Jonas, Wayne B., commentator. We're talking about a $3 or $4 billion a year drug. We want more tests. That's my routine. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. Transcripts; License . I haven't exercised. I mean, I can't think of a single negative in doing this. And abolitionists more broadly encouraged northerners to refuse to comply with the enforcement of fugitive slave laws and to disobey the Supreme Court's ignoble Dred Scott v. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. (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. And here's the secret, healthier people cost less money too. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). And if you look at even devices like -- this is a needle that's used for biopsy. UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. We have a lot more power over how healthy we are than we are willing to take credit for or willing to take responsibility for. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. And to me, that's not the only issue. Let me distinguish two terms. You get paid for the service that you're doing as opposed to for the overall care of the patient. GUPTA: Stay with us. 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. DR. SANJAY GUPTA,. GUPTA: You know, one can't help but walk away from the documentary, Doctor , frankly, they are scared of stents. It is important to keep in mind. I was on Trizadon. I don't want to go down the same path. Then all of a sudden I started getting chest pains. I mean, everyone wants that probably in every system. Here you go. The film examines the powerful forces trying to . 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. I decided out of curiosity to go check this out. Sometimes they are related to lifestyle habits. UNIDENTIFIED MALE: Not, not when I'm doing that. BERWICK: Everybody is doing what makes sense to them individually. A lot of unnecessary stents? NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. I just could not continue doing what I was doing. 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. UNIDENTIFIED MALE: Yes. UNIDENTIFIED FEMALE: Yes. ROSS: How long ago was that? There's no crisis worker at lunchtime? It takes a village to make an unhealthy patient healthy. She's still taking her Lexapro, but it's obviously not doing the job. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. It just doesn't work out financially. A flower for you. NIEMTZOW: If you didn't have the acupuncture needles, how do you think you'd be feeling? And they have a hard time believing that these simple choices that we make in our lives each day can make such a powerful difference. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. BROWNLEE: We have a disease care system, and we have a very profitable disease care system. DR. ELIZABETH BLACKBURN, NOBEL PRIZE IN MEDICINE, 2009, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: Telomere are the ends of chromosomes. Healthcare, it's headed for really, really bad trouble. If you can delay treatment, then that man is not at risk for side effects during that period of time. Incentivizing them to be healthy or not charging them as much if they're healthy. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. Fire Escape. MARTIN: Are you taking your medication? Look at this. Let me get right to it, Erin. (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. BURD: Yes. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. That is how many medications I was on. For example, in 2007, the average Medicare recipient in Miami tallied more than $15,000 in health care bills, whereas a recipient in Minneapolis only cost the government about half that amount. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. 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. UNIDENTIFIED MALE: I feel different. And I think we're in a great deal of trouble because of that. 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 MALE: I feel like I'm warming up a little bit. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. 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? They can't recognize an invention when it's among them and they can't give up their old habits. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. Cost about $1200. You will learn if your health care costs are going to go down any time soon. You know, Nancy, we talked a lot about these bills. Log in to your account. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. MARSHALL: You and I both know, it's hard to change the habits of a lifestyle. Those are the kind of things that would actually have an impact. And the fire spread around him. The present healthcare system doesn't work. 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. When I'm running and it's a hot day and I feel like giving up, it never fails. And all insurance companies are saying is your behavior should drive the premium. The really astonishing part about the fact that we spend more is we have worse health outcomes. It's still not over, but it's better from Germany, I promise you that. I mean, what is that, boy? Sometimes we're talking about them on a daily basis. YATES: I meditate, and it has opened up a whole new world for me. If it's a radiologist, they get paid for each CT scan they deliver. 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. Fire Escape Transcript. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. Look at our results, our life span isn't even in the top 20. MARTIN: I think what the American people need is, they need good health care. GUPTA: You feel better when you're healthier too. UNIDENTIFIED FEMALE: Loratab, Naproxen. YATES: Wow. Right? Tom's Escape In The Fire Escape. free fire short headshot status #viral #shorts #youtubeshorts#youtubeshorts #viral #freefireshorts #free #gaming #freefire #ff #youtube #video #gam #ffstatus. They may keep the disease process going and they may strengthen it over time. (END VIDEO CLIP) GUPTA: And Yvonne I the patient in that video. Psychologically, you deal with a lot of these sorts of things. 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. We're part of the community. As an overall system, no, we're not anywhere near at the best in the world. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. Ten allotted. 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 it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? What do you say when someone calls you? I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. Published: Santa Monica, Calif. : Lionsgate, [2013]. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? Aladdin and the King of Thieves/Transcript. DAN BULLIS, WALTER REED ARMY MEDICAL CENTER, DEPLOYMENT HEALTH CENTER: Post-traumatic stress disorder, PTSD, is an individual's reaction to the exposure and experiences of war. 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. Tell me what happened. That prevents tissues from renewing themselves in the body and diseases take hold. UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? Prevention is cost effective. But I think, to be honest, when you add more people to the system; that raises costs. It's unseen, but it's there and it's very, very powerful. And they formed a group practice they decided that they would pay themselves a salary and the money that was left would go back into growing the organization. Power your marketing strategy with perfectly branded videos to drive better ROI. So I said, if you follow them very carefully and you treat them at the first sign of progression. She needs a follow-up within three month with an echo. Am I going to be paying more? Michelle? UNIDENTIFIED MALE: What do we want? Still bothers me to this day. POTTER: We have been trying to reform the health care system for a hundred years. Dodge survived, nearly unharmed. It was a great life. ORNISH: The limitations of high-tech medicine have never been clearer. If they are surgeons, they get paid for each procedure. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. Healthcare reform was a good place to start, but it will do little to address the root problems. And then clearly we have social and economic issues that impact people's ability to access if you look at our percentage of un-insurers. 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. It would be a very different system that probably would be less high-tech and more high touch. Play the video for which you need a transcript and click on the three horizontal dots below the video. It has to do with expectations of patients. Are you incentivized to do more stents? BURD: All right. She joins us now. This -- medications I was on. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. It's the same challenge. (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. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. 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. GUPTA: And I want to leave all of you at home with a thought as well. I'm not sure every country in the world does it perfectly. I'm Dr. Sanjay Gupta. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. And it will not protect you from having a heart attack. 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. 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. Much more than money spent on much more expensive services. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? Carry a lot of weight because I'm infantry. So we took the men with prostate cancer. And that model has continued until today. And that is where the affordable care act can help which is bringing more competition to the bidding and pricing of these items. Alexander/Transcript. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. 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. They are patients with heart failure, they are morbidly obese patients. We can't prevent disease in everybody, but we have to try. We even found that when you change your lifestyle, over 500 genes were changed. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. UNIDENTIFIED FEMALE: They are all combined. Got to push through it. So now, "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." You almost forget that what you're doing is providing healthcare. GUPTA: Can you actually get a-hold of those people? So Doctor Rice, let me start with you. And if you try and buck the system, someone says, what can we do to get your productivity up? Dr. Berwick suggests that the current state of healthcare. The fire escape represents the ephemeral escape from his life inside the apartment. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. I actually practice emergency medicine at the University of Virginia in Charlottesville. Good. When they have insurance and they have access to usual source of care, primary care. NISSEN: We do have a problem in America, and that is we have misaligned incentives. WEIL: In Western medicine, all of our effort is on dispelling evil. They either couldn't afford it, or they worked for small employers that had been purged by big insurance companies. And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. Escape Fire Worksheet Escape Fire: The Fight to Rescue American Healthcare HSC 507 Introduction to Health Service Systems & Organizations Central Michigan University - Spring 2020 Print your name: _Kya Churchill _____ The video has been placed on reserve in the CMU Library. It's about saving the health of a nation. I know you're heading home and you're excited. 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 we just change reimbursement, it's a game changer, we change medical practice and we change medical education. 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. 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. But I think the economic imperatives are much stronger now. I lost a lot of good men. Credit: Battlestate Games. Type the text of what was said in your video and save it as a plain text file (.txt). BROWNLEE: The vast majority of doctors in this country are paid by a fee-for-service system. People eat what's cheap and what's available. It was with a huge amount of skepticism and resistance. That Medicare bidding demonstration. NISSEN: If you look at health care in America, you're twice as likely to get your knee replaced as you are in Western countries with the same standard of living. The only other country, by the way, is New Zealand. Stay tuned because afterwards, we're going to have a very important discussion regarding what we can all do to live longer and healthier lives and maybe avoid unnecessary costs and procedures. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. CARNES: Release the breath in a smooth, even stream out. UNIDENTIFIED FEMALE: How are you? A different perspective that there's a different way of doing things, that it's possible. So, if there's a concern someone has a tumor, they who use a needle like this. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. It is the largest health insurance company in the country. It had to do with the idea of essentially paying people to be healthy. UNIDENTIFIED MALE: Yes. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. When you're injured they feed you, feed you, feed you all this stuff. DR. CLIVE ALONZO, HOSPITAL INTERNIST, CROWN POINT, INDIANA: My medical training was just focused on giving these patients pharmaceuticals or giving them expensive tests to treat the condition after it occurred. You know, they'll actually fix it. That requires so much work, but we do it because we're committed to having her stay out of the hospital. And so behavior becomes a form of currency for people to accomplish their lifestyle changes. 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. He's, like, clutching his head. Half. MARTIN: How are you today? If you get a bump on your head as a friend of mine had, and you go into the emergency department, in America, you get a cat scan. The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. When telomere wear down and get frayed, the genetic material would get messed up. We have a disease management system. ROSS: What do you think about that? I had to do something. It's OK. You're good, you're good. You are going to hear from many different voices with varying opinions and backgrounds tonight. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. 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. THIS IS A RUSH TRANSCRIPT. Now, thanks to both of you for joining us. In the dialog that appears, select the language of the file you're uploading. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. I had difficulty sleeping at night. Not just the health, but healthcare, the health of a nation. How long were you there? GUPTA: So you're salaried. All Dogs Go to Heaven/Transcript. I don't believe in that stuff. And, in fact, they were more likely to die. I mean, the impression I think was a little misleading there, don't you think Nissen? UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. 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) Sometimes when you go, go to bad places in your head. Joining me to talk more about this is doctor Steven Nissen, he is the man in the documentary, the chairman of cardiology at the Cleveland clinic. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. She had had bypass surgery at an early age. I mean, that sounds like a really dire situation. I have an insurance now perhaps. We're glad to have you home. Things could move in that direction here, and this is not the choice of the doctor. The emergency department is the safety net of health care. 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. NIEMTZOW: Oh, you would? GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: This is a national problem for us, you know, we're seeing the military just being a microcosm, I think, of the problems society is having. So, if you have a patient comes in, you get paid a certain amount because you do a stent. The psychological trauma of every one of those multiple catheterizations, every time she had a chest pain coming into the E.R., and unfortunately, there are lots of Yvonnes out there. I would probably leave healthcare before I went back to practicing the way I practiced last year. This drug was the number one selling diabetes drug in the world in 2006. It's too much paying for it. I'm sorry, it's going to get pretty tight. 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. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. This is going to caused about %800 dollars. 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. UNIDENTIFIED MALE: These are all one person's? 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. Impressive. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. We have made all of this unhealthy food the cheapest and most available food. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. Transcripts Dragons: The Nine Realms Fire Escape Script view. There's saving money and there's cost effective. To get the best results, use these formatting tips: To force the start of a new caption . MARTIN: Can you feel this? Because what we think is best for us often isn't. And that worked for awhile. So Lexapro is the only thing you're on right now? WEIL: It could get worse. And my doctor told him he wouldn't recommend taking me because he didn't think I would live the year. But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. That simply means they get paid for each office visit. If you ask the manufacturers a device like this, why so much money? UNIDENTIFIED MALE: When do we want it? 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. We say they don't prevent heart attacks, they don't lengthen life. And maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. I was shutting down emotionally. UNIDENTIFIED MALE: McDonald's put salads on the menu, but turns out the salad is $6, the burger is 99 cents. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. It's here, right in the center of your chest. NISSEN: Now, the leading cause of death in diabetes is heart disease. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. Thank you so much. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? 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. 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. He asked for pain medication. UNIDENTIFIED FEMALE: Oh. Job number two was to make sure that there was not a public option. (COMMERCIAL BREAK) DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: If we really can't begin to change, from paying for volume, paying for how much you do, to paying for outcomes, paying for how well you do, how well the patient does, that will change the game, people will start to say, well, now the money is in health and well being and safety and vitality, not in more, more, more, more, more. And, you know, you kind of get busy. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. But with regard to prevention, preventing disease, does that save us money? So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. And ironically, it was only two hours away at the Cleveland Clinic. Determine, did you indeed have two MRI's during the course of one week? GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. Let's be honest. OSBORN: I've started doing research about where in the United States do I have to go to get the best heart care. BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. Maybe even a provider service. BROWNLEE: We spend a spectacular amount of money on healthcare. I'd rather be shot again than go through withdrawals of coming off that medicine. Compared to having your chest cut open? 5. Came off the mountain with only eight. 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. 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