And we're going to be doing CPR on a patient. 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. It goes back to Teddy Roosevelt. What we don't know, is that a fundamental change? It's too much paying for it. Eight IEDs through this deployment. BROWNLEE: The really astonishing part about the fact that we spend more is we have worst health outcomes. UNIDENTIFIED MALE: People often think it has to be a new drug or a new laser or something really high-tech and expensive for it to be powerful. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. And that's parts of what a really great healthcare system would do. (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. See you soon. "Escape Fire" airs March 10 on CNN. You have all these stents, and these stents, once they go in, they never come out and are part of you. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. Escape Fire. . MARTIN: OK, OK. You lost five pounds. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. Only thing we can do is separate them out, because there's no way for us to tell which are which. MARTIN: How much were you drinking before? You can convert other formats (like Microsoft Word, HTML) into a plain text file or you can use native programs on your computer like Notepad. GUPTA: So you're salaried. No eastern medicine. But, one of the arguments seems to be, you add more people to the system, you get a lot more people insured. And I think those discussions that we between the patient and the provider about lifestyle disincentives. NIEMTZOW: Normally you would? I was on anti-depressants. He overdosed. GUPTA: You know, one can't help but walk away from the documentary, Doctor , frankly, they are scared of stents. Still bothers me to this day. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. UNIDENTIFIED FEMALE: I think we have about 25 patients for today for Dr. Martin. 1 hr 39 min PG-13 Documentary A powerful and thought-provoking documentary that exposes the U.S. healthcare system as one designed to profit on disease rather than health. It sounded like it was so bad that you basically had to leave your practice. Obesity leads to heart disease and strokes and diabetes. It is so addictive. And water, they are saying, I'm going to have to give up to get there. It was like something that I could never have imagined I'd ever see in this country. No soldier should have to go through this. Impressive. 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. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. He was featured in the film. I had difficulty sleeping at night. We have that technology, it's right there. I'm one of the busiest surgeons in the country, however, I don't believe every men with prostate cancer needs immediate treatment. 0. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. It just wants you to keep coming back for your care of your chronic disease. It's just so much more than money. 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. And for the large majority of people we help, they often don't understand what many of the charges are. It really does. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. They'll say, it took years to develop something like this, the research and development costs are significant. MARTIN: Yes? What we do with waste in healthcare. I was shutting down emotionally. POTTER: We have been trying to reform the health care system for a hundred years. And that being applied to health care just doesn't work. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. NIEMTZOW: Oh, you would? The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. So, you want to take a look at that and find out what it is. We don't have to spend ourselves into poverty on healthcare. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. UNIDENTIFIED MALE: These are all one person's? Receive your transcript. They didn't want to have a new competitor. Who pays for that? Let me just take a listen to you. UNIDENTIFIED MALE: Yes. UNIDENTIFIED MALE: McDonald's put salads on the menu, but turns out the salad is $6, the burger is 99 cents. UNIDENTIFIED FEMALE: No. You know? 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. I need to speak with the crisis worker. Committed to her living longer and better. I'd rather be shot again than go through withdrawals of coming off that medicine. UNIDENTIFIED FEMALE: Oh, my god. JONAS: If the military is able to successfully integrate acupuncture, meditation, and mind body, yoga, then we'll find that the culture at large will learn how to adopt it, and it will have a transformative effect on our healthcare system. So we provide incentives for people to engage in healthier behavior. DR. REED TUCKSON, EXECUTIVE VICE PRESIDENT, CHIEF OF MEDICAL AFFAIRS, UNITED HEALTH GROUP: There is no question that primary care doctors are underpaid, especially relative to their specialty counter parts, those who do procedures. Here's a couple simple tips. GUPTA: So, tell me how that would work? For example, in 2007, the average Medicare recipient in Miami tallied more than $15,000 in health care bills, whereas a recipient in Minneapolis only cost the government about half that amount. He asked for pain medication. DR. ANDREW WEIL: There's the bright blue slush. Your company becomes more competitive. UNIDENTIFIED FEMALE: He was issued the bottle today with 20 in it and 10 are missing. 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. I can't be having heart problems. 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. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. Event marketing. Never needed you. I mean, when the cost of some of the things we use on a regular basis. It should bring some of these costs down, because now more people are actually, you're not spreading the costs out over a few people, but rather more. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. (END VIDEO CLIP) GUPTA: In fact to build on that, if you talk to some of the executives of these hospitals, they will say for every dollar that is actually billed they may collect just pennies. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. You know? Escape Fire: The Fight To Save American Health Care. That prevents tissues from renewing themselves in the body and diseases take hold. You're doing this radical intervention, you know, I say radical? UNIDENTIFIED MALE: He really did. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. ROSS: If you had to? Your harm's heavy, your leg's heavy. They couldn't get insurance. We don't have a healthcare system in this country. If they are surgeons, they get paid for each procedure. Adding Avandia can help. STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. Okay. UNIDENTIFIED FEMALE: Where are you coming from? It's completely changed food. We have a model that works simply by making changes in diet and lifestyles. Try to break a sweat every day. We're not talking about a handful of people here. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. And feel yourself observing all these constantly changing sensations and thoughts and feelings. And we see that suffering. I can't be having heart problems. (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. I was on Trizadon. UNIDENTIFIED FEMALE: Oh. detail. 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. What is really striking is how little they have written the last few years. 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. BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. I never had a personal doctor, family doctor, nothing, all my life. Look at the thinness. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. We want more specialists. If you account for that, we do much better. And they have to, these for-profit companies by law have to serve shareholders. So I went into the hospital and they told me I had had a heart attack. Jonas, Wayne B., commentator. It goes into the other areas, and it's just not sustainable. 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. (END VIDEO CLIP) GUPTA: Time to introduce Dr. Valerie Montgomery Rice, she's Dean at the Morehouse school of medicine. You can't have a cafeteria that doesn't have calorie counts on it. People say you're doing this radical intervention. UMBDENSTOCK: Why? We're 50 percent more likely to have a stent than we wait and say, countries in western Europe where they have similar disease rates. This is a chest tube. It's getting rid of the bad thing. OK, I can see what you can have for pain, all right? That isn't true in Canada. He is also a president of the society for interventional and geography in intervention. UNIDENTIFIED MALE: Oh, yes. Open your favorite browser and launch YouTube. 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. Where I'm at right now, patients are in desperate need of care. How to Get YouTube Transcripts on Desktop On a desktop or laptop, head on over to YouTube.com in a web browser such as Google Chrome and open a video to watch. Carry a lot of weight because I'm infantry. UNIDENTIFIED FEMALE: Loratab, Naproxen. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. To a man with a hammer, everything looks like a nail. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. I don't want to go down the same path. If you have cholesterol under control, a discount. 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. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. It's still not over, but it's better from Germany, I promise you that. It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. YATES: I meditate, and it has opened up a whole new world for me. Alexander/Transcript. UNIDENTIFIED MALE: I quit drinking, too. MARSHALL: It doesn't matter if I do one stent or five or ten stents. 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. NISSEN: Yes, but we have to educate patients. A flower for you. They had to live with some of the new consumer protections in the bill that does make it illegal for companies to just cancel someone's policy because of a preexisting condition. (COMMERCIAL BREAK). It would empower patients. Those are the kind of things that would actually have an impact. So, if you have a patient comes in, you get paid a certain amount because you do a stent. But you end up being this revolving door. They can't recognize an invention when it's among them and they can't give up their old habits. Treated for sciatic nerve, back, L-3, L-4, L-5, swelling left side of my brain, and extreme PTSD. 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. UNIDENTIFIED MALE: How's your pain, sir? MARTIN: Have you cut yourself before? And, you know, you kind of get busy. People talk about two-minute doctors. May everyone be healthy. Aliens in the Attic/Transcript. They can pretty much get away with increasing the rates as much as they want to. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. I'll be -- and what came to be known as an escape fire. I was popping 20 or 30 Nitrols a day. UNIDENTIFIED MALE: What are you going to do at work? UNIDENTIFIED CHILD: There we go. 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. As an overall system, no, we're not anywhere near at the best in the world. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. I haven't exercised. A stapler, this stapler that is often to used in surgery, like this? There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? Click on "Export" and choose your preferred file format. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. The way that the system is set up, you can't be effective. At some point he's going to stop breathing if he's taken too much narcotics. So I decided to leave. The present system doesn't work and it's going to take us down. 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. And to me, that's not the only issue. All right. So, you compare us to those other nations, you have to understand that we come to the table with the bigger burden of disease. ROSS: How long ago was that? (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. 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. And that was the first study showing that heart disease was reversible. It's OK. You're good, you're good. Rescue care is second to none. 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