What would happen? UNIDENTIFIED MALE: Yes. We're spending almost twice as much in America as any other country on earth. Jonathan, you know, we want better care and lower costs. ROSS: All right. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. SGT. Let me get right to it, Erin. Until my doctor said to me, I don't know what else to do for you. 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. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. Where I'm at right now, patients are in desperate need of care. 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. They are patients with heart failure, they are morbidly obese patients. People say you're doing this radical intervention. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. And you say that you can help negotiate the price of these bills down, what do you tell people? We're not talking about a handful of people here. A documentary highlighting the shortcomings of the American healthcare system. And the owners of those pockets do not want anything to fundamentally change. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. There's also administrative costs that are built in. You will learn if your health care costs are going to go down any time soon. Compared to having your chest cut open? Transcripts Dragons: The Nine Realms Fire Escape Script view. That was the message that, you know, I think was the you got from that documentary. What is really striking is how little they have written the last few years. We're the only providers for. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. MARTIN: Are you taking your medication? Okay. He is also a president of the society for interventional and geography in intervention. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. UNIDENTIFIED MALE: He really did. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? I think there's some very good drugs out there, I think drug treatment has its place. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: All I hear is how we're going to give more people access to the present system and how we're going to pay for it. You bike to work today? That Medicare bidding demonstration. And then, being paid, on top of that, a bonus if they can demonstrate, if they have improve the quality of care and have also may cause saving. We know it's there. Again, you were part of the documentary. YATES: I've chose to get off all narcotics, all medicine, everything. MARTIN: Thyroid is a little bit big. We don't know what they are. Do you want to tell me about some of those that you lost? Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? I need to speak with the crisis worker. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. And you know, our grandparents did not eat stuff like this. This is Prazosin. more . ORNISH: The program increased the telomere length. 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) I was on Trizadon. I was head of corporate communications, which means I was the top public relations officer for the company. Seventy-three seconds into the 28 January 1986 . MARTIN: Yes? We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. MARTIN: It was a dire situation and there are many times that myself and my colleagues would have the conversation of, you know, we are going to miss something, this could be really bad, and actually having the fear that this was going to be harmful to our patients at some point. These are techniques that should be used to relieve symptoms. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. That's how embedded people get in the status quo. 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. 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. Let me take a listen to you. It's a completely irrational system. A lot of unnecessary stents? ROBERTSON: It's a financial necessity. 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. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. And how to know if you're being prescribed unnecessary procedures. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. 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. All Dogs Go to Heaven 2/Transcript. DR. ELIZABETH BLACKBURN, NOBEL PRIZE IN MEDICINE, 2009, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: Telomere are the ends of chromosomes. UNIDENTIFIED FEMALE: OK. And by the way, they are number in the world and life expectancy. UNIDENTIFIED MALE: Eggs, sausage, grits, bacon. 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. UNIDENTIFIED MALE: Bye. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. UNIDENTIFIED FEMALE: These are all name brand. And so, one of the good news, the exciting news is, is that there's a lot of energy now to turn that around. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: Insurance companies have always been able to regulate the rates they charge. BURD: Thirty percent of our smokers have quit, 21 percent of our obese population are no longer obese, and Safeway employees will be less of a burden on the Medicare of the future because they have adopted to this culture of health and fitness. I know you're heading home and you're excited. ORNISH: The limitations of high-tech medicine have never been clearer. It was -- with a huge amount of skepticism and resistance. Some would say overrewarded specialty and subspecialties. We want more procedures. But we're going to talk to them about it still, you know? Trying to get Medicare to cover a heart disease program has been by far the hardest thing I've ever done in my entire life. NIEMTZOW: Oh, you would? I'm not sure every country in the world does it perfectly. So Lexapro is the only thing you're on right now? He lit a match and he lit a fire at his own feet. UNIDENTIFIED FEMALE: Oh, my god. 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. I smoked six cigars a day, 10 cups of coffee, a lot of wine. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. So I went into the hospital and they told me I had had a heart attack. He was featured in the film. WEIL: This is a problem with a lot of our suppressive treatments. We want more specialists. The medication depresses you, it makes you think that it's all you're ever going to be in. You are going to hear from many different voices with varying opinions and backgrounds tonight. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. 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. ROSS: When do you think it would be good to try it? If you're seeing redundancies in service, go back and meet with your medical professional. This is a chest tube. They have talked about a child between age of one and four, having the third most common causes of homicide. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. In Latin, it means, above all, do no harm. UNIDENTIFIED FEMALE: Because he's real sleepy? BURD: All right. 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. Simply the same way the hospitals and physicians. It will require a huge effort. You say there's a lot of Yvonnes (ph) out there, the patient we just met. Next, click the three-dot menu icon underneath the title of the video. GUPTA: I mean, both physically and mentally. And people do. It's unseen, but it's there and it's very, very powerful. I think that's an important point. CHO: Oh, my God. If you can delay treatment, then that man is not at risk for side effects during that period of time. 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. 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. Do you understand? UNIDENTIFIED MALE: I feel different. 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. 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. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. MARTIN: OK? ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. A flower for you. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: I don't recall any time telling a lie, but I know that there are many times that I didn't disclose full information, and I was the company's chief spokesman. 0. You just look different. When you're injured they feed you, feed you, feed you all this stuff. There's no crisis worker at lunchtime? UNIDENTIFIED FEMALE: We'll do it at the front. It's just a terrible tragedy for patients. My very best friend from war, he was on narcotics. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: We only give lip service to prevention and we have to ask why as a society are we not working to prevent disease and promote health. UNIDENTIFIED FEMALE: Right. That's not good medicine. Jonas, Wayne B., commentator. I mean, where did that idea come from? That is how many medications I was on. Underrewarded primary care. WEIL: Where are you from? Impressive for it to react that quickly. I was in the hospital for two weeks. That prevents tissues from renewing themselves in the body and diseases take hold. Try to break a sweat every day. Because of this program that's here, the yoga. UNIDENTIFIED FEMALE: When I was a kid. Little did I know that it was followed by years of the same thing over and over and over again. If you have that happen in Germany or England, they say, here's a list of instructions, if you have problems come back and see us. It was either come and get care there or not get care at all. Event marketing. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. What we do with waste in healthcare. Eight IEDs through this deployment. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. If they are confirmed non-smoker, we give them a discount. YATES: Meditation is scary sometimes. It is important to keep in mind. Everybody is doing their job, we just design the jobs wrong. GUPTA: Why not just pay them more money? There are answers, we know what safe care looks like. 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. Physical Desc: JONAS: Fifteen years ago, we did a consensus conference at the National Institutes of Health and we asked the question, do we have good evidence to show that acupuncture is safe and effective for any condition? And yet the outcomes, the survival rates are at the highest levels. PROTESTERS: Now. About a 30 percent increase in the risk of heart attack and related complications. Escape Fire. If you talk to the employees around here that have lost 35, 50, 60, 100 pounds, they will tell you without a doubt they have a better quality of life. ROSS: I just want to review this pain. You're doing this radical intervention, you know, I say radical? 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. Here's a couple simple tips. Let me distinguish two terms. Look. And if you look at even devices like -- this is a needle that's used for biopsy. GUPTA: Stay with us. Determine, did you indeed have two MRI's during the course of one week? A different perspective that there's a different way of doing things, that it's possible. (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: I got my blood sugar under control. She ended up having another open heart operation, another bypass operation. MARSHALL: Me, personally, I'm on a salary. The present healthcare system doesn't work. I have an acutely suicidal patient in my office that I need help with. It just doesn't work out financially. Come back in a month or so? I'm really, really pleased. ROBERTSON: Right. Things could move in that direction here, and this is not the choice of the doctor. It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. MARTIN: OK. 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. Respiratory shutdown. I'm optimistic about the future. 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. UNIDENTIFIED MALE: I love you, too! (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. And when we come back, just how much does profit play a role in all these treatment decisions. OK. UNIDENTIFIED FEMALE: They are all combined. NISSEN: Contrary to what most people believe, getting a stent in your coronary, if you have stable chest pain, will likely relieve your pain, but it will not help you live longer. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. It would empower patients. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. And finally, keep in mind that what is charged and what is ultimately paid are two different numbers. Putting patients first. 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. He said, it was a year. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. 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. MARTIN: When was your last mammogram and pap smear? WEIL: Right. If it's a radiologist, they get paid for each CT scan they deliver. But when you're doing something that has never been done before, it's not universally accepted, to say the least. BROWNLEE: The vast majority of doctors in this country are paid by a fee-for-service system. That's going to be a little bit of a change and a little unfortunate. 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: What are you going to do at work? 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. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. I mean, an obvious one is nutrition, which is almost omitted from medical education. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. It was a great life. We see a lot of the chronic conditions that affect many Americans that have gone untreated for sometimes months, but sometimes years. The film is about finding a way out. The way that the system is set up, you can't be effective. Because they're not using health care now. If I'm frustrated by anything, it's that more of the nation hasn't adopted this. But, that's not the whole story. They may be a member of a health plan for a year and maybe no longer. When I was at U.S. News and World Report, I wrote cover stories about how great the newest and greatest treatment and pill and procedure was. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. I was so dependent on my pain medication. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. Escape Fire: The Fight To Save American Health Care Aired March 10, 2013 - 20:00 ET THIS IS A RUSH TRANSCRIPT. JONAS: There's very large randomized trials done at multiple centers that have demonstrated that acupuncture works, so we put together a study to see if we can actually insert this simple acupuncture technique during the aerovacs of wounded soldiers into Walter Reed and other medical centers in the United States. The easiest starting point was in the 30,000 non-union workforce, and I believe that within four years all of our employees will get this kind of healthcare plan. UNIDENTIFIED MALE: These are all one person's? 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. 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. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. And welcome home. That requires so much work, but we do it because we're committed to having her stay out of the hospital. What do you think? OK, so let's go into our meditation practice. CAIN: Exactly. 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. UNIDENTIFIED MALE: I'd do it if I had to. GRUBER: Premiums will rise. Look at our results, our life span isn't even in the top 20. CARNES: Notice where you are in the room, the people around. I actually practice emergency medicine at the University of Virginia in Charlottesville. Who should get a stent? How are you feeling? UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. I was on Valium just for the anxiety. What does it look like over the next few years? If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. Did you go to the diabetes education? UNIDENTIFIED MALE: But Mommy, what are you going to do? 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