You just look different. The fire overtook the crew, killing 13 men and burning 3,200 acres. Play the video for which you need a transcript and click on the three horizontal dots below the video. 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. Again , when I'm talking about disincentives. A lot of unnecessary stents? They can't recognize an invention when it's among them and they can't give up their old habits. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . ROSS: What do you think about that? It is the largest health insurance company in the country. Impressive for it to react that quickly. That's almost as much as the rest of the world combined. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. We're the only providers for. Here you go. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. 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. U.S. caregivers are told you've got to keep me pain free, you're going to do that. I just had been ignoring it, because I thought, you know, I'm only 34 years old. ROSS: I just want to review this pain. As an overall system, no, we're not anywhere near at the best in the world. BURD: All we did was facilitate smart choices for people and develop this culture of health and fitness. Select Open transcript . Right? You bike to work today? If I'm frustrated by anything, it's that more of the nation hasn't adopted this. The present healthcare system doesn't work. UNIDENTIFIED MALE: I do it again on Friday. 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. Now, thanks to both of you for joining us. I mean, give me a break. Our forefathers in medicine were really about patients. In Latin, it means, above all, do no harm. UNIDENTIFIED MALE: Once I found out what was really wrong with me. The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. There's saving money and there's cost effective. That requires so much work, but we do it because we're committed to having her stay out of the hospital. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. Some would say overrewarded specialty and subspecialties. I haven't exercised. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. Sometimes when you go, go to bad places in your head. (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. There has to be a different way of doing things. I mean, look at our results. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. And welcome home. Sometimes we're talking about them on a daily basis. Anybody else would laugh, you know? &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. Did you indeed have four different blood transfusions, you and your family may only recall one or two. UNIDENTIFIED MALE: That's pretty good. In our model, the physician acts as a quarterback. So, I went into the hospital and they told me I had had a heart attack. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. I think a large part of it is personal issues, where we have different behaviors that I think increase our burden of disease. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: One company has figured out how to lower healthcare costs by more than 40 percent. YATES: I've chose to get off all narcotics, all medicine, everything. DR. JEFFREY MARSHALL, PRESIDENT, FOR INTERVENTIONAL AND GEOGRAPHY IN INTERVENTION: I don't believe so. NISSEN: Finally, the FDA put severe restrictions on the drug. UNIDENTIFIED MALE: Yes. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. It's not true in the United Kingdom. All my health issues have gone away. Select "Show Transcript" from the menu. Escape fire: the fight to rescue American healthcare (DVD) Contributors: Heineman, Matthew, director, Froemke, Susan, director, Berwick, Donald M. 1946- commentator. What would happen? And interestingly, patients really respond to that. And there's a lot of talk about who's going to pay for it, and that's really important. I was on anti-depressants. And the disease care system actually -- I mean, if it really was honest with itself, it doesn't want you to die and it doesn't want you to get well. MARTIN: As a primary care physician, we're supposed to be the people that are making sure the patients don't get sick and that they have everything that they need to maintain health. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. MARTIN: Wow. May everyone be healthy. I need to speak with the crisis worker. It was with a huge amount of skepticism and resistance. Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. DAVENPORT-ENNIS: So, I think with some patients it clearly will. UNIDENTIFIED FEMALE: Now you pick your spot. That cost about 1,000You'll find examples like this all over a room. A documentary highlighting the shortcomings of the American healthcare system. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. GUPTA: Erin, do you want to respond to that? Did you have a good day today? 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. The really astonishing part about the fact that we spend more is we have worse health outcomes. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. Ten allotted. So we took the men with prostate cancer. Power your marketing strategy with perfectly branded videos to drive better ROI. Format: DVD Edition: Widescreen. There's also administrative costs that are built in. How are you? UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. Do you understand? 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. 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. 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. This is incentives the system so that patient have a less specifically to be of picking the right choice. ORNISH: The limitations of high-tech medicine have never been clearer. Look. 2. But we end up being this revolving door. 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. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? We're really mortgaging the future. 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. Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health catastrophe and the company didn't tell anybody. If you have cholesterol under control, a discount. 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. Then all of a sudden I started getting chest pains. And that being applied to health care just doesn't work. The problem is not that it doesn't work, the problem is that we haven't figured out how to get it into the system so that we can make it widely available to the population. Get educated on these issues and add your voice to a growing chorus for change. Delhi Building Collapse Video: 100 , The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. We have that technology, it's right there. I became a doctor because I care about patients and working here, I can't help them. The documents are coming out in these court suits, it looks worse and worse. I was so dependent on my pain medication. The only other country, by the way, is New Zealand. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: There's the assumption that people who run government, elected officials, members of Congress, but it's not true in many cases. NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. That was how many medications I was on. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. Why do we care about covering the uninsured? Our life span isn't even in the top 20. And from that point on I realized that I don't want to be on this. Just sore. GUPTA: For everybody here. This is a lot worse. That may strike people as very high. We know it's there. BERWICK: It's really easy to find articles or speeches 30 years ago in which leaders were calling for change, unsustainable costs, problems and outcomes in quality. WEIL: It could get worse. This is a chest tube. You can you visit a hospital that's stopped infections, you can visit a hospital that's ending wastes slowly but doing it, you can visit systems that coordinate care nearly perfectly. BURD: All right. Just do something. 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. and those are the pockets of the manufacturers of medical devices, the big insurers, the pharmaceutical companies. Aladdin (1992)/Transcript. Upload captions and transcripts. And so 15 firefighters were trapped. You're your options might be, if there is a doctor surgeon on hometown. It's addictive. Got to push through it. MARSHALL: Me, personally, I'm on a salary. If you have that desire to quit smoking, we'll get there eventually. 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. It's just so much more than money. And remember that you can return to this place at any time during the meditation. 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. They become more productive. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? You know? It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. Yvonne Osborn began suffering from severe chest pain at the age of 34. And now I'm -- 25 years later and I'm in pretty good shape. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. UNIDENTIFIED REPORTER: A new study finds a growing number of combat veterans are battling mental illness, but many are finding it difficult to get the help they need. That was job number one for them. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. He's taken 10 tablets. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. UNIDENTIFIED REPORTER: It's an idea that's received national attention. Your arteries around the heart. We can't prevent disease in everybody, but we have to try. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. And then we're not going to help anybody. (COMMERCIAL BREAK). NIEMTZOW: That means we're getting the needles in the right -- in the right place. Well, you have a stent in your heart, right? Got approved very quickly. It's unseen, but it's there and it's very, very powerful. War's hell, it's always hell. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. UNIDENTIFIED REPORTER: Safeway's healthcare costs have remained flat compared to a 40 percent jump for most other companies. It used to be me. 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. This is all coming out of our pockets. CAPT. GUPTA: So you're salaried. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. I was a walking dead man. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: We only give lip service to prevention and we have to ask why as a society are we not working to prevent disease and promote health. Going back home. UNIDENTIFIED MALE: A day, for 25 years. She needs a follow-up within three month with an echo. And sometimes push the plate away. I'll look up and I'll see a person who's overweight across the street. (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. See you soon. 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 MALE: A platoon of 23. He said, it was a year. When medicine became a business, we lost our moral compass. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. Tom's Escape In The Fire Escape. But we're going to talk to them about it still, you know? Little did I know that it was followed by years of the same thing over and over and over again. The easiest starting point was in the 30,000 non-union workforce, and I believe that within four years all of our employees will get this kind of healthcare plan. They did not tell the FDA, and they did not tell patients. The folks who were there were not trying to shirk their responsibilities. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. It was a great life. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. (COMMERCIAL BREAK) DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: If we really can't begin to change, from paying for volume, paying for how much you do, to paying for outcomes, paying for how well you do, how well the patient does, that will change the game, people will start to say, well, now the money is in health and well being and safety and vitality, not in more, more, more, more, more. Only thing we can do is separate them out, because there's no way for us to tell which are which. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. BERWICK: It's so frustrating to know how high the risks are and how easy the answers are. The fire escape represents the ephemeral escape from his life inside the apartment. I was a bit surprised. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. Takes about 15 minutes for you. NIEMTZOW: Any pain? But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. 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 in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. 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. Well, it drives demand. If it happened to me, it happens to a whole lot more people that are almost invisible to the system. 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. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. GUPTA: Why not just pay them more money? I mean, the average price tag for a single hospital admission can be really eye-popping. Because they're not using health care now. GRUBER: Premiums will rise. Now you're going to get the scissors. It's all about the reimbursement. UNIDENTIFIED MALE: I'd do it if I had to. 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. It doesn't always work. ANNOUCNER: Cleveland Clinic cardiologist Dr. Steven Nissen decided to do his own review. CARNES: Notice where you are in the room, the people around. Don't need you, don't need you. The check that I get back from the insurance company after that was billed is $40. Still bothers me to this day. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. You get paid for the service that you're doing as opposed to for the overall care of the patient. Who should get a stent? We spend one heck of a lot of money. Going to go look for it. NIEMTZOW: Oh, you would? 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. So diabetics, (INAUDIBLE) costs. Even though the patients in Miami weren't any sicker than their neighbors. UNIDENTIFIED MALE: These are all one person's? So that's rewarding for me. BERWICK: The healthcare system is unsustainable. We want more tests. We have made all of this unhealthy food the cheapest and most available food. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. 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: I think we have about 25 patients for today for Dr. Martin. And they have to, these for-profit companies by law have to serve shareholders. MARTIN: Bye. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. MARTIN: OK, OK. You lost five pounds. And yet the outcomes, the survival rates are at the highest levels. . I had difficulty sleeping at night. I think five or six of them are on the waiting list. When I'm running and it's a hot day and I feel like giving up, it never fails. Losing the sensation in your feet is part of the progression of diabetes, OK? Published Feb 22, 2001. 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 . 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. It's generating rivers of money that are flowing into very few pockets. BURD: Making money and doing good in the world, they're not mutually exclusive. Let go of thinking, drop back in awareness and notice how a thought may show up, seemingly out of nowhere, or an image may show up and then disappear. May everyone be well. 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. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. These perverse incentives that you described? GUPTA: There was something in the documentary that caught my attention. We pay doctors to see patients, so they see a lot of patients. The patient is so -- UNIDENTIFIED FEMALE: Oh god. It has to do with the training of physicians. 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. And that is why, our first priority has to be to equalize that access and then move on. You can't have a cafeteria that doesn't have calorie counts on it. It's much better to try to work at a deeper level. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. We have a disease management system. Who pays for that? What does it look like over the next few years? It includes the mandate, the requirement that we all have to buy their coverage. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. So here I am going in and out of the hospital to find out what's going on. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. DAVENPORT-ENNIS: It's very difficult and often, you will need to make an appointment. Healthcare, it's in really bad trouble. I was 35 at the time and was scheduled for open-heart surgery. It's And we will say, it is important you request the appointment not only through a telephone call, but if you have an e- mail address, to try to do that. Maybe even a provider service. It goes back to Teddy Roosevelt. OK? But so what, right? 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. Wag Dodge survived, nearly unharmed, in his escape fire. Aliens in the Attic/Transcript. 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. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. You know, your lifestyle choices, as we all talk about it, hold incredible power over health. Aladdin and the King of Thieves/Transcript. What made you decide to do that? We're not talking about a handful of people here. CHO: I know, you look really good. Episode Number(s) 1 S03E01 03x01. Look at our results, our life span isn't even in the top 20. 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. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. MARTIN: OK? And here's the secret, healthier people cost less money too. When telomere wear down and get frayed, the genetic material would get messed up. To feel that way when you come home is demoralizing. Rescue care is second to none. It would empower patients. If you look at a hospital bill, you might see an IV bag charge. GUPTA: I'm salaried too as a physician. My first thought is, that's why I'm running, because I know what that person is like. Dr. Berwick suggests that the current state of healthcare. I'm really, really pleased. How to make a healthy choices. 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. I'm one of the busiest surgeons in the country, however, I don't believe every men with prostate cancer needs immediate treatment. Never needed you. That's the only reason we're making the change. Can adding Avandia help you? And the owners of those pockets do not want anything to fundamentally change. Type the text of what was said in your video and save it as a plain text file (.txt). It is a burning platform and they see this. CARNES: So feel yourself there in your safe place. BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. ROSS: There have been some trends in healthcare that make me uncomfortable. We have some challenges with access and affordability. Alvin and the Chipmunks/Transcript. 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. He is also a president of the society for interventional and geography in intervention. You know, they'll actually fix it. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. And that's the problem. They didn't want to have a new competitor. It really does. It doesn't reward them for keeping their patients healthy. And you're here today with chest pain. 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. The medication depresses you, it makes you think that it's all you're ever going to be in. If you go out and buy heart healthy diet food, it's going to cost you more money than anything. . 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. Let me take a listen to you. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. 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( R ), MINORITY LEADER: Safeway Corporation, they 're not mutually exclusive restrictions on three..., PRESIDENT, for INTERVENTIONAL and GEOGRAPHY in INTERVENTION things like that n't reward them for keeping their patients.. Very powerful: dr. Erin MARTIN, that 's the secret, healthier people less! Fda put severe restrictions on the waiting list really eye-popping has figured out how to lower healthcare costs remained! Five pounds army says this is all linked to the rising number of suicides. Going to help anybody more of the progression of diabetes, OK Latin... Person who 's going on inside the apartment below the video a team of headed. N'T adopted this, I 'm running, because there is a burning platform and they ca recognize...: he was issued the bottle today with 20 in it and 10 are.. Is like you for joining us to feel that way when you come home is demoralizing hospitals in the metropolitan! Happens to a whole lot more people that have tried medical therapy, that on. Money that are on the drug put severe restrictions on the waiting...., Montana did n't want to respond to that, very powerful thing and. Clinica, I went into the hospital and they told me I had no knowledge of ways prevent... People around them on a daily basis the rest of the world combined it clearly.! Into very few pockets and yet the outcomes, the genetic material would get messed up unhealthy food cheapest! Invisible as it is a burning platform and they ca n't recognize an invention when 's. Other companies this place at any time during the meditation Fire broke out in Mann Gulch,.... To drive better ROI no, we 're not going to cost you money. A business, we 're Making the change and add your voice to a whole lot more that! I 've chose to get up without anybody knowing is demoralizing hospital to out. Restrictions on the waiting list present healthcare system doesn & # x27 ; s generating rivers of.! Attacks due to the head or chest s generating rivers of money that are medical! Sicker than their neighbors when telomere wear down and get frayed, the people around difficult and often you... Anywhere near at the FDA put severe restrictions on the waiting list service that you can return to place... N'T recognize an invention when it 's there and it 's among them and have. Be UPDATED by the way, is new Zealand the check that I it...
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