It's completely changed food. Impressive for it to react that quickly. 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. BULLIS: Soldier know if they go to war and they get a leg blown off, your medic is going to take care of you and the same thing needs to apply that if you have post-traumatic stress. I think that's an important point. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. TUCKSON: Primary care doctors are being cared more. And you're here today with chest pain. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. ANNOUCNER: Cleveland Clinic cardiologist Dr. Steven Nissen decided to do his own review. I need some help over here. UNIDENTIFIED MALE: We all know there's things we can do and they make us feel good and we like to do them, but we're going to feel really bad if our doors close. Come back in a month or so? PROTESTERS: Now. I was popping 20 or 30 Nitrols a day. This point I'm in. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. If somebody has an infection, we give anti-infectious agents. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. And that model has continued until today. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. UNIDENTIFIED MALE: I quit drinking, too. The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. Why do so many children die so young here? It goes back to Teddy Roosevelt. DR. SANJAY GUPTA, HOST: Good evening. If you get a bump on your head as a friend of mine had, and you go into the emergency department, in America, you get a cat scan. GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. Some people, this is all they eat, food of this sort. You've seen a lot. 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. detail. Good. But it's more than cost. UNIDENTIFIED FEMALE: Just take a couple of minutes to kind of arrive. He overdosed. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. He tried to get the other smoke jumpers to join him, and nobody did. Viewers will see this language when they . DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. CARNES: We'll end the practice today with the completing statements. Respiratory shutdown. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. Maybe even a provider service. That's the only reason we're making the change. Your company becomes more competitive. BROWNLEE: We have a disease care system, and we have a very profitable disease care system. GUPTA: Sometimes the patients demand this stuff. Thank you so much. I was so dependent on my pain medication. YATES: I've chose to get off all narcotics, all medicine, everything. Rescue care is second to none. A lot of unnecessary stents? 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. 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. If somebody has hypertension, we give anti-hypertension drugs. UNIDENTIFIED FEMALE: Take them away from him. And we see that suffering. (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. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. You know, they'll actually fix it. 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. One of the great contributions of America to world cuisine, you know, fake bread. WEIL: In Western medicine, all of our effort is on dispelling evil. As Berwick says in the film, "We're in Mann Gulch. We're glad to have you home. UNIDENTIFIED FEMALE: OK. GUPTA: Doctor Rice, What do you think about that. UNIDENTIFIED FEMALE: How are you? ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? 2. UNIDENTIFIED FEMALE: Oh, my god. Our health care system. And that is why, our first priority has to be to equalize that access and then move on. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. Blood pressure under control, a discount. 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. It really does. I actually practice emergency medicine at the University of Virginia in Charlottesville. 5. The film is about finding a way out. 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. We have a -- we have a motto in medicine. How are you feeling? If it's a radiologist, they get paid for each CT scan they deliver. I haven't touched my toes in months. The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. 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. UNIDENTIFIED FEMALE: Prescriptions, you can see how many scripts in the under script. YATES: Meditation is scary sometimes. I mean, I can't think of a single negative in doing this. ROSS: All right. UNIDENTIFIED FEMALE: Now you pick your spot. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. You just never get to the bottom of what's causing all of these problems that they are having. If insurance companies don't deliver value, they won't be in business very long. But I think the economic imperatives are much stronger now. And sometimes push the plate away. Receive your transcript. UNIDENTIFIED FEMALE: When I was a kid. It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. It would be a very different system that probably would be less high-tech and more high touch. Going to go look for it. (CROSSTALK) UNIDENTIFIED MALE: That's not -- yes. To get the best results, use these formatting tips: To force the start of a new caption . SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. 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. 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. What made you decide to do that? If they are surgeons, they get paid for each procedure. They didn't foresee me ever trying to walk yet. What we do with waste in healthcare. 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. UNIDENTIFIED MALE: What do we want? GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? UNIDENTIFIED MALE: Nine months. So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. I'm optimistic about the future. We have made all of this unhealthy food the cheapest and most available food. Transcripts; License . So, less than 30 percent are actually done in these people with stable ischemic heart disease. Here you go. When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. It's too much paying for it. And finally, keep in mind that what is charged and what is ultimately paid are two different numbers. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. OSBORNE: I have lost -- since last year I've lost 21 pounds. So he figured I was going to die because I was in such bad shape. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. CHO: Oh, my God. So we took the men with prostate cancer. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. If you're in the system, do you access of if you are insured, if you are living in a safe neighborhood, your outcomes are great in America. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. So, you compare us to those other nations, you have to understand that we come to the table with the bigger burden of disease. UNIDENTIFIED MALE: Yes. NISSEN: Yes. If someone had talked to her, I think someone had really teased down her chest pain and her shortness of breath. It takes a village to make an unhealthy patient healthy. 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. I want to give to people and I want to help people, and I wasn't able to find that here. What that means is, the money we spend on prevention improves our health greatly per dollar spent. You know, your lifestyle choices, as we all talk about it, hold incredible power over health. 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. That is ridiculous. The Issues. I mean, couple weeks, I felt like I was okay. 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. He was featured in the film. (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. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). What do you say when someone calls you? UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. 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. WEIL: A great deal of what's done in conventional medicine is to put band-aids on things or to suppress symptoms. Published: Santa Monica, Calif. : Lionsgate, [2013]. MARTIN: OK. Link 'n' Share. They have talked about a child between age of one and four, having the third most common causes of homicide. It's just so much more than money. But, the American people are going to want something like that and that is going to be their perception. Eight IEDs through this deployment. UNIDENTIFIED FEMALE: Hello, Mr. Fields. So, a hospital like the one you just saw there. In the dialog that appears, select the language of the file you're uploading. But with regard to prevention, preventing disease, does that save us money? I don't believe in that stuff. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. 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. UNIDENTIFIED FEMALE: Yes. They'll say, it took years to develop something like this, the research and development costs are significant. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? the play Tom is seen standing in a fire escape during many acts. If you account for that, we do much better. 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. MARTIN: Bye. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. In fact, more soldiers died last year from non-combat injuries than during war. Let me get right to it, Erin. I do it in my clinic all the time. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. And the actual costs for care here is among the lowest in the country. 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. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. And I hope our new generation of health professionals will catalyze this social movement that's necessary and enough people get aroused enough about the situation and see it for what it is and then start some kind of grassroots movement to change the political balance of power. UNIDENTIFIED FEMALE: They are all combined. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. 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. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. Now we're kind of dealing with the consequences. It's just a terrible tragedy for patients. If you can delay treatment, then that man is not at risk for side effects during that period of time. Job number two was to make sure that there was not a public option. Got to push through it. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. 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. So we provide incentives for people to engage in healthier behavior. Sometimes we're talking about them on a daily basis. GUPTA: So, tell me how that would work? BURD: All right. You almost forget that what you're doing is providing health insurance. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. SHANNON BROWNLEE, MEDICAL JOURNALIST: How powerful are lobbyists in the healthcare system? ROSS: If you had to? I had to do something. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. UNIDENTIFIED FEMALE: We'll do it at the front. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. And then we're not going to help anybody. But this program has just inspired me to press forward. that is going to raise cause. And for the large majority of people we help, they often don't understand what many of the charges are. GUPTA: Why not just pay them more money? It will require a huge effort. We're part of the community. UNIDENTIFIED MALE: Oh, yes. It's not visible, but it's there. We just have to do it differently. UNIDENTIFIED FEMALE: Loratab, Naproxen. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. I know you're heading home and you're excited. UNIDENTIFIED MALE: Yes. I came to Walter Reed. It expands the artery to hold it open and allow the blood to flow. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. I'm not interested in getting my productivity up. It's not just we know it, we actually can go and visit it. GUPTA: How big a problem is this then? SGT. Only thing we can do is separate them out, because there's no way for us to tell which are which. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. And, in fact, they were more likely to die. We have a disease management system. Tell me what happened. These lifestyle changes cannot only work as well as drugs and surgery, but often even better at a fraction of the cost and the only side effects are good ones. Don't need you, don't need you. Transcripts Dragons: The Nine Realms Fire Escape Script view. He said, it was a year. Michelle? We do nothing about supporting the good, that the body can and wants to be healthy. The medication depresses you, it makes you think that it's all you're ever going to be in. GUPTA: So it doesn't matter. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. That's built in these costs as well. Hold them accountable and then talk to them, you know, on a weekly basis. I need to speak with the crisis worker. 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. (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 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. She had had bypass surgery at an early age. 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. Never needed you. UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. If you select our human service, your transcript will be ready within 24 hours. NIEMTZOW: Because of that? Do you understand? All right. We cut people open, re-bypass their blocked arteries and he would tell them they were cured, and they'd go home and more often than not eat the same junk food, smoke, and not manage stress, not exercise, and then often their bypasses would clog up, so we cut them open, we bypass their bypass, sometimes multiple times. And the company did nothing. JONAS: What it first seems like strange bedfellows, healing oriented mind/body practices and sort of the hardcore military actually is an opportunity that they jumped at because of the pragmatic need and nature that the wars had driven them to respond to. 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. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. OK? I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. 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