I'm not sure every country in the world does it perfectly. DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Dr. Dean Ornish has studied and written about diet and heart disease for decades. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. GUPTA: Doctor Tuckson, I mean, one of the concerns -- and again, we will get right to it, it's simply not reimbursing enough money for primary care doctors. $300 billion on drugs. OSBORNE: I have lost -- since last year I've lost 21 pounds. We need primary care doctors. But this program has just inspired me to press forward. The answers among us, and only by accepting the fact that the American healthcare system is badly broken and the status quo isn't working, is bankrupting our nation, will we be able to seek out the escape fires, the potential solutions, and create a sustainable and patient centered system for the future. Is that how you get paid? &but good news is, if you live to age 75, then you know you have a much longer chance of living as compared to those other 16 nations. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. So he figured I was going to die because I was in such bad shape. Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. And I think those discussions that we between the patient and the provider about lifestyle disincentives. UNIDENTIFIED MALE: Nine months. UNIDENTIFIED FEMALE: Nine months? The present system doesn't work and it's going to take us down. Alexander/Transcript. The balloon is inflated to widen the blocked areas. NISSEN: I do. GUPTA: United health care makes a lot of money. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. If we just change reimbursement, it's a game changer, we change medical practice and we change medical education. It is so addictive. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. A heart cath, get another stent. 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? You can't have a cafeteria that doesn't have calorie counts on it. I can't be having heart problems. UNIDENTIFIED MALE: Not, not when I'm doing that. It's not true in the United Kingdom. How to know if you are being prescribed unnecessary medications or procedures, that's next. And how to know if you're being prescribed unnecessary procedures. You know? If you account for that, we do much better. You just never get to the bottom of what's causing all of these problems that they are having. There's also administrative costs that are built in. If you have that desire to quit smoking, we'll get there eventually. It's unseen, but it's there and it's very, very powerful. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. Insurance companies have always been able to regulate the rates they charge. You're doing this radical intervention, you know, I say radical? 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. Maybe even a provider service. Look. 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. (COMMERCIAL BREAK) DR. WAYNE JONAS, PRESIDENT, SAMUELI INSTITUTE, MILITARY MEDICAL RESEARCH: If our civilian healthcare system is smoldering and we see it's going to catch on fire and burn pretty soon, it is going to be unsustainable because of the costs, the military system is already on fire. She's still taking her Lexapro, but it's obviously not doing the job. UNIDENTIFIED MALE: Yes. 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. Sometimes they are related to lifestyle habits. He tried to get the other smoke jumpers to join him, and nobody did. more . I mean, an obvious one is nutrition, which is almost omitted from medical education. We need a whole new kind of medicine. A lot of unnecessary stents? ANNOUCNER: Cleveland Clinic cardiologist Dr. Steven Nissen decided to do his own review. Format: DVD Edition: Widescreen. ROSS: How long ago was that? 1. s03e01 - Fire Escape Tran script. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. The film is about finding a way out. That prevents tissues from renewing themselves in the body and diseases take hold. It was either come and get care there or not get care at all. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. You will learn if your health care costs are going to go down any time soon. If we get Medicare to cover it, then everyone else will cover it and if everyone covers it then it becomes a standard of care. It's much better to try to work at a deeper level. Exhale. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. Still bothers me to this day. I need some help over here. It just doesn't work out financially. Not very much, but a little. I don't want to go down the same path. YATES: I was on Parazasin just for nightmares. They did not tell physicians. Only thing we can do is separate them out, because there's no way for us to tell which are which. It doesn't reward them for keeping their patients healthy. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. May everyone be well. She ended up having another open heart operation, another bypass operation. To see if lifestyle changes can affect your (INAUDIBLE) even telomeres. 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. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. What does that do? Try to break a sweat every day. Because I've gotten a lot of inspiration from the fellowship. UNIDENTIFIED MALE: Six and over. And then we're not going to help anybody. CARNES: So feel yourself there in your safe place. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. Dodge survived, nearly unharmed. UNIDENTIFIED MALE: Once I found out what was really wrong with me. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). One of the great contributions of America to world cuisine, you know, fake bread. MARTIN: Uh-huh. The documents are coming out in these court suits, it looks worse and worse. NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. And that is where the affordable care act can help which is bringing more competition to the bidding and pricing of these items. 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. UNIDENTIFIED FEMALE: Where are you coming from? 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. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. And remember that you can return to this place at any time during the meditation. We're glad to have you home. Her cholesterol was never well controlled, and her high blood pressure was never well controlled. I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. 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. 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. What we don't know, is that a fundamental change? UNIDENTIFIED MALE: A day, for 25 years. There's the bright blue slush. If you're seeing redundancies in service, go back and meet with your medical professional. I was in the hospital for two weeks. And you know, our grandparents did not eat stuff like this. MARSHALL: Me, personally, I'm on a salary. You just look different. Can't wait to be there. Healthcare, it's in really bad trouble. They didn't foresee me ever trying to walk yet. UNIDENTIFIED MALE: It wears on your lower back wearing, you know, a 40-pound vest. 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. Maintaining my pain. They are going to healthcare. UNIDENTIFIED MALE: But Mommy, what are you going to do? May everyone be healthy. detail. 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. He asked for pain medication. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. Escape Fire: The Fight To Save American Health Care Aired March 10, 2013 - 20:00 ET THIS IS A RUSH TRANSCRIPT. Do you understand? Things could move in that direction here, and this is not the choice of the doctor. 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. It is important to keep in mind. We have a -- we have a motto in medicine. If you can delay treatment, then that man is not at risk for side effects during that period of time. UNIDENTIFIED FEMALE: He was issued this bottle today with 20 in it and 10 are missing. 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. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. There were even times, honestly, that I looked in the mirror and said, how did you get here? Adding Avandia can help. It was wonderful. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. Yvonne Osborn began suffering from severe chest pain at the age of 34. In Latin, it means, above all, do no harm. UNIDENTIFIED FEMALE: I think we have about 25 patients for today for Dr. Martin. And I think we're in a great deal of trouble because of that. The film interweaves personal stories with the efforts of leaders battling to transform it. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. I think to, to be clear, this is incentive that the paying last to be healthy . What do you say to people when they say look, pay Erin Martin a little more money, you guys are making $5 billion. UNIDENTIFIED MALE: That's pretty good. MARSHALL: So, anybody that's having a heart attack should get a stent. UNIDENTIFIED MALE: I'd do it if I had to. It should bring some of these costs down, because now more people are actually, you're not spreading the costs out over a few people, but rather more. MARTIN: Because of the bottom line, because of the cuts that are coming through the government, if it came to the point where they couldn't pay me anymore, that would suck, but I'm not afraid. All my health issues have gone away. Now you're going to get the scissors. MARTIN: Yes? It's here, right in the center of your chest. And now I'm -- 25 years later and I'm in pretty good shape. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. UNIDENTIFIED FEMALE: Oh. SHANNON BROWNLEE, MEDICAL JOURNALIST: How powerful are lobbyists in the healthcare system? I just had been ignoring it, because I thought, you know, I'm only 34 years old. 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. MARTIN: And they don't reimburse for nutritional counseling or anything like that. UNIDENTIFIED MALE: Yes. UNIDENTIFIED FEMALE: Prescriptions, you can see how many scripts in the under script. That's good. CARROLL: We found that the men who underwent lifestyle intervention, their PSA rates generally went down and they were less likely to require treatment. Or at least we think we do. UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? UNIDENTIFIED FEMALE: When I was a kid. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. 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. 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. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. We just spent $1,000. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. 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. It's completely changed food. UNIDENTIFIED MALE: Yes. Original Airdate 08/17/2022. That's almost as much as the rest of the world combined. DR. TIERAONA LOW DOG, FELLOWSHIP DIRECTOR, ARIZONA CENTER FOR INTEGRATIVE MEDICINE: We want to expose clinicians to a broader way of seeing the patient a deeper understanding of healing and a larger toolbox from which to choose for therapies. And I think that's a good place to start. It's a happy time in my life right now. MARTIN: You used to cut? ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? My job is to provide the right care for the right patient at the right time. I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. With the infantry division. 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. (LAUGHTER) NIEMTZOW: Hi. Impressive for it to react that quickly. CARNES: Release the breath in a smooth, even stream out. GUPTA: I want to point out something. I had difficulty sleeping at night. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. UNIDENTIFIED FEMALE: Hello, Mr. Fields. I mean, give me a break. Aladdin (1992)/Transcript. We are going to take a short break. DR. PETER CARROLL, CHAIR, DEPARTMENT OF UROLOGY, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: My path crossed with Dean's because we both wanted to bring rigorous clinical trial testing to this hypothesis that lifestyle intervention could have a impact on men with early stage prostate cancer. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. The power lies with corporations and corporate interests and the lobbyists that they buy. And yet the outcomes, the survival rates are at the highest levels. So we're going to open up some chi? 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. UNIDENTIFIED FEMALE: Yes. I was on Valium just for the anxiety. GUPTA: And I want to leave all of you at home with a thought as well. PROTESTERS: Now. UNIDENTIFIED REPORTER: Safeway's healthcare costs have remained flat compared to a 40 percent jump for most other companies. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. So that's rewarding for me. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. UNIDENTIFIED MALE: Yes. 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. It's generating rivers of money that are flowing into very few pockets. And so, I think it points to the violence in our society. Select Open transcript . You allow and encourage your employees to become healthier. It's wonderful. I would probably leave healthcare before I went back to practicing the way I practiced last year. That's built in these costs as well. CHO: Oh, my God. DR. ANDREW WEIL: There's the bright blue slush. NISSEN: We do have a problem in America, and that is we have misaligned incentives. And Doctor Nissen is in salaried as well. I'm not changed, but I'm changing. It got fast tracked by the FDA. Yes, this is Dr. Martin over at La Clinica. This isn't a game of this person against that group, this sector against that sector, but at the end of the day, the American people need solutions and the one thing they don't need is a bunch of finger pointing that doesn't take us forward. And water, they are saying, I'm going to have to give up to get there. There's saving money and there's cost effective. And, in fact, they were more likely to die. See you soon. We want that. So diabetics, (INAUDIBLE) costs. Aladdin (2019)/Transcript. Got to push through it. UNIDENTIFIED FEMALE: I just want to see what they've given him. It doesn't reward them for doing a better job. It's hard to say good-bye to the patients. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. Jonas, Wayne B., commentator. UNIDENTIFIED FEMALE: Do you have any pain right now? And they have to, these for-profit companies by law have to serve shareholders. They said, absolutely, it's been demonstrated that acupuncture is safe and effective, especially with post-operative and injury pain. 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 can't be having heart problems. 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. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. I want to give to people and I want to help people, and I wasn't able to find that here. If you go out and buy heart healthy diet food, it's going to cost you more money than anything. What we do with waste in healthcare. Healthcare reform was a good place to start, but it will do little to address the root problems. Click on "Export" and choose your preferred file format. 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. It's not true in France and Germany. When they have insurance and they have access to usual source of care, primary care. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. And maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. 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. As Berwick says in the film, "We're in Mann Gulch. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. He's, like, clutching his head. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. The check that I get back from the insurance company after that was billed is $40. I lost a lot of good men. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. 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. He was featured in the film. Let me just take a listen to you. They can pretty much get away with increasing the rates as much as they want to. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. She joins us now. WEIL: In the year of for-profit medicine, the time allowed for patient visits has shrunk to a point where you've got seven minutes with a patient. RICE: And I was surprised about this, particularly the data. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? OK, so let's go into our meditation practice. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. MARTIN: OK, OK. You lost five pounds. I think there's some very good drugs out there, I think drug treatment has its place. UNIDENTIFIED FEMALE: Take them away from him. The only other country, by the way, is New Zealand. It rewards them for delivering more care. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. If we can prevent that and even reverse it, that's how we're going to make true health care, not just sick care available. First Published 08/18/22 12:02. read transcript. Cost about $1200. Event marketing. (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. We are more likely to get a knee replacement or have a cat scanner, have an MRI. I'm interested in helping patients. Yvonne came to se me when she was sort of at her wit's end. Try to understand where the redundancies are. OSBORN: Oh, it's so beautiful! (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: I got my blood sugar under control. It's the best treatment and it saves lives, period. 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. And that's the problem. What the insurance industry's objective is, is to try to weaken those consumer protections over time and to try to influence how the law is being implemented. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . MARTIN: Are you taking your medication? Type the text of what was said in your video and save it as a plain text file (.txt). And interestingly, patients really respond to that. (CROSSTALK) KASCH: That's why he's a little high right now. Is that a fair message? These perverse incentives that you described? GRUBER: Premiums will rise. 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