She needs a follow-up within three month with an echo. Little did I know that it was followed by years of the same thing over and over and over again. This is just an unbelievable amount of stents and cardiac caths. Can't wait to be there. If you can delay treatment, then that man is not at risk for side effects during that period of time. The film is about finding a way out. And I say that as doctor. Sometimes we're talking about them on a daily basis. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. (END VIDEO CLIP) NISSEN: There was a drug on the market, Avandia. There's saving money and there's cost effective. To a man with a hammer, everything looks like a nail. Suture, one that's used in every operating room in the world. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. UNIDENTIFIED MALE: It was OK. Kind of gave me more idea on what to eat. It was important to keep expressing the hospital's position. A flower for you. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. All Dogs Go to Heaven 2/Transcript. I haven't exercised. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. MARTIN: Uh-huh. How did -- what did think about that? In the summer of 2007, I read about a health care expedition that was being held by Remote Area Medical a few miles from where I grew up. UNIDENTIFIED REPORTER: It's an idea that's received national attention. They told no one. And chromosomes have all genetic information on them. You've seen a lot. When you're injured they feed you, feed you, feed you all this stuff. Original Airdate 08/17/2022. Do you understand? I'm Dr. Sanjay Gupta. Am I going to be paying more? And those are surprising. I came to Walter Reed. There was obviously a problem. Seventy percent of all the deaths in diabetes are heart disease. I was so dependent on my pain medication. It's still a struggle. UNIDENTIFIED MALE: Six and over. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. I know you're heading home and you're excited. UNIDENTIFIED MALE: We have had enough. Those are the kind of things that would actually have an impact. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. These lifestyle changes cannot only work as well as drugs and surgery, but often even better at a fraction of the cost and the only side effects are good ones. And it's got to the point where the pain's radiating from my back down to my hips and then down to my thighs. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. And ironically, it was only two hours away at the Cleveland Clinic. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. I was a bit surprised. I'm not interested in getting my productivity up. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. To see if lifestyle changes can affect your (INAUDIBLE) even telomeres. 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. Try to understand where the redundancies are. We have made all of this unhealthy food the cheapest and most available food. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. GUPTA: Erin, what did you think about that particular theme? GUPTA: United health care makes a lot of money. Cost about $1200. Jonathan, you know, we want better care and lower costs. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. 5. All of us live here and work here. Okay. DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. That requires so much work, but we do it because we're committed to having her stay out of the hospital. BROWNLEE: We spend a spectacular amount of money on healthcare. Heart cath, get another stent. He is the president of the American Academy of Family Physicians. If we just change reimbursement, it's a game changer, we change medical practice and we change medical education. The Issues. Just sore. I say, radical? And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. That is chest pain that is actually currently damaging the heart in patients. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? The medication depresses you, it makes you think that it's all you're ever going to be in. He's like really not listening very well. OK, so let's go into our meditation practice. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. Let me distinguish two terms. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. I can't tell you how shocked we were when we saw her the first time, because here was a young woman whose diabetes was not well controlled. And that's the problem. ROSS: What's the regular food? How to make a healthy choices. GUPTA: Stay with us. You have all these stents, and these stents, once they go in, they never come out and are part of you. But he can have anywhere between five and 10 milligrams of morphine. BURD: You can't say you're interested in a culture of health and fitness without providing a first-class gym. (LAUGHTER) NIEMTZOW: Hi. We don't have to spend ourselves into poverty on healthcare. That's good. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Physicians are well intentioned. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. Hello, how are you? What do you think? It was wonderful. Published: Santa Monica, Calif. : Lionsgate, [2013]. 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. All Dogs Go to Heaven/Transcript. We want that. But, the American people are going to want something like that and that is going to be their perception. Not just the health, but healthcare, the health of a nation. They are patients with heart failure, they are morbidly obese patients. POTTER: We have been trying to reform the health care system for a hundred years. The present healthcare system doesn't work. 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. You almost forget that what you're doing is providing healthcare. GUPTA: And I want to leave all of you at home with a thought as well. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? This is incentives the system so that patient have a less specifically to be of picking the right choice. So, we decided to give you a look at a typical operating room bill and that breaks down. You have the ability to reduce or raise the risk of many preventable diseases. Now we're kind of dealing with the consequences. The documents are coming out in these court suits, it looks worse and worse. It's here, right in the center of your chest. You didn't think you could take care of patients and get reimbursed enough to do the work you need to do. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. Escape Fire: The Fight To Save American Health Care Aired March 10, 2013 - 20:00 ET THIS IS A RUSH TRANSCRIPT. And for the large majority of people we help, they often don't understand what many of the charges are. We're not talking about a handful of people here. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. That prevents tissues from renewing themselves in the body and diseases take hold. Afghanistan? We just spent $1,000. 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. You get paid for the service that you're doing as opposed to for the overall care of the patient. UNIDENTIFIED MALE: But Mommy, what are you going to do? Thank you so much. But you end up being this revolving door. All Americans have accepted for 50 or more years in the automobile insurance industry that driving record dictates premium. GUPTA: Sometimes the patients demand this stuff. And you've had heart attacks. Our approach here is completely holistic. What would happen? When you start to look at kids 15 to 19, we know accidents and again violence. What we don't know, is that a fundamental change? detail. Tom's Escape In The Fire Escape. Much more than money spent on much more expensive services. The fire raged past Wag Dodge and overtook the crew, killing thirteen men and burning 3,200 acres. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. 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. 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. And in some ways, I think of a lot of what's happening in health care is kind of dark matter. They had to live with some of the new consumer protections in the bill that does make it illegal for companies to just cancel someone's policy because of a preexisting condition. And, in fact, they were more likely to die. We have underpaid on a chronic basis. Viewers will see this language when they . And you're here today with chest pain. Ten allotted. Things could move in that direction here, and this is not the choice of the doctor. They become more productive. They sent me home with them. Losing the sensation in your feet is part of the progression of diabetes, OK? UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. It's the best treatment and it saves lives, period. If you're on a fixed income, what are you going to do for your family? Firefighters said they received about 12 calls . Thanks for watching. THIS IS A RUSH TRANSCRIPT. 1. s03e01 - Fire Escape Tran script. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. Got approved very quickly. 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. Our health care system. Also, Doctor Reed Tuckson, he is the chief medical officer for the united health group. And the company did nothing. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. 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. And when we work at that level, we find people are much more likely to make these sustainable changes and the patient learns how to empower themselves and to transform their lives. In Latin, it means, above all, do no harm. PROTESTERS: Healthcare. People come in and you try and fix one thing and they come back for the same thing over and over and over. It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. It was a great life. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. 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. He told Dean, how long is the program? 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. UNIDENTIFIED FEMALE: Do you want to do a pill count with me? MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. An estimated 600,000 stent procedures are performed every year in the United States. We say they don't prevent heart attacks, they don't lengthen life. We're really mortgaging the future. BERWICK: Everybody is doing what makes sense to them individually. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. It is the largest health insurance company in the country. This is major reason why we see kids getting fat in this country. UNIDENTIFIED MALE: Without the financial incentives, there's no way I could have gotten to the point that I am now, at saving literally thousands of dollars over the past few years by being healthier. Aladdin (2019)/Transcript. 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. 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. ROSS: I just want to review this pain. Hold my beer while I shoot this gator, you know? My energy level is up. YATES: I meditate, and it has opened up a whole new world for me. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? UNIDENTIFIED MALE: Good, how have you been? Meditation takes the place of that. And sometimes push the plate away. Host virtual events and webinars to increase engagement and generate leads. They can pretty much get away with increasing the rates as much as they want to. And interestingly, patients really respond to that. the play Tom is seen standing in a fire escape during many acts. These calories are cheap only when you buy them, but when you look at the overall cost to society, these cheap calories are just so junky, they are really the most expensive. BROWNLEE: 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. UNIDENTIFIED REPORTER: Safeway's healthcare costs have remained flat compared to a 40 percent jump for most other companies. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. And to me, that's not the only issue. 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. I had to do something. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. You know? Well, it drives demand. It's not whole food as nature produces it. We're part of the community. 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. 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. I can't be having heart problems. Thanks all of you for joining us. OSBORNE: I have lost -- since last year I've lost 21 pounds. And if you look at even devices like -- this is a needle that's used for biopsy. Came off the mountain with only eight. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. How long were you there? Published Feb 22, 2001. UNIDENTIFIED MALE: Let me get that jacket away from him. We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. So, you compare us to those other nations, you have to understand that we come to the table with the bigger burden of disease. Hold them accountable and then talk to them, you know, on a weekly basis. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. ORNISH: There's very little evidence that these conventional treatments make you live longer, but they cause many men to be impotent or incontinent or both. 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. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. So that's rewarding for me. 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. It would be a very different system that probably would be less high-tech and more high touch. 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? I'm going to the emergency department. The balloon is inflated to widen the blocked areas. We don't know what they are. MARTIN: A day? Wag Dodge had an idea. GRUBER: For everybody. 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. DR. RICHARD NIEMTZOW, DIRECTOR, ANDREWS AIR FORCE ACUPUNCTURE CENTER: Right there. "Escape Fire" airs March 10 on CNN. It's still not over, but it's better from Germany, I promise you that. The small wire cage you see there is the actual step. 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. 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. It's a happy time in my life right now. UNIDENTIFIED MALE: I quit drinking, too. Don't need you, don't need you. I mean, give me a break. And we're going to be doing CPR on a patient. We need to change the nature of medicine. And I think we're in a great deal of trouble because of that. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. $300 billion on drugs. Sometimes it's related to what the individuals actually have access to. We need primary care doctors. U.S. caregivers are told you've got to keep me pain free, you're going to do that. 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. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. Escape Fire. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. CINDY ROBERTSON, ADMINISTRATOR, MD-COLOMBIA FAMILY HEALTH CENTER: We're the only clinic in this community county, so it's about 20,000 people overall. We're on track for that on Tuesday. Delhi Building Collapse Video: 100 , Literally, 30 patients an hour. That is ridiculous. But when you're doing something that has never been done before, it's not universally accepted, to say the least. SHANNON BROWNLEE, MEDICAL JOURNALIST: How powerful are lobbyists in the healthcare system? (COMMERCIAL BREAK) (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: If you need serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. BERWICK: The healthcare system is unsustainable. OK? 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. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. People say you're doing this radical intervention. That's my routine. OSBORNE: I am great. It's much better to try to work at a deeper level. I don't want to go down the same path. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: Insurance companies have always been able to regulate the rates they charge. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. When I'm running and it's a hot day and I feel like giving up, it never fails. Now, thanks to both of you for joining us. She ended up having another open heart operation, another bypass operation. The answers among us, and only by accepting the fact that the American healthcare system is badly broken and the status quo isn't working, is bankrupting our nation, will we be able to seek out the escape fires, the potential solutions, and create a sustainable and patient centered system for the future. 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. People talk about two-minute doctors. They did not tell the FDA, and they did not tell patients. So he figured I was going to die because I was in such bad shape. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. And I think those discussions that we between the patient and the provider about lifestyle disincentives. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. And it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? CAIN: Exactly. We have to be mindful to those points in time where you can intervene and say enough's enough. Respiratory shutdown. I never had a personal doctor, family doctor, nothing, all my life. As an overall system, no, we're not anywhere near at the best in the world. Again, you were part of the documentary. UNIDENTIFIED MALE: A day, for 25 years. YATES: I was in the worst place in Afghanistan. I think five or six of them are on the waiting list. But with regard to prevention, preventing disease, does that save us money? DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: We only give lip service to prevention and we have to ask why as a society are we not working to prevent disease and promote health. WEIL: Where are you from? 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. Where I'm at right now, patients are in desperate need of care. UNIDENTIFIED MALE: What do we want? 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. I was on Trizadon. MARSHALL: It doesn't matter if I do one stent or five or ten stents. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. I'm optimistic about the future. That also happened in the 1990s. If you're in the system, do you access of if you are insured, if you are living in a safe neighborhood, your outcomes are great in America. It just wants you to keep coming back for your care of your chronic disease. GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: As we've pushed medical innovation and capability to the leading edge of the battlefield where we can save their life, and we've got some guys who have had some horrific injuries and they're getting narcotics for a longer period of time, they certainly are at risk to develop dependency, and that's what we're trying to avoid. ROSS: What do you think about that? Some people, this is all they eat, food of this sort. And the problem is, some of those procedures will lead to bad outcomes. ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. Your arteries around the heart. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. (COMMERCIAL BREAK). Because they're not using health care now. And people do. My job is to provide the right care for the right patient at the right time. And that being applied to health care just doesn't work. UNIDENTIFIED MALE: No. I'm sorry, it's going to get pretty tight. Or at least we think we do. It caused their blockages to become less blocked in their arteries. That is how many medications I was on. That's almost as much as the rest of the world combined. Well, you have a stent in your heart, right? Not having to eat all these pills. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? That was the message that, you know, I think was the you got from that documentary. We could do 1,000 studies with a million patients, it would remain on the fringes, it's all about the Benjamins, as (INAUDIBLE) would say. You say there's a lot of Yvonnes (ph) out there, the patient we just met. I can't be having heart problems. I think many of her cardiac catheterizations instead would not have been necessary. There's the bright blue slush. ORNISH: The limitations of high-tech medicine have never been clearer. 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. If you ask the manufacturers a device like this, why so much money? The really astonishing part about the fact that we spend more is we have worse health outcomes. And yet the outcomes, the survival rates are at the highest levels. Or stroke or cancer or things like that and that being applied to care. Want to go down the same thing over and over and over again lt. COL. GARNER. Out and are part of you for biopsy in some ways, I promise you that:! Desperate need of care imagine the other smoke jumpers thought the guy was crazy but. The heart in patients: United health care is kind of dark matter,. 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