UNIDENTIFIED MALE: Six and over. You have all these stents, and these stents, once they go in, they never come out and are part of you. The fire broke out around 10 p.m. Monday at the Cozumel Apartments in the 6400 block of Sierra Blanca Drive near Westpark Tollway and Highway 6. 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. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. She had had bypass surgery at an early age. 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. How are you feeling? They can pretty much get away with increasing the rates as much as they want to. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. I mean, the impression I think was a little misleading there, don't you think Nissen? ESCAPE FIRE exposes the perverse nature of American healthcare, contrasting the powerful forces opposing change with the compelling stories of pioneering leaders and the patients they seek to help. I don't believe in that stuff. MARTIN: Wow. I was in the hospital for two weeks. And I think that's a good place to start. They become more productive. 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. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. BURD: All right. But when you're doing something that has never been done before, it's not universally accepted, to say the least. We don't have to spend ourselves into poverty on healthcare. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. Escape Fire premiered at the Sundance Film Festival, [1] opened in select theaters on October 5, 2012, and was simultaneously released on iTunes and Video-on-Demand. And the actual costs for care here is among the lowest in the country. Hold my beer while I shoot this gator, you know? I think many of her cardiac catheterizations instead would not have been necessary. 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." It's been a wild ride. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? SGT. It's about saving the health of a nation. The patient is so -- UNIDENTIFIED FEMALE: Oh god. Video: This tiny shape-shifting robot can melt its way out of a cage . (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. I started getting sick in my 30s. I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. That's the only reason we're making the change. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. We're the only providers for. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. 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. Only thing we can do is separate them out, because there's no way for us to tell which are which. We are going to take a short break. There's a contradiction to what we do. There's saving money and there's cost effective. Sometimes we're talking about them on a daily basis. Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. UNIDENTIFIED MALE: Yes. UNIDENTIFIED FEMALE: Loratab, Naproxen. About three weeks ago, because of the state budget crisis, we got told with very little notice that Medicare and Medicaid reimbursement was going to be cut by about 25 percent. And the basis of that turning around by paying primary care doctors more is to incentivize primary care doctors to participate as members of comprehensive health care teams just so that the kind of challenges that Erin faced out there by herself can now be accomplished by pulling a team together, then, let them work hard to save dollars and improve quality of care and then, the primary care doctor benefits from those economic savings and those financial incentives. Did you go to the diabetes education? SGT. ROBERTS: The research found that embracing a low-fat vegetarian diet, exercising half an hour a day, and taking part in daily stress reducing activities can actually change the regulation of genes that are key players in cancer development and contribute to better overall survival. MARTIN: You used to cut? They have talked about a child between age of one and four, having the third most common causes of homicide. Up next, CNN Films presents "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." Yes, this is Dr. Martin over at La Clinica. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. But, the American people are going to want something like that and that is going to be their perception. I'm not sure every country in the world does it perfectly. You are going to hear from many different voices with varying opinions and backgrounds tonight. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. UNIDENTIFIED MALE: Let me get that jacket away from him. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. As an overall system, no, we're not anywhere near the best in the world. You're your options might be, if there is a doctor surgeon on hometown. And those are surprising. This -- medications I was on. Compared to having your chest cut open? (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. The question was, can we relieve their pain and reduce the amount of medications that they are on so by the time they get back, they are not snowed under on multiple medications. (COMMERCIAL BREAK) (BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: 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, her cholesterol was never well controlled and her high blood pressure was never well controlled. And you say that you can help negotiate the price of these bills down, what do you tell people? NANCY DAVENPORT-ENNIS, FOUNDER, CEO, PATIENT ADVOCATE FOUNDATION: So, what we tell them first and foremost, is get a copy of the entire bill and look for redundancies. That's my routine. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Physicians are well intentioned. 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. Escape fire: the fight to rescue American healthcare (DVD) Contributors: Heineman, Matthew, director, Froemke, Susan, director, Berwick, Donald M. 1946- commentator. It was important to keep expressing the hospital's position. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. But you end up being this revolving door. If you have that desire to quit smoking, we'll get there eventually. Maybe even a provider service. It caused their blockages to become less blocked in their arteries. You say there's a lot of Yvonnes (ph) out there, the patient we just met. Transcript In Escape Fire: The Fight to Rescue American Healthcare", director Matthew Heineman exposes what he sees as flaws in the U.S. healthcare system, such as a doctor who can spend just. And that was the first study showing that heart disease was reversible. (LAUGHTER) That's the way I like to look at it. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. When you're injured they feed you, feed you, feed you all this stuff. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? How are you? OSBORNE: I have lost -- since last year I've lost 21 pounds. UNIDENTIFIED FEMALE: Nine months? The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. 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. and those are the pockets of the manufacturers of medical devices, the big insurers, the pharmaceutical companies. And, you know, you kind of get busy. It used to be me. 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. The really astonishing part about the fact that we spend more is we have worse health outcomes. UNIDENTIFIED FEMALE: You need to get up and pee? It argues that American medical treatment is largely focused on getting people into hospitals and giving them drugs, two profit centers that are hugely expensive and supported by massive lobbying campaigns. 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. UNIDENTIFIED FEMALE: If there is a 50-minute queue, I'm sure we can probably squeeze them into the schedule. So we're going to open up some chi? 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. They'll say, it took years to develop something like this, the research and development costs are significant. We have a disease management system. Some people, this is all they eat, food of this sort. UNIDENTIFIED MALE: Once I found out what was really wrong with me. UNIDENTIFIED FEMALE: Not in there? It only reduces symptoms. You've done some sweating. All of us live here and work here. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. But I think the economic imperatives are much stronger now. BULLIS: Catching it very, very early after their exposure and allowing them to process that is so critical in the long-term recovery. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. GRUBER: For everybody. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. UNIDENTIFIED FEMALE: Oh. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? If you look at a hospital bill, you might see an IV bag charge. I'm going to the emergency department. Next, click the three-dot menu icon underneath the title of the video. GUPTA: There was something in the documentary that caught my attention. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. I tried to get him up, he just rolled himself out. To a man with a hammer, everything looks like a nail. . UNIDENTIFIED MALE: What do we want? 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. UNIDENTIFIED FEMALE: I think we have about 25 patients for today for Dr. Martin. UNIDENTIFIED FEMALE: We'll do it at the front. I mean, when the cost of some of the things we use on a regular basis. I would probably leave healthcare before I went back to practicing the way I practiced last year. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. That also happened in the 1990s. And the owners of those pockets do not want anything to fundamentally change. I'll look up and I'll see a person who's overweight across the street. I was so dependent on my pain medication. YATES: OK. We have a model that works simply by making changes in diet and lifestyles. 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. GUPTA: Why not just pay them more money? ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. UNIDENTIFIED MALE: I did yesterday. What do you say when someone calls you? GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. It's just a terrible tragedy for patients. NISSEN: Finally, the FDA put severe restrictions on the drug. To get the best results, use these formatting tips: To force the start of a new caption . UNIDENTIFIED FEMALE: You know, I'm only 34 years old. The film interweaves personal stories with the efforts of leaders battling to transform it. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. MARTIN: Barely? SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. UNIDENTIFIED FEMALE: How are you? It doesn't reward them for doing a better job. And Doctor Jeff Cain. But this program has just inspired me to press forward. We're part of the community. Impressive. CARNES: So feel yourself there in your safe place. And, in fact, they were more likely to die. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. Let's be honest. He said, it was a year. He tried to get the other smoke jumpers to join him, and nobody did. 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. When you start to look at kids 15 to 19, we know accidents and again violence. You know? If somebody has hypertension, we give anti-hypertension drugs. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. 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. I mean, look at our results. We've just created a completely different system here. I was taking 64 pills a day of combinations of Roxaset and Oxycotin. You just look different. Then all of a sudden I started getting chest pains. You have to play this game with what does this patient need and how much time am I willing to spend with them, because the administration is telling you you need to see more patients, we're in the red. 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. Carry a lot of weight because I'm infantry. You know, Nancy, we talked a lot about these bills. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. What we don't know, is that a fundamental change? POTTER: We have been trying to reform the health care system for a hundred years. We're in Mann Gulch. What we do with waste in healthcare. 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. 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. But he can have anywhere between five and 10 milligrams of morphine. And I think those discussions that we between the patient and the provider about lifestyle disincentives. UNIDENTIFIED MALE: Yes. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? It has to do with expectations of patients. Let me get right to it, Erin. On my way. It's not whole food as nature produces it. We are more likely to get a knee replacement or have a cat scanner, have an MRI. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. It got fast tracked by the FDA. 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. People go in and out of health plans. 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. Look at the thinness. I stopped taking my medicine months ago. NISSEN: I do. When medicine became a business, we lost our moral compass. We even found that when you change your lifestyle, over 500 genes were changed. 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