determine, did you indeed have two MRI's during the course of one week? UNIDENTIFIED FEMALE: Because he's real sleepy? YATES: I meditate, and it has opened up a whole new world for me. That's not good medicine. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. And then we're not going to help anybody. Tom's Escape In The Fire Escape. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. Expand the Transcripts and captions section if closed, then select Upload. Also remember this. This is a lot worse. RICE: And I was surprised about this, particularly the data. ROSS: What do you think about that? 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. May everyone be well. BERWICK: Everybody is doing what makes sense to them individually. He's got Lunesta and also has Valium. And that's the problem. 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. (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. We're part of the community. NISSEN: We do have a problem in America, and that is we have misaligned incentives. And interestingly, patients really respond to that. That simply means they get paid for each office visit. They are patients with heart failure, they are morbidly obese patients. &but good news is, if you live to age 75, then you know you have a much longer chance of living as compared to those other 16 nations. They can pretty much get away with increasing the rates as much as they want to. If somebody has an infection, we give anti-infectious agents. I had difficulty sleeping at night. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. Instead of basing things on outcomes, on how good of a job we're doing, the government sets the reimbursement completely on the number of patients that we see. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. I'm optimistic about the future. UNIDENTIFIED CHILD: There we go. WEIL: Right. We're talking about a $3 or $4 billion a year drug. And, in fact, they were more likely to die. I'm not interested in getting my productivity up. Format: DVD Edition: Widescreen. 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. UNIDENTIFIED FEMALE: These are all name brand. A stapler, this stapler that is often to used in surgery, like this? ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. 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. UNIDENTIFIED FEMALE: Loratab, Naproxen. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. He told Dean, how long is the program? OK? And in some ways, I think of a lot of what's happening in health care is kind of dark matter. I think five or six of them are on the waiting list. It's still a struggle. Look at the thinness. Select Open transcript . Recognize that you are this spacious, welcoming, open awareness no matter what thought, no matter what feeling, no matter what sensation or circumstance happens to arise. UNIDENTIFIED MALE: Once I found out what was really wrong with me. Fire Escape Transcript. GUPTA: Doctor Tuckson, I mean, one of the concerns -- and again, we will get right to it, it's simply not reimbursing enough money for primary care doctors. 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. THIS IS A RUSH TRANSCRIPT. You can export to TXT, DOCX, PDF, HTML, and many . Job number two was to make sure that there was not a public option. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. ROBERTSON: It's a financial necessity. That ended and it rose quickly. Am I going to be paying more? I mean, I can't think of a single negative in doing this. GUPTA: You know, one can't help but walk away from the documentary, Doctor , frankly, they are scared of stents. There were even times, honestly, that I looked in the mirror and said, how did you get here? (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. It doesn't always work. Michelle? 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. You know, they'll actually fix it. And how to know if you're being prescribed unnecessary procedures. Some would say overrewarded specialty and subspecialties. I smoked six cigars a day, 10 cups of coffee, a lot of wine. We create a public expectation that more is better, which isn't actually true so people seek more. Are you incentivized to do more stents? DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. Healthcare, it's headed for really, really bad trouble. 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. Seventy-three seconds into the 28 January 1986 . UNIDENTIFIED MALE: Yes. How are you feeling? 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. There's nothing else I can do. You know? The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. (COMMERCIAL BREAK) SHANNON BROWNLEE, MEDICAL JOURNALIST: Dark matter is a discovery by astronomers that there is a huge amount of the universe that we can't see. He tried to get the other smoke jumpers to join him, and nobody did. 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. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. I need some help over here. 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. I said, there's got to be a better way. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? Our approach here is completely holistic. What do you say to people when they say look, pay Erin Martin a little more money, you guys are making $5 billion. It's just a terrible tragedy for patients. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. I'm not changed, but I'm changing. Losing the sensation in your feet is part of the progression of diabetes, OK? A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. He overdosed. And Doctor Nissen is in salaried as well. I mean, when the cost of some of the things we use on a regular basis. 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) Be in what gives lobbyists power is the amount of money they have for campaign contributions problems they... That is we have a stent in your coronaries because I 've gotten a of! Create a public expectation that more of the UNITED STATES: Following the example places..., in his escape FIRE tackles one of the file you & # x27 ; uploading! 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