UNIDENTIFIED MALE: Yes. It is so addictive. YATES: I was in the worst place in Afghanistan. Does it make a difference? If you select our human service, your transcript will be ready within 24 hours. And, of course, the natural end point is going to be in the emergency department. Have you -- UNIDENTIFIED FEMALE: 2008. And they have to, these for-profit companies by law have to serve shareholders. My energy level is up. Log in to your account. 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. Afghanistan? It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. I tried to get him up, he just rolled himself out. As an overall system, no, we're not anywhere near at the best in the world. Click on "Export" and choose your preferred file format. Event marketing. GUPTA: And I want to leave all of you at home with a thought as well. DR. ANDREW WEIL: There's the bright blue slush. UNIDENTIFIED FEMALE: Oh. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. And when we come back, just how much does profit play a role in all these treatment decisions. UNIDENTIFIED MALE: Yes. So we provide incentives for people to engage in healthier behavior. He or she assembles a team of five other people to work with, a nurse, a yoga teacher, an exercise physiologist, a registered dietitian, and a clinical psychologist. They said, absolutely, it's been demonstrated that acupuncture is safe and effective, especially with post-operative and injury pain. You know? Just sheer numbers, $2.7 trillion per year. (LAUGHTER) NIEMTZOW: Hi. Compared to having your chest cut open? 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. We do nothing about supporting the good, that the body can and wants to be healthy. Get educated on these issues and add your voice to a growing chorus for change. She had bypass surgery in her 30, 27 cardiac cauterization and well over seven stents before she went to the Cleveland clinic for treatment. We want more procedures. I mean, that sounds like a really dire situation. He had -- he had Percocet then he has Marco which is Percocet. In the United States, it was around $8,000 annually. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. Look at this. Adding Avandia can help. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. 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. We are second to none in this country for those things. We need a whole new kind of medicine. You say there's a lot of Yvonnes (ph) out there, the patient we just met. They can pretty much get away with increasing the rates as much as they want to. You allow and encourage your employees to become healthier. That Medicare bidding demonstration. UNIDENTIFIED FEMALE: Came off the mountain with only eight? The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? Committed to her living longer and better. To get the best results, use these formatting tips: To force the start of a new caption . 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. 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. UNIDENTIFIED MALE: I quit drinking, too. (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. If somebody has an infection, we give anti-infectious agents. Recognize that you are this spacious, welcoming, open awareness no matter what thought, no matter what feeling, no matter what sensation or circumstance happens to arise. It's a happy time in my life right now. All right? But, you know, we have the means to decrease disease. NISSEN: I do. But I'm doing it. We need a whole new kind of medicine. 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. (CROSSTALK) UNIDENTIFIED MALE: That's not -- yes. UNIDENTIFIED MALE: I feel different. UNIDENTIFIED FEMALE: I think we have about 25 patients for today for Dr. Martin. WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. UNIDENTIFIED MALE: I have no health insurance. DR. ELIZABETH BLACKBURN, NOBEL PRIZE IN MEDICINE, 2009, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: Telomere are the ends of chromosomes. UNIDENTIFIED REPORTER: The Safeway supermarket chain looked for a way to rein in spiraling premiums and hit in what seems to be a win-win solution. I feel like I'm changing. Why do we care about covering the uninsured? This is a lot worse. Seventy-three seconds into the 28 January 1986 . BURD: All right. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? 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. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. Come back in a month or so? With their city in ruins, the people of London finally realized the only escape from the devastation of . So he figured I was going to die because I was in such bad shape. That may strike people as very high. 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. I mean, the average price tag for a single hospital admission can be really eye-popping. YATES: Meditation is scary sometimes. And doctors wanting to please their patients will often prescribe it. And that worked for awhile. OK. Bend down. detail. . It will require a huge effort. Your arteries around the heart. 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. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. I haven't exercised. It only reduces symptoms. Did you go to the diabetes education? 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. I mean -- but you have to have the time to educate your patient. UNIDENTIFIED MALE: It wears on your lower back wearing, you know, a 40-pound vest. ROBERTSON: It's a financial necessity. Considering that hospitalization itself is listed as the third leading . This is going to caused about %800 dollars. There's a contradiction to what we do. The patient just fell off the litter. It's all about the reimbursement. The emergency department is the safety net of health care. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. It's the same challenge. Then all of a sudden I started getting chest pains. So, you compare us to those other nations, you have to understand that we come to the table with the bigger burden of disease. Some would say overrewarded specialty and subspecialties. And here's the secret, healthier people cost less money too. I said, there's got to be a better way. UNIDENTIFIED MALE: Yes. GUPTA: Doctor Rice, What do you think about that. GRUBER: For everybody. Is that how you get paid? But I decided to give it a shot. 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? Try to break a sweat every day. 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. UNIDENTIFIED MALE: I did yesterday. We say they don't prevent heart attacks, they don't lengthen life. But this program has just inspired me to press forward. GUPTA: I want to point out something. He's like really not listening very 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. Okay. There's nothing else I can do. Fire Escape. That's not good medicine. This is Prazosin. I decided out of curiosity to go check this out. If you're on a fixed income, what are you going to do for your family? GUPTA: So it doesn't matter. GUPTA: In the spirit of educating people out there, I think I have cardiac disease in my family. May everyone be healthy. Never needed you. YATES: I was on Parazasin just for nightmares. We want more tests. UNIDENTIFIED MALE: That was, what, a month and a half ago? GUPTA: Sometimes the patients demand this stuff. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. Michelle? UNIDENTIFIED MALE: A platoon of 23. We have a model that works simply by making changes in diet and lifestyles. 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. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. In the summer of 2007, I read about a health care expedition that was being held by Remote Area Medical a few miles from where I grew up. We even found that when you change your lifestyle, over 500 genes were changed. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. Escape Fire. Do you understand? ORNISH: The program increased the telomere length. Cost about $1200. 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. And to me, that's not the only issue. People say you're doing this radical intervention. NISSEN: Finally, the FDA put severe restrictions on the drug. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). 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) You bike to work today? OSBORNE: I am great. 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. NIEMTZOW: Oh, you would? 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. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. UNIDENTIFIED MALE: Six and over. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. UNIDENTIFIED MALE: What are you going to do at work? If somebody has hypertension, we give anti-hypertension drugs. And I say that as doctor. And now I'm -- 25 years later and I'm in pretty good shape. GUPTA: There was something in the documentary that caught my attention. If you ask the manufacturers a device like this, why so much money? I had difficulty sleeping at night. UNIDENTIFIED FEMALE: Take them away from him. . ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. Jonas, Wayne B., commentator. If you have cholesterol under control, a discount. They sent me home with them. Yvonne came to se me when she was sort of at her wit's end. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. I was a bit surprised. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. UNIDENTIFIED MALE: Let me get that jacket away from him. I think there's some very good drugs out there, I think drug treatment has its place. Healthcare reform was a good place to start, but it will do little to address the root problems. 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. When I had my first heart attack, did the cardiac catheterization, put the thing up there and put a stent in my heart, because I had a clogged artery. 0. Escape Fire: The Fight To Save American Health Care. Don't need you, don't need you. We're in Mann Gulch. Going back home. Sometimes when you go, go to bad places in your head. GUPTA: Stay with us. MARTIN: Are you taking your medication? 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. How are you feeling? DR. RICHARD NIEMTZOW, DIRECTOR, ANDREWS AIR FORCE ACUPUNCTURE CENTER: Right there. MARTIN: I had to do the fellowship because it was kind of my little ray of hope that things could be better, things can be done differently. UNIDENTIFIED FEMALE: Because he's real sleepy? He was featured in the film. They did not tell physicians. UNIDENTIFIED REPORTER: It's an idea that's received national attention. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. CARNES: We'll end the practice today with the completing statements. The small wire cage you see there is the actual step. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. It's not whole food as nature produces it. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. UNIDENTIFIED MALE: Once I found out what was really wrong with me. MARSHALL: It doesn't matter if I do one stent or five or ten stents. And water, they are saying, I'm going to have to give up to get there. 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. Sometimes they are related to lifestyle habits. We're talking about a $3 or $4 billion a year drug. And if they have a relationship with you, feeling truncated. And if you look at even devices like -- this is a needle that's used for biopsy. (BEGIN VIDEO CLIP) DR. ERIN MARTIN, PRIMARY CARE: As a primary care physician, we are supposed to be the people that are making sure the patients don't get sick and they have everything they need to maintain health. 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. UNIDENTIFIED FEMALE: OK, I need some help over here. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? It is an IV like this, about $280 just for the IV bag. Her cholesterol was never well controlled, and her high blood pressure was never well controlled. It was a passion for healing. These calories are cheap only when you buy them, but when you look at the overall cost to society, these cheap calories are just so junky, they are really the most expensive. Again, you were part of the documentary. NISSEN: We do have a problem in America, and that is we have misaligned incentives. WEIL: Right. STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. If you account for that, we do much better. 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. 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. I think many of her cardiac catheterizations instead would not have been necessary. I want to give to people and I want to help people, and I wasn't able to find that here. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. And when we work at that level, we find people are much more likely to make these sustainable changes and the patient learns how to empower themselves and to transform their lives. Got to push through it. And so 15 firefighters were trapped. If I'm frustrated by anything, it's that more of the nation hasn't adopted this. UNIDENTIFIED MALE: How's your pain, sir? That is how many medications I was on. GlaxoSmithKline worked very hard to keep these numbers from the public. 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. 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. I'll look up and I'll see a person who's overweight across the street. And healthcare doesn't need to be immune to that. I was in the hospital for two weeks. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. People eat what's cheap and what's available. And I think that's a good place to start. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. We have a disease management system. We need primary care doctors. I mean, give me a break. 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. POTTER: We have been trying to reform the health care system for a hundred years. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. BROWNLEE: Fee for service rewards physicians for doing more. UNIDENTIFIED FEMALE: These are all name brand. It just wants you to keep coming back for your care of your chronic disease. UNIDENTIFIED FEMALE: Right. I haven't touched my toes in months. It's an expensive world to live in in terms of getting your voice heard in D.C., but that's the whole function of advocacy. 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. I mean, where did that idea come from? In fact, more soldiers died last year from non-combat injuries than during war. And I think those discussions that we between the patient and the provider about lifestyle disincentives. They become more productive. Do you want to tell me about some of those that you lost? May everyone be well. Rescue care is second to none. This place actually gave me the tools to put in my tool bag so I can go back and still continue my process of healing, recovery. He's, like, clutching his head. A stapler, this stapler that is often to used in surgery, like this? So diabetics, (INAUDIBLE) costs. It's not just we know it, we actually can go and visit it. Also, Nancy Davenport- Ennis, she heads the patient advocate foundation. Are my premiums going to go up? 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. MARTIN: Can you feel this? It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. I mean, give me a break. Instead of basing things on outcomes, on how good of a job we're doing, the government sets the reimbursement completely on the number of patients that we see. Your harm's heavy, your leg's heavy. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. GUPTA: United health care makes a lot of money. She got her cholesterol under control, her weight under control and things were great for her after that. You can't have a cafeteria that doesn't have calorie counts on it. And the problem is, some of those procedures will lead to bad outcomes. We want that. I think five or six of them are on the waiting list. Let me just take a listen to you. What we do with waste in healthcare. 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. I'd rather be shot again than go through withdrawals of coming off that medicine. UNIDENTIFIED FEMALE: Not in there? ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. And it will not protect you from having a heart attack. Who's next? You just never get to the bottom of what's causing al he these problems they're having. When medicine became a business, we lost our moral compass. GRUBER: Well, basically, Medicare actually - I don't have to tell - Medicare right on demonstration where they did bidding, where Medicare would pay -- would reimburse certain rates for medical devices and they had bidding across different manufacturers to be the low bidder, to brought that sources lower prices by 40 percent. UNIDENTIFIED FEMALE: How are you? I just could not continue doing what I was doing. I'm optimistic about the future. CARNES: So feel yourself there in your safe place. 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. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. 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