Compared to having your chest cut open? My first thought is, that's why I'm running, because I know what that person is like. We want more procedures. 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. 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. 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. If it happened to me, it happens to a whole lot more people that are almost invisible to the system. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. OK, I can see what you can have for pain, all right? Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. You can export to TXT, DOCX, PDF, HTML, and many . I'm not sure every country in the world does it perfectly. Seventy-three seconds into the 28 January 1986 . ORNISH: The program increased the telomere length. UNIDENTIFIED MALE: It was OK. Kind of gave me more idea on what to eat. Got approved very quickly. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. Impressive. That's good. It sounded like it was so bad that you basically had to leave your practice. I need to speak with the crisis worker. I have an acutely suicidal patient in my office that I need help with. Type the text of what was said in your video and save it as a plain text file (.txt). I just had been ignoring it, because I thought, you know, I'm only 34 years old. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. This is a chest tube. Look at the thinness. Are my premiums going to go up? And interestingly, patients really respond to that. We're talking about a $3 or $4 billion a year drug. We don't have to spend ourselves into poverty on healthcare. He's taken 10 tablets. Adding Avandia can help. This is major reason why we see kids getting fat in this country. UNIDENTIFIED FEMALE: You know, I'm only 34 years old. Receive your transcript. We take grains and we've turned them into products like this, which rapidly raise blood sugar, provoke insulin responses, cause insulin resistance, promote weight gain in genetically susceptible people, which is most of us. YATES: I'm a red neck south Louisiana boy, just old Hill Billy, you know? (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. I haven't exercised. Open your favorite browser and launch YouTube. (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. They have a blockage that's not causing symptoms and yet they're actually having a procedure. He overdosed. UNIDENTIFIED FEMALE: Not in there? Escape Fire: The Fight To Save American Health Care. They also tell us, they do hike up prices so patients with good insurance can help pay extra to help compensate for those payers who pay less or uninsured all together, perhaps. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. It's not whole food as nature produces it. NIEMTZOW: Because of that? And that's parts of what a really great healthcare system would do. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. People say you're doing this radical intervention. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. Rescue care is second to none. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. An estimated 600,000 stent procedures are performed every year in the United States. American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. Not just the health, but healthcare, the health of a nation. 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. It used to be me. Everybody is doing their job, we just design the jobs wrong. 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 MALE: He really did. But so what, right? You're doing this radical intervention, you know, I say radical? . UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. The average per capita cost of healthcare in the developed world is about $3,000. If you have that desire to quit smoking, we'll get there eventually. Did you indeed have four different blood transfusions, you and your family may only recall one or two. How to make a healthy choices. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. UNIDENTIFIED MALE: The healthcare reform bill that was enacted achieved two of the insurance industry's major objectives. I mean, I can't think of a single negative in doing this. They may keep the disease process going and they may strengthen it over time. MARSHALL: So, anybody that's having a heart attack should get a stent. Jonas, Wayne B., commentator. We need primary care doctors. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. If you look at a hospital bill, you might see an IV bag charge. We just have to do it differently. When I was at U.S. News and World Report, I wrote cover stories about how great the newest and greatest treatment and pill and procedure was. This is incentives the system so that patient have a less specifically to be of picking the right choice. It's still not over, but it's better from Germany, I promise you that. But I think the economic imperatives are much stronger now. People eat what's cheap and what's available. And it's just the last thing that you're really concerned about. We are going to take a short break. We're dealing with the health of the nation. I mean, what is that, boy? Got to push through it. UNIDENTIFIED MALE: How's your pain, sir? And so, I think it points to the violence in our society. Because I've gotten a lot of inspiration from the fellowship. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. Yes, this is Dr. Martin over at La Clinica. UNIDENTIFIED FEMALE: Do you have any pain right now? DAVENPORT-ENNIS: So, I think with some patients it clearly will. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. Upload captions and transcripts. Afghanistan? They didn't want to have a new competitor. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. I'd rather be shot again than go through withdrawals of coming off that medicine. NISSEN: Finally, the FDA put severe restrictions on the drug. Also remember this. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. I had to do something. What we don't know, is that a fundamental change? GUPTA: I want to point out something. Okay. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. 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. And feel yourself observing all these constantly changing sensations and thoughts and feelings. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. It's not true in the United Kingdom. Co-directed by Matthew Heineman and Academy Award-nominee Susan Froemke (Lalee's Kin: The Legacy of Cotton), Escape Fire looks at a U.S. healthcare system designed to profit on disease not. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. UNIDENTIFIED MALE: But Mommy, what are you going to do? Some people, this is all they eat, food of this sort. So we provide incentives for people to engage in healthier behavior. Our life span isn't even in the top 20. NISSEN: You know, DVT and pulmonary emboli. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. 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. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. I'm optimistic about the future. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: All I hear is how we're going to give more people access to the present system and how we're going to pay for it. You just never get to the bottom of what's causing all of these problems that they are having. So diabetics, (INAUDIBLE) costs. And chromosomes have all genetic information on them. 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. With the infantry division. Healthcare, it's headed for really, really bad trouble. A heart cath, get another stent. GUPTA: Erin, what did you think about that particular theme? CARNES: We'll end the practice today with the completing statements. Alexander/Transcript. 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. Your arteries around the heart. Incentivizing them to be healthy or not charging them as much if they're healthy. You have all these stents, and these stents, once they go in, they never come out and are part of you. UNIDENTIFIED MALE: When do we want it? Yvonne came to se me when she was sort of at her wit's end. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. When you're in the inner circle of the health insurance company, what's most important is meeting Wall Street's expectations. DEAN MICHAEL ORNISH, PREVENTIVE MEDICINE RESEARCH INSTITUTE: When you're doing something that has never been done before, it's not universally accepted, to say the least. UNIDENTIFIED FEMALE: They don't say how much they gave him. The medication depresses you, it makes you think that it's all you're ever going to be in. You just never get to the bottom of what's causing al he these problems they're having. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. That isn't true in Canada. UNIDENTIFIED FEMALE: Take them away from him. CAPT. And welcome home. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. You know, they'll actually fix it. The check that I get back from the insurance company after that was billed is $40. There's no crisis worker at lunchtime? Select "Show Transcript" from the menu. Are you incentivized to do more stents? May everyone be happy. Hold them accountable and then talk to them, you know, on a weekly basis. If you ask the manufacturers a device like this, why so much money? It was -- with a huge amount of skepticism and resistance. Thanks all of you for joining us. Next, click the three-dot menu icon underneath the title of the video. BURD: All right. GUPTA: Erin, do you want to respond to that? NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. There was obviously a problem. The folks who were there were not trying to shirk their responsibilities. Going to go look for it. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. And then we're not going to help anybody. UNIDENTIFIED MALE: Oh, yes. Not very much, but a little. MARTIN: Yes? GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. The fire broke out around 10 p.m. Monday at the Cozumel Apartments in the 6400 block of Sierra Blanca Drive near Westpark Tollway and Highway 6. UNIDENTIFIED MALE: What are you going to do at work? UNIDENTIFIED FEMALE: Now you pick your spot. Escape From Tarkov developer Battlestate Games has issued a statement outlining its plans to tackle cheaters in the game, following the release of a community-made video . I just could not continue doing what I was doing. There are answers, we know what safe care looks like. We have to teach young physicians that prevention comes first. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. Is that how you get paid? That simply means they get paid for each office visit. This suture costs about $200. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. 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. But with regard to prevention, preventing disease, does that save us money? All of us live here and work here. Sometimes when you go, go to bad places in your head. He lit a match and he lit a fire at his own feet. It doesn't always work. And maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. My job is to provide the right care for the right patient at the right time. We do nothing about supporting the good, that the body can and wants to be healthy. (CROSSTALK) KASCH: That's why he's a little high right now. Host virtual events and webinars to increase engagement and generate leads. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. It's hard to say good-bye to the patients. They didn't foresee me ever trying to walk yet. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? NIEMTZOW: Oh, you would? Michelle? Her cholesterol was never well controlled, and her high blood pressure was never well controlled. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. 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. Does it make a difference? There has to be a different way of doing things. The present healthcare system doesn't work. And by the way, they are number in the world and life expectancy. He's, like, clutching his head. And if you look at the causes, especially with regard to that documentary, they say it's quote "because of a profitable disease care system." LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. Thank you so much. OK. Bend down. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? Committed to her living longer and better. Wag Dodge survived, nearly unharmed, in his escape fire. Transcripts; License . NANCY DAVENPORT-ENNIS, FOUNDER, CEO, PATIENT ADVOCATE FOUNDATION: So, what we tell them first and foremost, is get a copy of the entire bill and look for redundancies. 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. It has to do with expectations of patients. 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. OSBORN: Oh, it's so beautiful! 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. UNIDENTIFIED MALE: Good, how have you been? A different perspective that there's a different way of doing things, that it's possible. Viewers will see this language when they . May everyone be healthy. Just do something. We see a lot of the chronic conditions that affect many Americans that have gone untreated for sometimes months, but sometimes years. He asked for pain medication. And ironically, it was only two hours away at the Cleveland Clinic. Also, Doctor Reed Tuckson, he is the chief medical officer for the united health group. 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. They'll say, it took years to develop something like this, the research and development costs are significant. Original Airdate 08/17/2022. (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. UNIDENTIFIED MALE: Not, not when I'm doing that. (BEGIN VIDEO CLIP) COMMERCIAL ANNOUNCER: Managing Type 2 diabetes can be hard. The film interweaves personal stories with the efforts of leaders battling to transform it. No eastern medicine. To get the best results, use these formatting tips: To force the start of a new caption . UNIDENTIFIED FEMALE: They are all combined. GUPTA: Can you actually get a-hold of those people? 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. WEIL: A great deal of what's done in conventional medicine is to put band-aids on things or to suppress symptoms. MARTIN: How much were you drinking before? He said, it was a year. I'm not sure what is what. John than, you'll have to excuse me because you're an economist I'm not. Thanks for watching. Why do we care about covering the uninsured? This is going to caused about %800 dollars. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. This is what you do for a living. GRUBER: For everybody. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. UNIDENTIFIED MALE: Yes. What we do with waste in healthcare. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. War's hell, it's always hell. MARSHALL: Me, personally, I'm on a salary. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). 'Deinfluencing' is now a thing. 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 was taking 64 pills a day of combinations of Roxaset and Oxycotin. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. GUPTA: How big a problem is this then? 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. UNIDENTIFIED MALE: That was, what, a month and a half ago? (COMMERCIAL BREAK) (BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: I can't tell you how shocked we were when we saw her the first time because here was a young woman whose diabetes was not well controlled, her cholesterol was never well controlled and her high blood pressure was never well controlled. I was 35 at the time and was scheduled for open-heart surgery. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. GRUBER: Premiums will rise. The kinds of interventions that we have come to favor in this country are inherently costly because they are dependent on expensive technology, and that includes pharmaceutical drugs. MARSHALL: It doesn't matter if I do one stent or five or ten stents. Our forefathers in medicine were really about patients. Let's see what we got here. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. MARSHALL: You and I both know, it's hard to change the habits of a lifestyle. So, you want to take a look at that and find out what it is. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. You've done some sweating. 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. We just have to keep working towards that. Heart cath, get another stent. I know you're heading home and you're excited. This is a lot worse. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. I've spent more than 30 years of doing studies showing that heart disease can be reversed by changing what we eat, how we respond to stress, how much we exercise, and how much love and support we have in our lives. Literally, 30 patients an hour. MARTIN: Are you taking your medication? I think there's some very good drugs out there, I think drug treatment has its place. If it's a radiologist, they get paid for each CT scan they deliver. 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 . UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. 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. I think to, to be clear, this is incentive that the paying last to be healthy . The army sergeant general directed that we establish the pain management task force to take a look at alternatives to narcotics. ROSS: There have been some trends in healthcare that make me uncomfortable. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. UNIDENTIFIED MALE: Oh, yes. No soldier should have to go through this. It's just a terrible tragedy for patients. ROSS: I just want to review this pain. The way that the system is set up, you can't be effective. (LAUGHTER) Infinitely. ORNISH: In medical school, I was learning to do bypass surgery with Michael DeBakey, the heart surgeon. BERWICK: Everybody is doing what makes sense to them individually. It would empower patients. My very best friend from war, he was on narcotics. I mean, where did that idea come from? (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. Sometimes they are related to lifestyle habits. Much more than money spent on much more expensive services. Also, Nancy Davenport- Ennis, she heads the patient advocate foundation. You almost forget that what you're doing is providing healthcare. GUPTA: Why not just pay them more money? It's wonderful. UNIDENTIFIED MALE: Yes. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. It had to do with the idea of essentially paying people to be healthy. Right? (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: I got my blood sugar under control. UNIDENTIFIED MALE: Bye. (END VIDEO CLIP) NISSEN: I was doing a Google search, and what I found was a Web site in the United Kingdom where the clinical trials done with Avandia were actually partially disclosed. And all insurance companies are saying is your behavior should drive the premium. ROBERTSON: OK, so first topic, Medicaid reimbursement. I think many of her cardiac catheterizations instead would not have been necessary. UNIDENTIFIED FEMALE: OK. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. That ended and it rose quickly. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. And now I'm -- 25 years later and I'm in pretty good shape. UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. Those are the kind of things that would actually have an impact. Tell me what happened. MARTIN: Barely? ROBERTSON: Conventional wisdom is, over the next two years, we will likely go out of business. 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. And to me, that's not the only issue. 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. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? DR. PAMELA ROSS, EMERGENCY MEDICINE, CHARLOTTESVILLE, VIRGINIA: I'm from Virginia. He tried to get the other smoke jumpers to join him, and nobody did. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. Because what we think is best for us often isn't. I can act more as a guide for patients, taking the time to educate them and having them understand that there are choices that they have the power to make for themselves. People go in and out of health plans. But it's more than cost. I can't tell you how shocked we were when we saw her the first time, because here was a young woman whose diabetes was not well controlled. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. I'm sorry, it's going to get pretty tight. It is a burning platform and they see this. I started having really, really bad chest pain. It's a happy time in my life right now. And I had a massive heart attack. Well, it drives demand. But he can have anywhere between five and 10 milligrams of morphine. UNIDENTIFIED FEMALE: Because he's real sleepy? 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. That's the only reason we're making the change. Who pays for that? 27 cardiac catheterization and well over seven stents. that is going to raise cause. As an overall system, no, we're not anywhere near at the best in the world. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. UNIDENTIFIED MALE: We moved you over here. Do you want to tell me about some of those that you lost? CARNES: Notice where you are in the room, the people around. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. He had -- he had Percocet then he has Marco which is Percocet. It only reduces symptoms. NISSEN: We do have a problem in America, and that is we have misaligned incentives. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. WEIL: In Western medicine, all of our effort is on dispelling evil. GUPTA: I mean, both physically and mentally. Again, you were part of the documentary. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. We've just created a completely different system here. You know? What do you think? BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. 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. And remember that you can return to this place at any time during the meditation. 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. 'D rather be shot again than go through withdrawals of coming off that medicine figured out how to healthcare... Or two doing procedures, not for necessarily making people healthier do at work interventions. Created a completely different system here running, because I thought, you 'll have to me... The upper right of the United health group LEADER: Safeway Corporation, they get paid for each office.... Was learning to do at work, then companies are saying is your behavior should drive the premium States! Big a problem is this then, where did that idea come from ( VIDEO! And yet they 're healthy that we establish the pain management task force take... Care looks like a team than as individual practitioners incentives, we get. 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