Our life span isn't even in the top 20. And welcome home. I have an insurance now perhaps. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. My energy level is up. We're really mortgaging the future. Some would say overrewarded specialty and subspecialties. Can't wait to be 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. What do you say when someone calls you? I'm not sure every country in the world does it perfectly. It has to do with expectations of patients. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. Just do something. Do you understand? It's wonderful. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. more . Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. Did you have a good day today? It's not true in the United Kingdom. That's not good medicine. I mean, when the cost of some of the things we use on a regular basis. I mean -- but you have to have the time to educate your patient. You're your options might be, if there is a doctor surgeon on hometown. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. A stapler, this stapler that is often to used in surgery, like this? (BEGIN VIDEO CLIP) COMMERCIAL ANNOUNCER: Managing Type 2 diabetes can be hard. He's taken 10 tablets. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. UNIDENTIFIED FEMALE: You know, I'm only 34 years old. 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. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. People talk about two-minute doctors. MARSHALL: You and I both know, it's hard to change the habits of a lifestyle. UNIDENTIFIED MALE: Let me get that jacket away from him. There are answers, we know what safe care looks like. I mean, an obvious one is nutrition, which is almost omitted from medical education. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. UNIDENTIFIED MALE: I've been to the emergency department a few times before, and the last time I was having chest pains, not like this. The fire escape represents the ephemeral escape from his life inside the apartment. These perverse incentives that you described? We have underpaid on a chronic basis. I want to give to people and I want to help people, and I wasn't able to find that here. I smoked six cigars a day, 10 cups of coffee, a lot of wine. UNIDENTIFIED MALE: Oh, yes. 'Deinfluencing' is now a thing. And feel yourself observing all these constantly changing sensations and thoughts and feelings. And from that point on I realized that I don't want to be on this. And I thought, once I get this, I won't have the blockages anymore. UNIDENTIFIED FEMALE: OK. The answer is among us. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. An Entrenched System. This isn't a game of this person against that group, this sector against that sector, but at the end of the day, the American people need solutions and the one thing they don't need is a bunch of finger pointing that doesn't take us forward. 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. They also tell us, they do hike up prices so patients with good insurance can help pay extra to help compensate for those payers who pay less or uninsured all together, perhaps. Jonas, Wayne B., commentator. 2. 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. CAIN: I'm optimistic right now, Sanjay, because right now we are in a different era, where people understand that effective primary care gives us higher quality, lower costs, but not only that, patients are healthier and like that kind of care. It's nice to know that I've got a long time to spend with my family and I'm going to get to see my son grow older and go to college and all that fun stuff. I'm going to the emergency department. The folks who were there were not trying to shirk their responsibilities. But we're going to talk to them about it still, you know? So Lexapro is the only thing you're on right now? Get educated on these issues and add your voice to a growing chorus for change. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. Simply the same way the hospitals and physicians. 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. Job number two was to make sure that there was not a public option. I'm interested in helping patients. Original Airdate 08/17/2022. It's here, right in the center of your chest. UNIDENTIFIED FEMALE: Loratab, Naproxen. That's almost as much as the rest of the world combined. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. That ended and it rose quickly. This is what he's got left. That simply means they get paid for each office visit. The army sergeant general directed that we establish the pain management task force to take a look at alternatives to narcotics. I'm Dr. Sanjay Gupta. We're saying that the system has created incentives in subtle and not so subtle ways drives more procedures. It was a passion for healing. First Published 08/18/22 12:02. read transcript. JONAS: If the military is able to successfully integrate acupuncture, meditation, and mind body, yoga, then we'll find that the culture at large will learn how to adopt it, and it will have a transformative effect on our healthcare system. 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. 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. GUPTA: And I want to leave all of you at home with a thought as well. It only reduces symptoms. Impressive. It is a burning platform and they see this. And what I saw actually made me physically ill. As I looked at trial after trial, there were more heart attacks in the Avandia group. ROBERTSON: It's a financial necessity. But we end up being this revolving door. 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. UNIDENTIFIED MALE: I feel different. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. WEIL: This is a problem with a lot of our suppressive treatments. You know, the ads always end with the same phrase, ask your doctor. I need to speak with the crisis worker. And to me, that's not the only issue. 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. On my way. UNIDENTIFIED MALE: Yes. Hold my beer while I shoot this gator, you know? It had to do with the idea of essentially paying people to be healthy. Where does that money come from? I'm not changed, but I'm changing. It's your money. UNIDENTIFIED MALE: I do it again on Friday. And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? What would happen? And that was the first study showing that heart disease was reversible. And there's a lot of talk about who's going to pay for it, and that's really important. MARTIN: Good. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. OK? 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. 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. It's still a struggle. What we do with waste in healthcare. And if they have a relationship with you, feeling truncated. The patient just fell off the litter. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. 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. UNIDENTIFIED MALE: I'd be chomping narcotics. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. BERWICK: The healthcare system isn't affordable anymore. This is major reason why we see kids getting fat in this country. ROBERT YATES, INFANTRY, U.S. ARMY: Medications I was on. Can adding Avandia help you? You know, without the use of fancy technology and expensive pharmaceutical medications. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. Did you go to the diabetes education? 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. Again, you were part of the documentary. We pay hospitals to be full, so they try to be full. As an overall system, no, we're not anywhere near the best in the world. To get people to eat different, to eat, you know, to lose weight, to exercise regularly, those are hard things to get people to do, and we need to be better at it. I would probably leave healthcare before I went back to practicing the way I practiced last year. All Dogs Go to Heaven 2/Transcript. Came off the mountain with only eight. People eat what's cheap and what's available. And you're here today with chest pain. How to know if you are being prescribed unnecessary medications or procedures, that's next. Transcripts Dragons: The Nine Realms Fire Escape Script view. Your arteries around the heart. 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. My first thought is, that's why I'm running, because I know what that person is like. We need to change the nature of medicine. GUPTA: Stay with us. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. We want more specialists. To get the best results, use these formatting tips: To force the start of a new caption . Let me take a listen to you. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Physicians are well intentioned. Try to understand where the redundancies are. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. That's it. And I think those discussions that we between the patient and the provider about lifestyle disincentives. About a 30 percent increase in the risk of heart attack and related complications. Rescue care is second to none. 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. NIEMTZOW: Because of that? 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. 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. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. These for- profit companies by law have to serve shareholders. ROBERTSON: OK, so first topic, Medicaid reimbursement. War's hell, it's always hell. 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. Escape Fire: The Fight To Save American Health Care. And it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? We are second to none in this country for those things. $300 billion on drugs. The really astonishing part about the fact that we spend more is we have worse health outcomes. 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. (COMMERCIAL BREAK) SHANNON BROWNLEE, MEDICAL JOURNALIST: Dark matter is a discovery by astronomers that there is a huge amount of the universe that we can't see. I had difficulty sleeping at night. Exhale. 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: First one's going in. But it's more than cost. 27 cardiac catheterization and well over seven stents. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. We have a disease management system. 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. 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