UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? It goes into the other areas, and it's just not sustainable. Invisible as it is, it's just as significant as a bullet wounds to the -- to the head or chest. But, that's not the whole story. ROSS: What do you think about that? People eat what's cheap and what's available. And I think those discussions that we between the patient and the provider about lifestyle disincentives. They'll say, it took years to develop something like this, the research and development costs are significant. He overdosed. Got approved very quickly. GlaxoSmithKline worked very hard to keep these numbers from the public. And welcome home. We just have to keep working towards that. I'm Dr. Sanjay Gupta. ROBERT YATES, INFANTRY, U.S. ARMY: Medications I was on. 2. It doesn't reward them for doing a better job. You just look different. Thanks all of you for joining us. That cost about 1,000You'll find examples like this all over a room. It's just a terrible tragedy for patients. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. You know, the ads always end with the same phrase, ask your doctor. They can pretty much get away with increasing the rates as much as they want to. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. I decided out of curiosity to go check this out. And all insurance companies are saying is your behavior should drive the premium. I actually practice emergency medicine at the University of Virginia in Charlottesville. But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. Can't wait to be there. You know? UNIDENTIFIED MALE: Oh, yes. UNIDENTIFIED MALE: It's traveling down my arm, my neck, and my head and ears are buzzing and rings. UNIDENTIFIED FEMALE: Because he's real sleepy? OSBORNE: I have lost -- since last year I've lost 21 pounds. It's the best treatment and it saves lives, period. I was on Trizadon. We don't have to spend ourselves into poverty on healthcare. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. He knew that they would lose the race back to the top of the ridge, so he suddenly stopped. The small wire cage you see there is the actual step. We could do 1,000 studies with a million patients, it would remain on the fringes, it's all about the Benjamins, as (INAUDIBLE) would say. 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 . I just could not continue doing what I was doing. UNIDENTIFIED FEMALE: Hi. Get educated on these issues and add your voice to a growing chorus for change. You will learn if your health care costs are going to go down any time soon. Thank you so much. You don't necessarily make a lot of investments in preventive care for someone who's not going to be a part of your health plan for a long period of time. So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. 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. That prevents tissues from renewing themselves in the body and diseases take hold. If someone had talked to her, I think someone had really teased down her chest pain and her shortness of breath. MARTIN: A day? They are going to healthcare. Healthcare reform was a good place to start, but it will do little to address the root problems. POTTER: We have been trying to reform the health care system for a hundred years. Is that how you get paid? I had to do something. MARTIN: Yes? Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. 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. 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. When medicine became a business, we lost our moral compass. We create a public expectation that more is better, which isn't actually true so people seek more. I don't want to go down the same path. We want more tests. Rescue care is second to none. To feel that way when you come home is demoralizing. I was shutting down emotionally. We're dealing with the health of the nation. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. It's a happy time in my life right now. But so what, right? That's not good medicine. 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. Determine, did you indeed have two MRI's during the course of one week? Going to go look for it. I am back in the chest pain center with a pretty sick patient, and I'm going to need you to call attending phone, too. I feel like I'm changing. WGRZ reported that crews encountered heavy fire and thick smoke coming from the building at 747 Main St., after they got the call at 10:08 a.m. A Mayday was called early in the operation. So Lexapro is the only thing you're on right now? So tired of it. 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. And I had a massive heart attack. It's generating rivers of money that are flowing into very few pockets. Event marketing. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. GUPTA: Doctor Rice, What do you think about that. She needs a follow-up within three month with an echo. 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. Those are the kind of things that would actually have an impact. 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. 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. Tell me what happened. An estimated 600,000 stent procedures are performed every year in the United States. (LAUGHTER) NIEMTZOW: Hi. U.S. caregivers are told you've got to keep me pain free, you're going to do that. 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. To a man with a hammer, everything looks like a nail. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. CARNES: So feel yourself there in your safe place. When you're injured they feed you, feed you, feed you all this stuff. NISSEN: Yes, but we have to educate patients. DR. SANJAY GUPTA, HOST: Good evening. Hello, how are you? Yvonne Osborn began suffering from severe chest pain at the age of 34. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. The, you know, the food that we eat and the nutrition that we put in our body, that's been around since the beginning of time. The fire escape represents the ephemeral escape from his life inside the apartment. JOE BIDEN, VICE PRESIDENT: Good morning, folks, how are you? Anybody else would laugh, you know? Our forefathers in medicine were really about patients. But one evening, I sat straight up in bed with the worst chest pain. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. 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. The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. 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. Meditation takes the place of that. UNIDENTIFIED MALE: Yes. JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. UNIDENTIFIED FEMALE: Hello, Mr. Fields. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. 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. It is important to keep in mind. The patient is so -- UNIDENTIFIED FEMALE: Oh god. Format your transcript file. Fire Escape Transcript. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. Expand the Transcripts and captions section if closed, then select Upload. (END VIDEO CLIP) NISSEN: There was a drug on the market, Avandia. Transcripts; License . And sometimes push the plate away. I smoked six cigars a day, 10 cups of coffee, a lot of wine. UNIDENTIFIED MALE: I'd be chomping narcotics. 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? UNIDENTIFIED FEMALE: Not in there? And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. UNIDENTIFIED FEMALE: Now you pick your spot. They told no one. UNIDENTIFIED MALE: What are you going to do at work? I'll be -- and what came to be known as an escape fire. The US healthcare system has to be overhauled to put the patient's needs above the doctors and the insurers. CINDY ROBERTSON, ADMINISTRATOR, MD-COLOMBIA FAMILY HEALTH CENTER: We're the only clinic in this community county, so it's about 20,000 people overall. OK. NISSEN: Good morning. And Doctor Nissen is in salaried as well. UNIDENTIFIED FEMALE: Just take a couple of minutes to kind of arrive. Trying to get Medicare to cover a heart disease program has been by far the hardest thing I've ever done in my entire life. CAPT. We pay hospitals to be full, so they try to be full. I was head of corporate communications, which means I was the top public relations officer for the company. Where does that money come from? But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. We're part of the community. They either couldn't afford it, or they worked for small employers that had been purged by big insurance companies. And for the large majority of people we help, they often don't understand what many of the charges are. NISSEN: Finally, the FDA put severe restrictions on the drug. Try to break a sweat every day. Well, it drives demand. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. I mean, an obvious one is nutrition, which is almost omitted from medical education. Only thing we can do is separate them out, because there's no way for us to tell which are which. There's saving money and there's cost effective. The Escape fire Video demonstrates human stories and leaders in the fight to transform Medicare at the level of medicine, the US military, industry, and government. . Takes about 15 minutes for you. Jonas, Wayne B., commentator. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. It is so addictive. 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. And I say that as doctor. NISSEN: Yes. 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. 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. And the owners of those pockets do not want anything to fundamentally change. 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. How are you? Escape fire: the fight to rescue American healthcare (DVD) Contributors: Heineman, Matthew, director, Froemke, Susan, director, Berwick, Donald M. 1946- commentator. We are going to take a short break. Not just the health, but healthcare, the health of a nation. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. And water, they are saying, I'm going to have to give up to get there. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. 27 cardiac catheterization and well over seven stents. Sometimes they are related to lifestyle habits. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. Your harm's heavy, your leg's heavy. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. They may keep the disease process going and they may strengthen it over time. I say, radical? There's also administrative costs that are built in. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. She ended up having another open heart operation, another bypass operation. (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. It's your money. Type the text of what was said in your video and save it as a plain text file (.txt). You know, Nancy, we talked a lot about these bills. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. UNIDENTIFIED FEMALE: You need to get up and pee? 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. UNIDENTIFIED FEMALE: Nine months? (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. Mountains of Afghanistan are not easy to climb, so pain in my back. YATES: Meditation is scary sometimes. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. May everyone be happy. 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. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. Thank you all. GUPTA: I mean, both physically and mentally. 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. It's about saving the health of a nation. How are you feeling? We have a -- we have a motto in medicine. BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. UNIDENTIFIED FEMALE: Do you have any pain right now? I mean, what is that, boy? But I'm doing it. YATES: That's a healing process because you're not bottling up, it's going to a different section in your mind to where you can start processing it. The answers among us, can we please stop and think and make sense of the situation and get our way out of it? Students also viewed Com presentation 2 - This is an informative speech outline for com 101. 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. 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. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: Hippocrates said let food be your medicine and medicine be your food. UNIDENTIFIED MALE: I did yesterday. GRUBER: For everybody. MARTIN: It was a dire situation and there are many times that myself and my colleagues would have the conversation of, you know, we are going to miss something, this could be really bad, and actually having the fear that this was going to be harmful to our patients at some point. DR. WAYNE JONAS, PRESIDENT, SAMUELI INSTITUTE, MILITARY MEDICAL RESEARCH: With 10 years of ongoing wars, the amount of suffering that's going on in the military right now is tremendous. I was on anti-depressants. UNIDENTIFIED MALE: Oh, yes. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. It sounded like it was so bad that you basically had to leave your practice. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. UNIDENTIFIED MALE: I have pain, but it's more of an annoyance than it is pain. He had -- he had Percocet then he has Marco which is Percocet. There were even times, honestly, that I looked in the mirror and said, how did you get here? I'd have my pizza, I'd have my comics, I'd have my DVDs, and that was the weekend. Most diseases don't happen overnight. 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. DAN BULLIS, WALTER REED ARMY MEDICAL CENTER, DEPLOYMENT HEALTH CENTER: Post-traumatic stress disorder, PTSD, is an individual's reaction to the exposure and experiences of war. 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. MARSHALL: It doesn't matter if I do one stent or five or ten stents. You didn't have to be a statistician or in the words of my old friend Bob Dylan, you don't have to be a weatherman to know which way the wind blows. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. You've seen a lot. It really does. UNIDENTIFIED MALE: Yes. UNIDENTIFIED FEMALE: They don't say how much they gave him. Select "Show Transcript" from the menu. Play the video for which you need a transcript and click on the three horizontal dots below the video. He is the president of the American Academy of Family Physicians. Alice in Wonderland (1951)/Transcript. I was 35 at the time and was scheduled for open-heart surgery. CARNES: Release the breath in a smooth, even stream out. These are techniques that should be used to relieve symptoms. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. that is going to raise cause. Log in to your account. I became a doctor because I care about patients and working here, I can't help them. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. 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. NISSEN: Now, the leading cause of death in diabetes is heart disease. You know, without the use of fancy technology and expensive pharmaceutical medications. BULLIS: Catching it very, very early after their exposure and allowing them to process that is so critical in the long-term recovery. "Escape Fire" airs March 10 on CNN. A heart cath, get another stent. Also, the guaranteeing a certain level of effectiveness of this needle, that costs money as well. ROSS: There have been some trends in healthcare that make me uncomfortable. On my way. NIEMTZOW: If you didn't have the acupuncture needles, how do you think you'd be feeling? 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. GUPTA: How big a problem is this then? There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? At some point he's going to stop breathing if he's taken too much narcotics. We're the only providers for. Your company becomes more competitive. 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. Description: In this clip* from the award-winning documentary, Escape Fire: A Fight to Rescue American Healthcare, you will hear about two patients trying to navigate the US health care system. He said, it was a year. Upload captions and transcripts. Credit: Battlestate Games. I'm optimistic about the future. And, you know, you kind of get busy. If it happened to me, it happens to a whole lot more people that are almost invisible to the system. I started getting sick in my 30s. The present healthcare system doesn't work. If you have that desire to quit smoking, we'll get there eventually. He lit a match and he lit a fire at his own feet. So, you want to take a look at that and find out what it is. Now you're going to get the scissors. I mean, when the cost of some of the things we use on a regular basis. But this program has just inspired me to press forward. Fire Escape. BERWICK: The healthcare system isn't affordable anymore. Who pays for that? And it's got to the point where the pain's radiating from my back down to my hips and then down to my thighs. Then all of a sudden I started getting chest pains. What do you think of that? Open your favorite browser and launch YouTube. ORNISH: There's very little evidence that these conventional treatments make you live longer, but they cause many men to be impotent or incontinent or both. It doesn't always work. UNIDENTIFIED MALE: A day, for 25 years. GUPTA: Can you actually get a-hold of those people? We've just created a completely different system here. The only way that you can continue to make the profits that you are expected to make is to charge more for the policies. the play Tom is seen standing in a fire escape during many acts. 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. That's how embedded people get in the status quo. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. Here's a couple simple tips. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. It was either come and get care there or not get care at all. Treated for sciatic nerve, back, L-3, L-4, L-5, swelling left side of my brain, and extreme PTSD. A stapler, this stapler that is often to used in surgery, like this? Our health care system. This is Prazosin. BROWNLEE: Fee for service rewards physicians for doing more. Do you think that will make a difference? And by the way, they are number in the world and life expectancy. It just wants you to keep coming back for your care of your chronic disease. MARTIN: Barely? ROSS: How long ago was that? We are second to none in this country for those things. That ended and it rose quickly. Okay. 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. At a time when the medical system is so badly broken. This point I'm in. Dodge had invented what is now called an "escape fire," and soon after it became standard practice. 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