I'm two and a half months out of combat. And I say that as doctor. He tried to get the other smoke jumpers to join him, and nobody did. (COMMERCIAL BREAK) (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: If you need serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. I was head of corporate communications, which means I was the top public relations officer for the company. $300 billion on drugs. How to know if you are being prescribed unnecessary medications or procedures, that's next. Let me distinguish two terms. PROTESTERS: Now. But with regard to prevention, preventing disease, does that save us money? (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. Your company becomes more competitive. Determine, did you indeed have two MRI's during the course of one week? BURD: All right. the play Tom is seen standing in a fire escape during many acts. You bike to work today? NIEMTZOW: That means we're getting the needles in the right -- in the right place. Literally, 30 patients an hour. GUPTA: I want to point out something. GUPTA: Are you optimistic about the future when it am could to family care, and when it comes to our health care overall? 4:00 Minute Teaser Video UPDATE: "In 2010, the US spent $2.5 trillion on healthcare." But now (in 2018) we are spending $3.65 trillion/year. UNIDENTIFIED FEMALE: When I was a kid. And the fire spread around him. 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. I love you. 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. Just do something. I would probably leave healthcare before I went back to practicing the way I practiced last year. I took care of them and I was responsible for them and just worrying about if somebody else is going to do for them what they need. I haven't touched my toes in months. 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. He was featured in the film. What we don't know, is that a fundamental change? UNIDENTIFIED FEMALE: Hi. You will learn if your health care costs are going to go down any time soon. Here you go. UNIDENTIFIED MALE: Bye. JOE BIDEN, VICE PRESIDENT: Good morning, folks, how are you? Am I going to be paying more? UNIDENTIFIED REPORTER: It's an idea that's received national attention. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. Upload captions and transcripts. ORNISH: The program increased the telomere length. And, in fact, they were more likely to die. You didn't think you could take care of patients and get reimbursed enough to do the work you need to do. It's still not over, but it's better from Germany, I promise you that. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. UMBDENSTOCK: Why? That's almost as much as the rest of the world combined. Because I've gotten a lot of inspiration from the fellowship. Most diseases don't happen overnight. I lost him. What do you say when someone calls you? We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. You know, Nancy, we talked a lot about these bills. Afghanistan? GUPTA: You feel better when you're healthier too. ROSS: I just want to review this pain. That's not good medicine. BROWNLEE: We spend a spectacular amount of money on healthcare. Maybe even a provider service. If you can delay treatment, then that man is not at risk for side effects during that period of time. The small wire cage you see there is the actual step. UNIDENTIFIED MALE: Six and over. UNIDENTIFIED FEMALE: No. 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) NISSEN: Finally, the FDA put severe restrictions on the drug. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. May everyone be well. That simply means they get paid for each office visit. 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. Prevention is cost effective. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. They didn't foresee me ever trying to walk yet. People say you're doing this radical intervention. I'll look up and I'll see a person who's overweight across the street. ROBERTSON: OK, so first topic, Medicaid reimbursement. And in some ways, I think of a lot of what's happening in health care is kind of dark matter. GUPTA: Erin, do you want to respond to that? Sometimes I go to the hospital and that's the only health care I ever got. 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. (LAUGHTER) That's the way I like to look at it. 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. To feel that way when you come home is demoralizing. How to make a healthy choices. When telomere wear down and get frayed, the genetic material would get messed up. All right? Escape fire: the fight to rescue American healthcare (DVD) Contributors: Heineman, Matthew, director, Froemke, Susan, director, Berwick, Donald M. 1946- commentator. MARTIN: Barely? UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. The documents are coming out in these court suits, it looks worse and worse. I need to speak with the crisis worker. We create a public expectation that more is better, which isn't actually true so people seek more. Impressive for it to react that quickly. And remember that you can return to this place at any time during the meditation. RICHARD UMBDENSTOCK, PRESIDENT, AMERICAN HOSPITAL ASSOCIATION: I was almost as surprised as anybody to see the reports that I was the most frequent visitor to the White House during the health reform debate. UNIDENTIFIED MALE: I love you, too! When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. We say they don't prevent heart attacks, they don't lengthen life. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. There's saving money and there's cost effective. People talk about two-minute doctors. OK? So we're going to open up some chi? Again, you were part of the documentary. What does that do? DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? Only thing we can do is separate them out, because there's no way for us to tell which are which. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. We want more procedures. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. UNIDENTIFIED MALE: I'd do it if I had to. It's getting rid of the bad thing. I'm going to the emergency department. People come in and you try and fix one thing and they come back for the same thing over and over and over. The emergency department is the safety net of health care. I'm Dr. Sanjay Gupta. I haven't exercised. 2. I was so dependent on my pain medication. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? And that worked for awhile. A flower for you. Physical Desc: NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. UNIDENTIFIED MALE: I have no health insurance. 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. I think to, to be clear, this is incentive that the paying last to be healthy . That was job number one for them. ROSS: When do you think it would be good to try it? But we end up being this revolving door. If you account for that, we do much better. Where does that money come from? Aladdin and the King of Thieves/Transcript. He asked for pain medication. If you ask the manufacturers a device like this, why so much money? 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. He's, like, clutching his head. It's generating rivers of money that are flowing into very few pockets. But, you know, we have the means to decrease disease. Something like that. As an overall system, no, we're not anywhere near at the best in the world. 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. They sent me home with them. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. 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. YATES: Meditation is scary sometimes. Fire Escape Transcript. UNIDENTIFIED FEMALE: OK. GUPTA: And I want to leave all of you at home with a thought as well. So Lexapro is the only thing you're on right now? Fire Escape. The film is about finding a way out. That is ridiculous. I mean, look at our results. Next, click the three-dot menu icon underneath the title of the video. We have made all of this unhealthy food the cheapest and most available food. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. It sounded like it was so bad that you basically had to leave your practice. This is going to caused about %800 dollars. Episode Number(s) 1 S03E01 03x01. 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. I could hardly just about walk three steps and I'd have to stop and rest. Our life span isn't even in the top 20. An estimated 600,000 stent procedures are performed every year in the United States. That requires so much work, but we do it because we're committed to having her stay out of the hospital. But we're going to talk to them about it still, you know? 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. ROBERTSON: It's a financial necessity. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. And it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. BERWICK: The healthcare system isn't affordable anymore. MARSHALL: You and I both know, it's hard to change the habits of a lifestyle. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. 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. So at this point, we will administer the medication. It's unseen, but it's there and it's very, very powerful. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. Escape Fire Worksheet Escape Fire: The Fight to Rescue American Healthcare HSC 507 Introduction to Health Service Systems & Organizations Central Michigan University - Spring 2020 Print your name: _Kya Churchill _____ The video has been placed on reserve in the CMU Library. I know you're heading home and you're excited. And the actual costs for care here is among the lowest in the country. If you have cholesterol under control, a discount. GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: As we've pushed medical innovation and capability to the leading edge of the battlefield where we can save their life, and we've got some guys who have had some horrific injuries and they're getting narcotics for a longer period of time, they certainly are at risk to develop dependency, and that's what we're trying to avoid. ROSS: All right. Here's a couple simple tips. You have all these stents, and these stents, once they go in, they never come out and are part of you. And so behavior becomes a form of currency for people to accomplish their lifestyle changes. I was on anti-depressants. When medicine became a business, we lost our moral compass. Can adding Avandia help you? 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. And to me, that's not the only issue. And that's parts of what a really great healthcare system would do. And then we're not going to help anybody. Wag Dodge had an idea. YATES: I was on Parazasin just for nightmares. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. ORNISH: Dr. Peter Carroll and I collaborated with Dr. Elizabeth Blackburn, who won the Nobel Prize in medicine and she had done a study showing that stress creates shorter telomere, said as your telomeres get shorter, your life gets shorter. There has to be a different way of doing things. Just sore. The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. It would empower patients. ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. UNIDENTIFIED FEMALE: We'll do it at the front. UNIDENTIFIED MALE: I feel like I'm warming up a little bit. Little did I know that it was followed by years of the same thing over and over and over again. And Doctor Nissen is in salaried as well. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: Insurance companies have always been able to regulate the rates they charge. ROSS: What do you think about that? She got her cholesterol under control, her weight under control and things were great for her after that. Our health care system. I was in the hospital for two weeks. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). They can't recognize an invention when it's among them and they can't give up their old habits. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. ROBERTSON: Right. Delhi Building Collapse Video: 100 , About a 30 percent increase in the risk of heart attack and related complications. In the dialog that appears, select the language of the file you're uploading. WARD: For a long period of time I was hiding. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. I mean, give me a break. But, that's not the whole story. It turns out lots and lots of men who had a cancer that didn't need to be treated, but they got treated anyway and it was causing a lot of harm. I don't believe in that stuff. And the owners of those pockets do not want anything to fundamentally change. Dr. Berwick suggests that the current state of healthcare. Why do we care about covering the uninsured? CHO: Oh, my God. THIS IS A RUSH TRANSCRIPT. Transcripts; License . Thanks for watching. OK. Bend down. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? 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. Mountains of Afghanistan are not easy to climb, so pain in my back. That's the only reason we're making the change. Now we're kind of dealing with the consequences. that is going to raise cause. Exhale. It would be a very different system that probably would be less high-tech and more high touch. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. So diabetics, (INAUDIBLE) costs. Thanks all of you for joining us. 5. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. UNIDENTIFIED MALE: Good, how have you been? SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. GUPTA: I'm salaried too as a physician. All of us live here and work here. UNIDENTIFIED FEMALE: Do you want to do a pill count with me? Also, Doctor Reed Tuckson, he is the chief medical officer for the united health group. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. And so, that's clearly one of the issues. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. When they have insurance and they have access to usual source of care, primary care. CARNES: We'll end the practice today with the completing statements. 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. GUPTA: I mean, both physically and mentally. 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. MARTIN: I think what the American people need is, they need good health care. 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