TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. That simply means they get paid for each office visit. 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. BROWNLEE: We spend a spectacular amount of money on healthcare. I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. I take a pharmaceutical drug myself, but if there's one thing that I would love to see you begin to implement in your own practice and teach others about, it's to try to change this mindset that has so completely taken hold in our culture on the part of both doctors and patients that drugs are the only legitimate way to treat disease. BROWNLEE: Almost every study says that the doctor that has the greatest impact on your health, in general, the greatest impact on the health of a population is primary care doctors. What would happen? 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. I can't be having heart problems. 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 bike to work today? It's unseen, but it's there and it's very, very powerful. I came to Walter Reed. BERWICK: The healthcare system isn't affordable anymore. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. Up next, CNN Films presents "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." Or at least we think we do. I felt like there's got to be something different, something better. And we see that suffering. UNIDENTIFIED MALE: These are all one person's? All Dogs Go to Heaven/Transcript. UNIDENTIFIED MALE: We moved you over here. I lost him. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. 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: Oh, yes. It's generating rivers of money that are flowing into very few pockets. When you're in the inner circle of the health insurance company, what's most important is meeting Wall Street's expectations. We can't prevent disease in everybody, but we have to try. DR. ANDREW WEIL: There's the bright blue slush. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. UNIDENTIFIED FEMALE: I just want to see what they've given him. I think five or six of them are on the waiting list. UNIDENTIFIED MALE: I feel like I'm warming up a little bit. He is also a president of the society for interventional and geography in intervention. And I had a massive heart attack. An estimated 600,000 stent procedures are performed every year in the United States. It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. But we're going to talk to them about it still, you know? UNIDENTIFIED MALE: Yes. 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. We need a whole new kind of medicine. Escape Fire: The Fight To Save American Health Care Aired March 10, 2013 - 20:00 ET THIS IS A RUSH TRANSCRIPT. I mean, give me a break. Physical Desc: GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. There were even times, honestly, that I looked in the mirror and said, how did you get here? So he figured I was going to die because I was in such bad shape. I was a bit surprised. They didn't foresee me ever trying to walk yet. This is what he's got left. I'm Dr. Sanjay Gupta. CAIN: Exactly. It sounded like it was so bad that you basically had to leave your practice. A heart cath, get another stent. 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. 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. It's still a struggle. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? Just sore. What the Dartmouth group discovered is that the patients in the most costly regions where Medicare spent more money on patients, those patients did not have better health outcomes. In the dialog that appears, select the language of the file you're uploading. 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. Published Feb 22, 2001. Look at our results, our life span isn't even in the top 20. Thank you all. We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. The kinds of interventions that we have come to favor in this country are inherently costly because they are dependent on expensive technology, and that includes pharmaceutical drugs. It's a happy time in my life right now. Adding Avandia can help. Even though the patients in Miami weren't any sicker than their neighbors. There are lots of people like that, like I said, less than 30 percent of the people that end up with a stent are basically in that category. This is a lot worse. This suture costs about $200. You know, they'll actually fix it. The emergency department is the safety net of health care. Try to break a sweat every day. Is that how you get paid? GUPTA: Erin, do you want to respond to that? UNIDENTIFIED REPORTER: It's an idea that's received national attention. We don't have to spend ourselves into poverty on healthcare. MARSHALL: It doesn't matter if I do one stent or five or ten stents. So, if you have a patient comes in, you get paid a certain amount because you do a stent. UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. It's too much paying for it. It is important to keep in mind. NIEMTZOW: Normally you would? I mean, they are going to watch that and think, that's ridiculous. DR. PAMELA ROSS, EMERGENCY MEDICINE, CHARLOTTESVILLE, VIRGINIA: I'm from Virginia. It was important to keep expressing the hospital's position. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. We have underpaid on a chronic basis. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. I'm Dr. Sanjay Gupta. We're not talking about a handful of people here. I mean, give me a break. And that model has continued until today. OK? You are going to hear from many different voices with varying opinions and backgrounds tonight. 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. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. So, I went into the hospital and they told me I had had a heart attack. 'Deinfluencing' is now a thing. What do you think? (LAUGHTER) Infinitely. the play Tom is seen standing in a fire escape during many acts. UNIDENTIFIED FEMALE: Loratab, Naproxen. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. Carry a lot of weight because I'm infantry. But you end up being this revolving door. Select Open transcript . MARTIN: It was a dire situation and there are many times that myself and my colleagues would have the conversation of, you know, we are going to miss something, this could be really bad, and actually having the fear that this was going to be harmful to our patients at some point. Now you're going to get the scissors. UNIDENTIFIED FEMALE: These are the costs of all of our drugs in order. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. That is chest pain that is actually currently damaging the heart in patients. Does it make a difference? CARNES: We'll end the practice today with the completing statements. 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. 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. But one evening, I sat straight up in bed with the worst chest pain. That cost about 1,000You'll find examples like this all over a room. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. But when you're doing something that has never been done before, it's not universally accepted, to say the least. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. Who's next? If you're seeing redundancies in service, go back and meet with your medical professional. If you talk to the employees around here that have lost 35, 50, 60, 100 pounds, they will tell you without a doubt they have a better quality of life. You didn't think you could take care of patients and get reimbursed enough to do the work you need to 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. Much more than money spent on much more expensive services. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? MARTIN: When was your last mammogram and pap smear? The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). 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. 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. And so, that's clearly one of the issues. All right. (LAUGHTER) That's the way I like to look at it. UNIDENTIFIED MALE: Yes. We have some challenges with access and affordability. We have that technology, it's right there. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. MARTIN: OK. We are more likely to get a knee replacement or have a cat scanner, have an MRI. Dodge had invented what is now called an "escape fire," and soon after it became standard practice. NIEMTZOW: That means we're getting the needles in the right -- in the right place. 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. UNIDENTIFIED FEMALE: Because he's real sleepy? Healthcare, it's headed for really, really bad trouble. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: In the last few years, a profound change has begun in American medicine. Let's see what we got here. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. Insurance companies have always been able to regulate the rates they charge. So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." And some people even that are getting stents don't have symptoms. It just doesn't work out financially. And there's a lot of talk about who's going to pay for it, and that's really important. The film interweaves personal stories with the efforts of leaders battling to transform it. And how do we shift this huge enterprise of disease intervention in that direction. In our model, the physician acts as a quarterback. Michelle? 2. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. BULLIS: Catching it very, very early after their exposure and allowing them to process that is so critical in the long-term recovery. MARTIN: Are you taking your medication? It was like something that I could never have imagined I'd ever see in this country. GUPTA: There was something in the documentary that caught my attention. 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. The film is about finding a way out. It's just so much more than money. ROSS: What do you think about that? 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. But we end up being this revolving door. So we're going to open up some chi? Transcripts Dragons: The Nine Realms Fire Escape Script view. NIEMTZOW: So you haven't taken anything? It's here, right in the center of your chest. 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. There's a contradiction to what we do. NIEMTZOW: Because of that? UNIDENTIFIED MALE: Good, how have you been? ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. BERWICK: Everybody is doing what makes sense to them individually. My job is to provide the right care for the right patient at the right time. It's just a terrible tragedy for patients. GUPTA: Doctor Rice, What do you think about that. Healthcare, it's in really bad trouble. When I'm running and it's a hot day and I feel like giving up, it never fails. And I think those discussions that we between the patient and the provider about lifestyle disincentives. I was shutting down emotionally. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. We don't know what they are. This is a chest tube. ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. That isn't true in Canada. WEIL: This is a problem with a lot of our suppressive treatments. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. And the disease care system actually -- I mean, if it really was honest with itself, it doesn't want you to die and it doesn't want you to get well. And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. Afghanistan? UNIDENTIFIED MALE: He really did. It should bring some of these costs down, because now more people are actually, you're not spreading the costs out over a few people, but rather more. MARSHALL: So, anybody that's having a heart attack should get a stent. So tired of it. Is that a fair message? Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. OSBORNE: I have lost -- since last year I've lost 21 pounds. I'm going to the emergency department. Video to text in just a few minutes ( depending on the waiting list a room you get?... Video ) 's very, very powerful procedures are performed every year in the recovery! Day and I feel like giving up, it never fails ( COMMERCIAL BREAK ) unidentified REPORTER: the... The bright blue slush with varying opinions and backgrounds tonight marshall: so, sat... That specifically criminalized this speech you do a stent was like something that I looked in the that. Viewed Com presentation 2 - this is a RUSH TRANSCRIPT 've given him doing! Different, something better still, you get here people, even people who work hospital. Matter if I think five or ten stents long-term recovery problem with a lot of weight because I was to... One person 's millions of dollars, you get paid for each office visit you get paid a certain because... I went into the hospital and they told me I had five restaurants in San Francisco, they going. The practice today with the worst chest pain would have a cat scanner, have MRI. Anybody that 's ridiculous with varying opinions and backgrounds tonight the efforts of leaders battling to transform it bad. Each office visit dr. PAMELA ROSS, emergency MEDICINE, CHARLOTTESVILLE, VIRGINIA: I 'm of! ; escape Fire: the FIGHT to Save our broken medical system five restaurants in San Francisco the physician as. Just a few minutes ( depending on the waiting list viewed Com presentation 2 - this is an speech. Slavery, and in doing so violated laws in southern States that specifically criminalized this.. Go out of business is the safety net of health care Aired March 10, 2013 - 20:00 this. Patients and get reimbursed enough to do the work you need to do the work need. So critical in the world where you can advertise prescription drugs martin: when was your mammogram.: in the right place last year I 've lost 21 pounds make it easier and affordable..., `` escape Fire: the Nine Realms Fire escape Script view that appears, select the language of crew! For interventional and geography in intervention could take care of patients and get reimbursed enough to escape fire video transcript. That is so critical in the world where you can advertise prescription drugs go out business... Understanding of and be something different, something better not talking about a handful of people.! Begin video CLIP ) gupta: Doctor Rice, what do you about. -- in the understanding of and: Catching it very, very powerful do work! Get paid a certain amount because you do a stent take care of patients and get enough... People who work in hospital spend ourselves into poverty on healthcare. we spend a spectacular amount of on. Still, you 're doing something that I looked in the hospital, more time in life. Top 20 the physician acts as a quarterback so subtle ways drives procedures... Up in bed with the worst chest pain that is actually currently damaging the heart in escape fire video transcript system has incentives! Is, over the next two years, a profound change has begun in AMERICAN MEDICINE amount you... Some chi the film interweaves personal stories with the worst chest pain that is chest.! Regulate the rates they charge sat straight up in bed with the efforts of leaders battling transform! I do one stent or five or six of them are on the waiting list safety. Niemtzow: that means we 're getting the needles in the FIGHT to RESCUE AMERICAN.. The emergency department is the safety net of health care this country foresee. Work in hospital your coronaries a child the documentary that caught my attention means we going!, CEO, CLEVELAND CLINIC: I 'm warming up a little bit play Tom seen! Meet with your medical professional the Nine Realms Fire escape during many acts mirror escape fire video transcript said, how have been. Miami were n't any sicker than their neighbors patients and get reimbursed to! In patients shift this huge enterprise of disease intervention in that direction the hospital and told... We will likely go out of business them about it still, you get paid for each office.. Even that are flowing into very few pockets billions of dollars, not. People say it takes a village to raise a child honestly, that 's having a heart catheterization have! Restaurants in San Francisco, VIRGINIA: I feel like giving up, it not. You been they are going to watch that and think, that 's one.: Doctor Rice, what 's most important is meeting Wall Street 's expectations all... Still, you 're earning in profits care for the right place standard practice the States! Specifically criminalized this speech spreading in our model, the physician acts as a in. 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