escape fire video transcript

UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. I can't be having heart problems. All my health issues have gone away. We have a model that works simply by making changes in diet and lifestyles. BURD: All right. They didn't want to have a new competitor. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. Or at least we think we do. BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. Never needed you. NIEMTZOW: Normally you would? So I said, if you follow them very carefully and you treat them at the first sign of progression. It's not just we know it, we actually can go and visit it. UNIDENTIFIED FEMALE: Oh, my god. They are often poor patients, but not always. As an overall system, no, we're not anywhere near the best in the world. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. MARTIN: Yes? BULLIS: Soldier know if they go to war and they get a leg blown off, your medic is going to take care of you and the same thing needs to apply that if you have post-traumatic stress. We have underpaid on a chronic basis. I need some help over here. CARROLL: We found that the men who underwent lifestyle intervention, their PSA rates generally went down and they were less likely to require treatment. UNIDENTIFIED MALE: I did yesterday. DR. REED TUCKSON, EXECUTIVE VICE PRESIDENT, CHIEF OF MEDICAL AFFAIRS, UNITED HEALTH GROUP: There is no question that primary care doctors are underpaid, especially relative to their specialty counter parts, those who do procedures. She ended up having another open heart operation, another bypass operation. And how to know if you're being prescribed unnecessary procedures. UNIDENTIFIED MALE: What are you going to do at work? When you're injured they feed you, feed you, feed you all this stuff. This is a chest tube. The balloon is inflated to widen the blocked areas. I mean, to talk about how we shift toward -- away from disease intervention toward disease prevention and health promotion, I mean, that -- that requires a massive rethinking about medicine and healthcare at all levels of society. They did not tell physicians. UNIDENTIFIED REPORTER: A new study finds a growing number of combat veterans are battling mental illness, but many are finding it difficult to get the help they need. It would empower patients. 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. MARTIN: Have you cut yourself before? We want more procedures. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. (CROSSTALK) KASCH: That's why he's a little high right now. Our health care system. Let me just take a listen to you. UNIDENTIFIED FEMALE: Take them away from him. It's the best treatment and it saves lives, period. UNIDENTIFIED MALE: When do we want it? JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. I mean -- but you have to have the time to educate your patient. UNIDENTIFIED MALE: We moved you over here. She needs a follow-up within three month with an echo. Eight IEDs through this deployment. I don't believe in that stuff. 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. I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. And so, that's clearly one of the issues. We want more specialists. Co-directed by Matthew Heineman and Academy Award-nominee Susan Froemke (Lalee's Kin: The Legacy of Cotton), Escape Fire looks at a U.S. healthcare system designed to profit on disease not. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. It was important to keep expressing the hospital's position. The film interweaves personal stories with the efforts of leaders battling to transform it. And, of course, the natural end point is going to be in the emergency department. I had difficulty sleeping at night. But I think, to be honest, when you add more people to the system; that raises costs. It only reduces symptoms. It's too much paying for it. They either couldn't afford it, or they worked for small employers that had been purged by big insurance companies. Not having to eat all these pills. 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. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. (COMMERCIAL BREAK) BROWNLEE: The history of how the American healthcare system grew is not one of order, it's one of sort of happen hazard chaos. POTTER: We have been trying to reform the health care system for a hundred years. If they are confirmed non-smoker, we give them a discount. How are you feeling? I mean, where did that idea come from? We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. YATES: That's a healing process because you're not bottling up, it's going to a different section in your mind to where you can start processing it. I had to do something. There are answers, we know what safe care looks like. Your arteries around the heart. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? The problem is not that it doesn't work, the problem is that we haven't figured out how to get it into the system so that we can make it widely available to the population. Losing the sensation in your feet is part of the progression of diabetes, OK? 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. 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. Sometimes it's related to what the individuals actually have access to. 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. UNIDENTIFIED FEMALE: You need to get up and pee? But this program has just inspired me to press forward. And there's a lot of talk about who's going to pay for it, and that's really important. Things could move in that direction here, and this is not the choice of the doctor. And you've had heart attacks. But one evening, I sat straight up in bed with the worst chest pain. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. 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. Little did I know that it was followed by years of the same thing over and over and over again. NISSEN: Yes, but we have to educate patients. That's almost as much as the rest of the world combined. It used to be me. Maybe even a provider service. Half of Americans will be diabetic or pre-diabetic in the next 10 years. If you can delay treatment, then that man is not at risk for side effects during that period of time. Physical Desc: 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. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. MARTIN: Good. The film is about finding a way out. Okay. And I think those discussions that we between the patient and the provider about lifestyle disincentives. And by the way, they are number in the world and life expectancy. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. Wag Dodge had an idea. Anybody else would laugh, you know? Even if I lose 30 more pounds, which probably is my ultimate target, I'm not going to stop doing this. They sent me home with them. And now I'm -- 25 years later and I'm in pretty good shape. YATES: I was in the worst place in Afghanistan. Hold my beer while I shoot this gator, you know? 27 cardiac catheterization and well over seven stents. 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. It really does. Only thing we can do is separate them out, because there's no way for us to tell which are which. He is the president of the American Academy of Family Physicians. We have a -- we have a motto in medicine. Carry a lot of weight because I'm infantry. I have an acutely suicidal patient in my office that I need help with. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. I mean, the impression I think was a little misleading there, don't you think Nissen? 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. Much more than money spent on much more expensive services. In the dialog that appears, select the language of the file you're uploading. UNIDENTIFIED MALE: But Mommy, what are you going to do? We cut people open, re-bypass their blocked arteries and he would tell them they were cured, and they'd go home and more often than not eat the same junk food, smoke, and not manage stress, not exercise, and then often their bypasses would clog up, so we cut them open, we bypass their bypass, sometimes multiple times. If you look at a hospital bill, you might see an IV bag charge. And the owners of those pockets do not want anything to fundamentally change. 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. I was 35 at the time and was scheduled for open-heart surgery. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: There's the assumption that people who run government, elected officials, members of Congress, but it's not true in many cases. As Berwick says in the film, "We're in Mann Gulch. 1 hr 39 min PG-13 Documentary A powerful and thought-provoking documentary that exposes the U.S. healthcare system as one designed to profit on disease rather than health. I mean, look at our results. We even found that when you change your lifestyle, over 500 genes were changed. Rescue care is second to none. (END VIDEO CLIP) NISSEN: I was doing a Google search, and what I found was a Web site in the United Kingdom where the clinical trials done with Avandia were actually partially disclosed. 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. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. DR. PETER CARROLL, CHAIR, DEPARTMENT OF UROLOGY, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: My path crossed with Dean's because we both wanted to bring rigorous clinical trial testing to this hypothesis that lifestyle intervention could have a impact on men with early stage prostate cancer. So inhale. CARNES: I will be at your side should anything challenging come up for you. You know? Blood pressure under control, a discount. And so, I think it points to the violence in our society. We need a whole new kind of medicine. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. 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. What does it look like over the next few years? GUPTA: But, why are these causing hospitals so expensive? We create a public expectation that more is better, which isn't actually true so people seek more. I'm Dr. Sanjay Gupta. We need to change the nature of medicine. I tried to get him up, he just rolled himself out. One of the ways to think about saving money in health care is to focus our energies on that 20 percent of patients and think about treating those people in a more effective way. Let's be honest. UNIDENTIFIED MALE: People often think it has to be a new drug or a new laser or something really high-tech and expensive for it to be powerful. When they have insurance and they have access to usual source of care, primary care. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. I have an insurance now perhaps. And in some ways, I think of a lot of what's happening in health care is kind of dark matter. Thank you all. So that's rewarding for me. (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. UNIDENTIFIED MALE: Yes. Going back home. WEIL: This is a problem with a lot of our suppressive treatments. It had to do with the idea of essentially paying people to be healthy. 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. They couldn't get insurance. DR. SANJAY GUPTA, HOST: Good evening. With their city in ruins, the people of London finally realized the only escape from the devastation of . So, if you have a patient comes in, you get paid a certain amount because you do a stent. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. You allow and encourage your employees to become healthier. CARNES: Release the breath in a smooth, even stream out. I haven't exercised. Well, you have a stent in your heart, right? Published: Santa Monica, Calif. : Lionsgate, [2013]. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. We are going to take a short break. A documentary highlighting the shortcomings of the American healthcare system. It is an IV like this, about $280 just for the IV bag. NISSEN: I do. I need to speak with the crisis worker. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. Because they're not using health care now. GUPTA: I'm salaried too as a physician. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. Upload captions and transcripts. Also, Doctor Reed Tuckson, he is the chief medical officer for the united health group. 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. Dodge had invented what is now called an "escape fire," and soon after it became standard practice. And that being applied to health care just doesn't work. No eastern medicine. Maintaining my pain. BROWNLEE: Fee for service rewards physicians for doing more. (COMMERCIAL BREAK). The average per capita cost of healthcare in the developed world is about $3,000. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. We have made all of this unhealthy food the cheapest and most available food. We're in Mann Gulch. And it's just the last thing that you're really concerned about. GRUBER: Premiums will rise. UNIDENTIFIED FEMALE: If there is a 50-minute queue, I'm sure we can probably squeeze them into the schedule. I'm sorry, it's going to get pretty tight. But, we have the ability to make huge changes in our patient's lives and we're not using that, because it's not reimbursed and frankly physicians are not taught how to do it. UNIDENTIFIED FEMALE: Loratab, Naproxen. MARTIN: Bye. That Medicare bidding demonstration. A flower for you. Because I've gotten a lot of inspiration from the fellowship. It is important to keep in mind. It's OK. You're good, you're good. And if you look at even devices like -- this is a needle that's used for biopsy. We're talking about a $3 or $4 billion a year drug. And the actual costs for care here is among the lowest in the country. I'm not changed, but I'm changing. At a time when the medical system is so badly broken. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. UNIDENTIFIED FEMALE: Now you pick your spot. People talk about two-minute doctors. Everybody agrees on that. I could hardly just about walk three steps and I'd have to stop and rest. But, the American people are going to want something like that and that is going to be their perception. So, a hospital like the one you just saw there. But so what, right? What do you think? UMBDENSTOCK: Why? It's getting rid of the bad thing. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. UNIDENTIFIED FEMALE: Not in there? I'm optimistic about the future. ORNISH: I thought, most things in biology go both ways, so if bad things make your telomere shorter, maybe good things will make them longer. A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. And ironically, it was only two hours away at the Cleveland Clinic. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. You know, they'll actually fix it. Now, thanks to both of you for joining us. I was on Trizadon. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? NIEMTZOW: Oh, you would? Let me take a listen to you. UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. That isn't true in Canada. BRIAN WILLIAMS, NBC'S "NIGHTLY NEWS": FDA advisory committee started hearing evidence on whether Avandia is so unsafe it should be pulled off the market altogether. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. You just never get to the bottom of what's causing al he these problems they're having. If it's a radiologist, they get paid for each CT scan they deliver.
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