We spend one heck of a lot of money. I am back in the chest pain center with a pretty sick patient, and I'm going to need you to call attending phone, too. It was like something that I could never have imagined I'd ever see in this country. Am I going to be paying more? Select Open transcript . UNIDENTIFIED FEMALE: Loratab, Naproxen. "Escape Fire" airs March 10 on CNN. Select "Show Transcript" from the menu. And sometimes push the plate away. Right? This is what you do for a living. It is important to keep in mind. They did not tell physicians. I mean, give me a break. Yes, this is Dr. Martin over at La Clinica. Determine, did you indeed have two MRI's during the course of one week? And to me, that's not the only issue. And I think those discussions that we between the patient and the provider about lifestyle disincentives. You will learn if your health care costs are going to go down any time soon. 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. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. I became a doctor because I care about patients and working here, I can't help them. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. Compared to having your chest cut open? I feel like I'm changing. It's still a struggle. Let's see what we got here. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. The balloon is inflated to widen the blocked areas. If you ask the manufacturers a device like this, why so much money? ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? 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. UNIDENTIFIED FEMALE: If there is a 50-minute queue, I'm sure we can probably squeeze them into the schedule. Most diseases don't happen overnight. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. Healthcare reform was a good place to start, but it will do little to address the root problems. UNIDENTIFIED FEMALE: OK. We have a disease management system. 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. And how do we shift this huge enterprise of disease intervention in that direction. This drug was the number one selling diabetes drug in the world in 2006. UNIDENTIFIED MALE: That was, what, a month and a half ago? It's your money. It doesn't matter how complicated they are, how much time that we spend on them, it's just a number, one, two, three, four, five. They didn't foresee me ever trying to walk yet. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. They have a blockage that's not causing symptoms and yet they're actually having a procedure. So, I went into the hospital and they told me I had had a heart attack. Try to break a sweat every day. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. Entitled Escape Fire, Dr. Berwick's speech took its audience back to the year 1949, when a wildfire broke out on a Montana hillside, taking the lives of 13 young men and changing the way firefighting was managed in the United States. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: The problem is, if you have stable chest pain, we have very good studies dating back a number of years that show that getting a stint will not prevent a heart attack, and will not make you live longer. Escape Fire escape fire University Central Michigan University Course Introduction to Health Service Organizations and Systems (HSC 507) Academic year 2021/2022 Helpful?00 Share Comments Please sign inor registerto post comments. 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. MARTIN: Uh-huh. But I decided to give it a shot. 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. At a time when the medical system is so badly broken. 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. 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. And we see that suffering. And you're here today with chest pain. 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. You bike to work today? Not very much, but a little. About 70 percent of all angioplasty and stent procedures in this country are done in people actively having heart attacks, large heart attacks or smaller heart attacks or having what we call unstable angina. No eastern medicine. What's wrong with medical education is that it simply doesn't address whole subject areas that are absolutely essential to understanding human beings, health, illness, and treatment. This -- medications I was on. GUPTA: Why not just pay them more money? You get paid for the service that you're doing as opposed to for the overall care of the patient. Underrewarded primary care. They may be a member of a health plan for a year and maybe no longer. I was a bit surprised. It takes a village to make an unhealthy patient healthy. And some people even that are getting stents don't have symptoms. And that being applied to health care just doesn't work. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. 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. (LAUGHTER) That's the way I like to look at it. NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. She ended up having another open heart operation, another bypass operation. Something like that. You don't necessarily make a lot of investments in preventive care for someone who's not going to be a part of your health plan for a long period of time. LT. GEN. DAVID FRIDOVICH, THREE STAR COMMANDER, U.S. SPECIAL FORCES: I can see why there's a link between opiates, dependency, misuse, and suicide. But one evening, I sat straight up in bed with the worst chest pain. It is a burning platform and they see this. If they are confirmed non-smoker, we give them a discount. Who pays for that? You say there's a lot of Yvonnes (ph) out there, the patient we just met. UNIDENTIFIED FEMALE: When I was a kid. I need to speak with the crisis worker. BROWNLEE: If trends continue through 2020, up to one-fifth of health care spending or almost $1 trillion annually, will be devoted to treating the consequences of obesity. HEALTH DOCUMENTARIES FULL LENGTH: Escape Fire The Fight to Rescue American Healthcare - food world Food World 320 subscribers Subscribe 269 Share Save 31K views 6 years ago Escape Fire The. BROWNLEE: Fee for service rewards physicians for doing more. There are answers, we know what safe care looks like. And welcome home. It's a completely irrational system. Aladdin and the King of Thieves/Transcript. OK, so let's go into our meditation practice. MARSHALL: You and I both know, it's hard to change the habits of a lifestyle. The film examines the powerful forces trying to . LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. Did you go to the diabetes education? But you end up being this revolving door. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. You've seen a lot. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. CARNES: I will be at your side should anything challenging come up for you. 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. I felt like there's got to be something different, something better. UNIDENTIFIED FEMALE: Nine months? And if they have a relationship with you, feeling truncated. 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. There's no crisis worker at lunchtime? UNIDENTIFIED FEMALE: These are the costs of all of our drugs in order. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. That is ridiculous. And you say that you can help negotiate the price of these bills down, what do you tell people? Thank you so much. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. You can convert other formats (like Microsoft Word, HTML) into a plain text file or you can use native programs on your computer like Notepad. Probably put him on the bottom on the other side. OSBORN: I've started doing research about where in the United States do I have to go to get the best heart care. UNIDENTIFIED FEMALE: They don't say how much they gave him. Well, you have a stent in your heart, right? They are going to healthcare. With the infantry division. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. He overdosed. It's not true in the United Kingdom. And that is where the affordable care act can help which is bringing more competition to the bidding and pricing of these items. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. But, in fact, the more I looked, the more I found that there's all this stuff in medicine that we don't think about that is actually harmful. YATES: OK. Well, it drives demand. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. You know, they'll actually fix it. And, in fact, they were more likely to die. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? Escape Fire: The Fight To Save American Health Care. UNIDENTIFIED FEMALE: Because he's real sleepy? Escape From Tarkov developer Battlestate Games has issued a statement outlining its plans to tackle cheaters in the game, following the release of a community-made video . We're spending almost twice as much in America as any other country on earth. Do you understand? So that's rewarding for me. UNIDENTIFIED MALE: But Mommy, what are you going to do? 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. It was important to keep expressing the hospital's position. SGT. If it's a radiologist, they get paid for each CT scan they deliver. He lit a match and he lit a fire at his own feet. GUPTA: Doctor Rice, What do you think about that. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. She got her cholesterol under control, her weight under control and things were great for her after that. We're in Mann Gulch. They sent me home with them. That's how embedded people get in the status quo. The documents are coming out in these court suits, it looks worse and worse. ROBERT YATES, INFANTRY, U.S. ARMY: Medications I was on. And ironically, it was only two hours away at the Cleveland Clinic. UNIDENTIFIED MALE: Nine months. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. To get the best results, use these formatting tips: To force the start of a new caption . WEIL: It could get worse. A stapler, this stapler that is often to used in surgery, like this? He's like really not listening very well. 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. I need some help over here. And we're going to be doing CPR on a patient. UNIDENTIFIED FEMALE: I think we have about 25 patients for today for Dr. Martin. It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. Let me get right to it, Erin. The answer is among us. MARTIN: I'm going to make a phone call and try and get some wheels in motion so that we can get you the help that you need. He told Dean, how long is the program? 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. RICE: And I was surprised about this, particularly the data. GUPTA: There was something in the documentary that caught my attention. The small wire cage you see there is the actual step. The Dartmouth study showed the patients in places like Miami were receiving more care. Alexander/Transcript. I think this is important because I think when people watch the film, they are left with the impression that Yvonne finally came to the Cleveland clinic. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. That's my routine. GUPTA: I want to point out something. Adding Avandia can help. 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. It's the best treatment and it saves lives, period. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. And it's got to the point where the pain's radiating from my back down to my hips and then down to my thighs. WARD: For a long period of time I was hiding. NISSEN: You know, DVT and pulmonary emboli. There's been a lot of change in me in that transition between La Clinica and here. It doesn't reward them for keeping their patients healthy. Got approved very quickly. I could hardly just about walk three steps and I'd have to stop and rest. 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. 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. But we're going to talk to them about it still, you know? 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. So inhale. UNIDENTIFIED FEMALE: Came off the mountain with only eight? I would probably leave healthcare before I went back to practicing the way I practiced last year. BURD: All right. YATES: I meditate, and it has opened up a whole new world for me. Why do so many children die so young here? DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. I mean, they are going to watch that and think, that's ridiculous. It is an IV like this, about $280 just for the IV bag. If you go out and buy heart healthy diet food, it's going to cost you more money than anything. UNIDENTIFIED MALE: Yes. ROSS: All right. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. But, that's not the whole story. It's generating rivers of money that are flowing into very few pockets. The present system doesn't work and it's going to take us down. It expands the artery to hold it open and allow the blood to flow. 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." We want that. Viewers will see this language when they . I can't be having heart problems. It's not visible, but it's there. I have an insurance now perhaps. I'd rather be shot again than go through withdrawals of coming off that medicine. NISSEN: Now, the leading cause of death in diabetes is heart disease. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. He asked for pain medication. 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. We just have to keep working towards that. 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. 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. The costs are going through the roof and the ability to help these service members and their families recover and repair and come back to a functional life is getting less and less. I mean, the average price tag for a single hospital admission can be really eye-popping. 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. Video: This tiny shape-shifting robot can melt its way out of a cage . UNIDENTIFIED FEMALE: They are all combined. That was how many medications I was on. I'm Dr. Sanjay Gupta. Michelle? And you know, our grandparents did not eat stuff like this. This is just an unbelievable amount of stents and cardiac caths. UNIDENTIFIED FEMALE: OK. But I think the economic imperatives are much stronger now. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. The, you know, the food that we eat and the nutrition that we put in our body, that's been around since the beginning of time. If someone had talked to her -- I think someone had really teased out her chest pain and shortness of breath, I think many of her cardiac catheterization and stents would not be necessary. All right. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. UNIDENTIFIED MALE: Without the financial incentives, there's no way I could have gotten to the point that I am now, at saving literally thousands of dollars over the past few years by being healthier. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. Not having to eat all these pills. Then all of a sudden I started getting chest pains. CARNES: Ready? Again , when I'm talking about disincentives. It was with a huge amount of skepticism and resistance. That may strike people as very high. That's good. There were even times, honestly, that I looked in the mirror and said, how did you get here? And now I'm -- 25 years later and I'm in pretty good shape. 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. ORNISH: In medical school, I was learning to do bypass surgery with Michael DeBakey, the heart surgeon. Aladdin (1992)/Transcript. 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. To see if lifestyle changes can affect your (INAUDIBLE) even telomeres. 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