They didn't foresee me ever trying to walk yet. Escape Fire. 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. Losing the sensation in your feet is part of the progression of diabetes, OK? Suture, one that's used in every operating room in the world. So, less than 30 percent are actually done in these people with stable ischemic heart disease. Fire Escape. I just had been ignoring it, because I thought, you know, I'm only 34 years old. You know? (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. Mountains of Afghanistan are not easy to climb, so pain in my back. But you end up being this revolving door. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. We need primary care doctors. What would happen? UNIDENTIFIED FEMALE: You know, I'm only 34 years old. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. BROWNLEE: We spend a spectacular amount of money on healthcare. If they are surgeons, they get paid for each procedure. 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. 5. SGT. They have talked about a child between age of one and four, having the third most common causes of homicide. As an overall system, no, we're not anywhere near at the best in the world. UNIDENTIFIED MALE: Yes. First Published 08/18/22 12:02. read transcript. . 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. Anybody else would laugh, you know? Here's a couple simple tips. MARTIN: OK, OK. You lost five pounds. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. detail. We just have to do it differently. There are answers, we know what safe care looks like. 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. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. When you're injured they feed you, feed you, feed you all this stuff. Rescue care is second to none. When they have insurance and they have access to usual source of care, primary care. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. I felt like there's got to be something different, something better. MARTIN: Good. How long were you there? UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. We have a model that works simply by making changes in diet and lifestyles. You know, the ads always end with the same phrase, ask your doctor. In fact, more soldiers died last year from non-combat injuries than during war. And feel yourself observing all these constantly changing sensations and thoughts and feelings. We don't have a healthcare system in this country. ROSS: How long ago was that? UNIDENTIFIED MALE: That was, what, a month and a half ago? UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. It rewards them for delivering more care. Prevention is cost effective. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. We're all salaried so the decision on what we do for a patient is dependent upon what the patient needs not on our financial incentives. 27 cardiac catheterization and well over seven stents. UNIDENTIFIED FEMALE: Not in there? UNIDENTIFIED FEMALE: We'll do it at the front. It doesn't reward them for doing a better job. Is that how you get paid? Just sore. Is that a fair message? We have made all of this unhealthy food the cheapest and most available food. And the company did nothing. UNIDENTIFIED MALE: Yes. UNIDENTIFIED MALE: I quit drinking, too. The first description that the play makes about the fire escapes is "The apartment faces an alley and is entered by a fire escape, a structure whose name is a . I mean, look at our results. UMBDENSTOCK: Why? ROBIN CARNES, WALTER REED ARMY MEDICAL ENTER MEDITATION INSTRUCTOR: The first thing I'd like to do is teach you a breathing exercise with a targeted effect on post-traumatic stress. And chromosomes have all genetic information on them. They'll say, it took years to develop something like this, the research and development costs are significant. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. And you know, our grandparents did not eat stuff like this. Ten allotted. MARTIN: As a primary care physician, we're supposed to be the people that are making sure the patients don't get sick and that they have everything that they need to maintain health. And welcome home. ORNISH: There's very little evidence that these conventional treatments make you live longer, but they cause many men to be impotent or incontinent or both. They said, absolutely, it's been demonstrated that acupuncture is safe and effective, especially with post-operative and injury pain. ROSS: We've become a culture where you drive up, you get what you want, you get it fast, you get it right away, and you drive off. Simply the same way the hospitals and physicians. 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. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. Got approved very quickly. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. What does that do? DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. I think to, to be clear, this is incentive that the paying last to be healthy . 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. We have to be mindful to those points in time where you can intervene and say enough's enough. The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. He was featured in the film. If they are confirmed non-smoker, we give them a discount. 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. It was so consistent. DR. RICHARD NIEMTZOW, DIRECTOR, ANDREWS AIR FORCE ACUPUNCTURE CENTER: Right there. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. 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. YATES: I've chose to get off all narcotics, all medicine, everything. I mean, when the cost of some of the things we use on a regular basis. UNIDENTIFIED MALE: Let me get that jacket away from him. We have some challenges with access and affordability. They may keep the disease process going and they may strengthen it over time. 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. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. UNIDENTIFIED MALE: Yes. It is an IV like this, about $280 just for the IV bag. Well, it drives demand. OK. Bend down. CAPT. The patient just fell off the litter. ROBERT YATES, INFANTRY, U.S. ARMY: Medications I was on. Everybody is doing their job, we just design the jobs wrong. We are second to none in this country for those things. And how to know if you're being prescribed unnecessary procedures. I lost him. Your company becomes more competitive. It was either come and get care there or not get care at all. OK, so let's go into our meditation practice. An Entrenched System. They did not tell the FDA, and they did not tell patients. And it will not protect you from having a heart attack. CINDY ROBERTSON, ADMINISTRATOR, MD-COLOMBIA FAMILY HEALTH CENTER: We're the only clinic in this community county, so it's about 20,000 people overall. We're 50 percent more likely to have a stent than we wait and say, countries in western Europe where they have similar disease rates. It's addictive. STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. Alvin and the Chipmunks/Transcript. GUPTA: You feel better when you're healthier too. UNIDENTIFIED MALE: I'd be chomping narcotics. There's saving money and there's cost effective. Six years ago before I became CEO, I stopped to think, I've never looked after a healthy person and maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. You almost forget that what you're doing is providing health insurance. That's going to be a little bit of a change and a little unfortunate. 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. I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. You also want to engage the billing representatives and the financial representatives of the hospital in that discussion and have them understand, I need an explanation of these charges. UNIDENTIFIED FEMALE: Oh. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. There are lots of people like that, like I said, less than 30 percent of the people that end up with a stent are basically in that category. ROSS: If you had to? No eastern medicine. Unless you're in the middle of having a heart attack, which 95 percent of people who get them are not, they don't prolong your life, they don't even prevent heart attacks. Adding Avandia can help. You can't have a cafeteria that doesn't have calorie counts on it. Half of Americans will be diabetic or pre-diabetic in the next 10 years. It's not true in the United Kingdom. Select "Show Transcript" from the menu. 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. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. So we provide incentives for people to engage in healthier behavior. 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. Tom's Escape In The Fire Escape. Maintaining my pain. So we're going to open up some chi? LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. And, you know, you kind of get busy. People eat what's cheap and what's available. My energy level is up. Let's be honest. Expand the Transcripts and captions section if closed, then select Upload. And those are surprising. The balloon is inflated to widen the blocked areas. GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. GUPTA: Why not just pay them more money? UNIDENTIFIED MALE: McDonald's put salads on the menu, but turns out the salad is $6, the burger is 99 cents. They are going to healthcare. The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? This drug was the number one selling diabetes drug in the world in 2006. NISSEN: We're not saying that people are doing these procedures for profit. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. So at this point, we will administer the medication. And people do. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. We have a disease management system. This is just an unbelievable amount of stents and cardiac caths. Never needed you. UNIDENTIFIED MALE: Without the financial incentives, there's no way I could have gotten to the point that I am now in saving literally thousands of dollars over the past few years by being healthier. Our forefathers in medicine were really about patients. We see a lot of the chronic conditions that affect many Americans that have gone untreated for sometimes months, but sometimes years. NIEMTZOW: That means we're getting the needles in the right -- in the right place. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. It is the largest health insurance company in the country. The Escape fire Video demonstrates human stories and leaders in the fight to transform Medicare at the level of medicine, the US military, industry, and government. A flower for you. 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. UNIDENTIFIED MALE: Six and over. There's the cost of covering people who simply don't have insurance or can't pay. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. I have an acutely suicidal patient in my office that I need help with. Because they're not using health care now. It's about saving the health of a nation. (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. We're glad to have you home. 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. And for the large majority of people we help, they often don't understand what many of the charges are. It would empower patients. Some people, this is all they eat, food of this sort. Upload captions and transcripts. BROWNLEE: Fee for service rewards physicians for doing more. 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. I smoked six cigars a day, 10 cups of coffee, a lot of wine. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? If you look at a hospital bill, you might see an IV bag charge. It sounded like it was so bad that you basically had to leave your practice. We can't prevent disease in everybody, but we have to try. Try to understand where the redundancies are. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. We don't know what they are. And I knew what I was doing for a living was making it necessary for those folks to stand in line to wait for care in animal stalls and barns. WGRZ reported that crews encountered heavy fire and thick smoke coming from the building at 747 Main St., after they got the call at 10:08 a.m. A Mayday was called early in the operation. 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. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. The only other country, by the way, is New Zealand. And somebody's going to teach me how to do that, so I'm going to -- I'm going to do it. Here you go. ROSS: All right. In the dialog that appears, select the language of the file you're uploading. But he can have anywhere between five and 10 milligrams of morphine. I mean, the impression I think was a little misleading there, don't you think Nissen? 0. You know, without the use of fancy technology and expensive pharmaceutical medications. Carry a lot of weight because I'm infantry. We're spending almost twice as much in America as any other country on earth. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. I had to do something. And is it still traveling into your neck? And there's a lot of talk about who's going to pay for it, and that's really important. 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. 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 so 15 firefighters were trapped. And if you try and buck the system, someone says, what can we do to get your productivity up? Okay. NIEMTZOW: Because of that? She needs a follow-up within three month with an echo. And remember that you can return to this place at any time during the meditation. Now we're kind of dealing with the consequences. 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. 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. 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. 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. 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. Again, you were part of the documentary. Published: Santa Monica, Calif. : Lionsgate, [2013]. They can pretty much get away with increasing the rates as much as they want to. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? Are my premiums going to go up? 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. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. I want to give to people and I want to help people, and I wasn't able to find that here. GUPTA: How big a problem is this then? The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. MARTIN: Thyroid is a little bit big. All right? May everyone be healthy. 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. 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. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. They are often poor patients, but not always. About a 30 percent increase in the risk of heart attack and related complications. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). They are patients with heart failure, they are morbidly obese patients. Who should get a stent? And Doctor Jeff Cain. 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. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? 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. Or at least we think we do. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. Most diseases don't happen overnight. WEIL: Where are you from? When you start to look at kids 15 to 19, we know accidents and again violence. And every year they have to turn people away. We create a public expectation that more is better, which isn't actually true so people seek more. (LAUGHTER) NIEMTZOW: Hi. He's taken 10 tablets. GUPTA: In the spirit of educating people out there, I think I have cardiac disease in my family. She joins us now. 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