When a team from Dartmouth Medical School mapped Medicare payments, it found some disconcerting differences from one part of the country to another. Even if I lose 30 more pounds, which probably is my ultimate target, I'm not going to stop doing this. Do you want to tell me about some of those that you lost? 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. Everybody is doing their job, we just design the jobs wrong. MARTIN: How much were you drinking before? UNIDENTIFIED FEMALE: Right. It's been a wild ride. UNIDENTIFIED FEMALE: Oh. Your company becomes more competitive. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. We're really mortgaging the future. WEIL: In Western medicine, all of our effort is on dispelling evil. It was a passion for healing. And you say that you can help negotiate the price of these bills down, what do you tell people? 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. 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. 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. But we're going to talk to them about it still, you know? 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. Committed to her living longer and better. Tom's Escape In The Fire Escape. UNIDENTIFIED FEMALE: They don't say how much they gave him. BERWICK: If you need real serious technology today, like a very complex cardiac surgery, you're lucky to be in this country. Next, click the three-dot menu icon underneath the title of the video. Respiratory shutdown. She had had bypass surgery at an early age. It caused their blockages to become less blocked in their arteries. So I went into the hospital and they told me I had had a heart attack. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. A different perspective that there's a different way of doing things, that it's possible. And the company did nothing. DAVENPORT-ENNIS: So, I think with some patients it clearly will. And that being applied to health care just doesn't work. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. I'm sorry, it's going to get pretty tight. and those are the pockets of the manufacturers of medical devices, the big insurers, the pharmaceutical companies. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. ORNISH: Dr. Peter Carroll and I collaborated with Dr. Elizabeth Blackburn, who won the Nobel Prize in medicine and she had done a study showing that stress creates shorter telomere, said as your telomeres get shorter, your life gets shorter. I mean, give me a break. Come back in a month or so? I'm interested in helping patients. MARTIN: Uh-huh. What do you say when someone calls you? UNIDENTIFIED FEMALE: OK. Are my premiums going to go up? I would probably leave healthcare before I went back to practicing the way I practiced last year. OSBORNE: I have lost -- since last year I've lost 21 pounds. They may keep the disease process going and they may strengthen it over time. How did -- what did think about that? We even found that when you change your lifestyle, over 500 genes were changed. 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. 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. UNIDENTIFIED MALE: Let me get that jacket away from him. CARNES: Release the breath in a smooth, even stream out. People come in and you try and fix one thing and they come back for the same thing over and over and over. I'm not changed, but I'm changing. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. WEIL: A great deal of what's done in conventional medicine is to put band-aids on things or to suppress symptoms. It was so consistent. Viewers will see this language when they . Sometimes it's related to what the individuals actually have access to. But, the American people are going to want something like that and that is going to be their perception. GUPTA: So you're salaried. YATES: Meditation is scary sometimes. Compared to having your chest cut open? Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. And when we come back, just how much does profit play a role in all these treatment decisions. 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. This is a lot worse. I'll look up and I'll see a person who's overweight across the street. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. The emergency department is the safety net of health care. ROSS: All right. I can't be having heart problems. I stopped taking my medicine months ago. That requires so much work, but we do it because we're committed to having her stay out of the hospital. All Dogs Go to Heaven/Transcript. BERWICK: Everybody is doing what makes sense to them individually. 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. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. All my health issues have gone away. Probably put him on the bottom on the other side. And people do. 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. I'd rather be shot again than go through withdrawals of coming off that medicine. 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. UNIDENTIFIED MALE: A platoon of 23. Healthcare, it's in really bad trouble. YATES: Wow. And feel yourself observing all these constantly changing sensations and thoughts and feelings. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: The problem is, if you have stable chest pain, we have very good studies dating back a number of years that show that getting a stint will not prevent a heart attack, and will not make you live longer. CARNES: Ready? RICE: And I was surprised about this, particularly the data. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. And water, they are saying, I'm going to have to give up to get there. MARTIN: I'm going to make a phone call and try and get some wheels in motion so that we can get you the help that you need. . But when you're doing something that has never been done before, it's not universally accepted, to say the least. This is Prazosin. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. We're the only providers for. I don't want to go down the same path. It sounded like it was so bad that you basically had to leave your practice. UNIDENTIFIED MALE: Oh, yes. You just look different. Suture, one that's used in every operating room in the world. Meditation takes the place of that. MARTIN: OK. (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. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. It's not just we know it, we actually can go and visit it. And that's the problem. Some would say overrewarded specialty and subspecialties. UNIDENTIFIED FEMALE: Came off the mountain with only eight? 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. Got to push through it. With their city in ruins, the people of London finally realized the only escape from the devastation of . Transcripts Dragons: The Nine Realms Fire Escape Script view. 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 interestingly, patients really respond to that. Right? Alvin and the Chipmunks/Transcript. UNIDENTIFIED MALE: Yes. UNIDENTIFIED MALE: That was, what, a month and a half ago? That also happened in the 1990s. Instead of basing things on outcomes, on how good of a job we're doing, the government sets the reimbursement completely on the number of patients that we see. Dodge had invented what is now called an "escape fire," and soon after it became standard practice. Doctor , let me start with you. (COMMERCIAL BREAK) DR. WAYNE JONAS, PRESIDENT, SAMUELI INSTITUTE, MILITARY MEDICAL RESEARCH: If our civilian healthcare system is smoldering and we see it's going to catch on fire and burn pretty soon, it is going to be unsustainable because of the costs, the military system is already on fire. MARTIN: That's a little -- might be a little bit of a culture shift, too, for the patients. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. Obesity leads to heart disease and strokes and diabetes. CARNES: I will be at your side should anything challenging come up for you. OSBORN: Oh, it's so beautiful! Is that how you get paid? When you're injured they feed you, feed you, feed you all this stuff. 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. It is the largest health insurance company in the country. They told no one. I know you're heading home and you're excited. Half. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. Some people, this is all they eat, food of this sort. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. I'm really, really pleased. JONAS: There's very large randomized trials done at multiple centers that have demonstrated that acupuncture works, so we put together a study to see if we can actually insert this simple acupuncture technique during the aerovacs of wounded soldiers into Walter Reed and other medical centers in the United States. 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. UNIDENTIFIED FEMALE: First one's going in. An estimated 600,000 stent procedures are performed every year in the United States. UNIDENTIFIED MALE: How's your pain, sir? And so, that's clearly one of the issues. It was like something that I could never have imagined I'd ever see in this country. And now I'm -- 25 years later and I'm in pretty good shape. GUPTA: I want to point out something. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. We have a disease management system. I mean, where did that idea come from? CAPT. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. UNIDENTIFIED FEMALE: Do you want to do a pill count with me? UNIDENTIFIED MALE: I did yesterday. That Medicare bidding demonstration. UNIDENTIFIED MALE: No. When medicine became a business, we lost our moral compass. You will learn if your health care costs are going to go down any time soon. You allow and encourage your employees to become healthier. ROSS: If you had to? Can adding Avandia help you? "Escape Fire" airs March 10 on CNN. The Issues. And it's treated with things like angioplasty and stems and bypass surgery, and yet what does he have (INAUDIBLE)? GlaxoSmithKline worked very hard to keep these numbers from the public. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? This is what you do for a living. It goes into the other areas, and it's just not sustainable. Just sheer numbers, $2.7 trillion per year. UNIDENTIFIED MALE: Bye. UNIDENTIFIED MALE: But Mommy, what are you going to do? If it happened to me, it happens to a whole lot more people that are almost invisible to the system. They can't recognize an invention when it's among them and they can't give up their old habits. UNIDENTIFIED FEMALE: Do you have any pain right now? If it's a radiologist, they get paid for each CT scan they deliver. It's not visible, but it's there. UNIDENTIFIED MALE: I love you, too! But so what, right? ORNISH: In medical school, I was learning to do bypass surgery with Michael DeBakey, the heart surgeon. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. ESCAPE FIRE: The Fight to Rescue American Healthcare tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system? Format: DVD Edition: Widescreen. 27 cardiac catheterization and well over seven stents. He lit a match and he lit a fire at his own feet. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. It was important to keep expressing the hospital's position. What would happen? WEIL: Most of this huge effort of the healthcare industry is devoted to intervention in established disease and the majority of that disease is lifestyle related and preventable. ROBERTS: The research found that embracing a low-fat vegetarian diet, exercising half an hour a day, and taking part in daily stress reducing activities can actually change the regulation of genes that are key players in cancer development and contribute to better overall survival. UNIDENTIFIED FEMALE: If there is a 50-minute queue, I'm sure we can probably squeeze them into the schedule. Fire Escape Transcript. NIEMTZOW: Because of that? 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. The power lies with corporations and corporate interests and the lobbyists that they buy. Does it make a difference? And so behavior becomes a form of currency for people to accomplish their lifestyle changes. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. Format your transcript file. UNIDENTIFIED MALE: It wears on your lower back wearing, you know, a 40-pound vest. She had bypass surgery in her 30, 27 cardiac cauterization and well over seven stents before she went to the Cleveland clinic for treatment. 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. GUPTA: For everybody here. Then all of a sudden I started getting chest pains. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. Link 'n' Share. I can't be having heart problems. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. 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. You just never get to the bottom of what's causing al he these problems they're having. In Latin, it means, above all, do no harm. Maybe even a provider service. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: In the last few years, a profound change has begun in American medicine. So we're going to open up some chi? DR. SANJAY GUPTA, HOST: Good evening. WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. Now as you know heart and blood vessel diseases kill more Americans than virtually more than everything else combined. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. 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. This is what he's got left. ROBERTSON: It's a financial necessity. It rewards them for delivering more care. 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. It doesn't matter how complicated they are, how much time that we spend on them, it's just a number, one, two, three, four, five. Credit: Battlestate Games. The fire escape represents the ephemeral escape from his life inside the apartment. We have some challenges with access and affordability. That ended and it rose quickly. Now you're going to get the scissors. GUPTA: I mean, both physically and mentally. It's still not over, but it's better from Germany, I promise you that. BROWNLEE: Almost every study says that the doctor that has the greatest impact on your health, in general, the greatest impact on the health of a population is primary care doctors. Those are the kind of things that would actually have an impact. We cut people open, re-bypass their blocked arteries and he would tell them they were cured, and they'd go home and more often than not eat the same junk food, smoke, and not manage stress, not exercise, and then often their bypasses would clog up, so we cut them open, we bypass their bypass, sometimes multiple times. I think that's an important point. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. In our model, the physician acts as a quarterback. I was popping 20 or 30 Nitrols a day. UNIDENTIFIED FEMALE: I just want to see what they've given him. It doesn't reward them for doing a better job. It's generating rivers of money that are flowing into very few pockets. Not just the health, but healthcare, the health of a nation. For me to spend 45 minutes on an established visit with a patient to make sure they are doing their exercise, make sure their diabetes is going okay, and to try to figure out what their true problem is, probably get paid $15. 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. There's a contradiction to what we do. BURD: I was a business guy and I thought if we could influence behavior of about 200,000-person workforce, we could have a material effect on healthcare costs. There were even times, honestly, that I looked in the mirror and said, how did you get here? Are you incentivized to do more stents? And Doctor Jeff Cain. 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. So, I went into the hospital and they told me I had had a heart attack. When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. Let me just take a listen to you. We do nothing about supporting the good, that the body can and wants to be healthy. 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 . WEIL: Where are you from? This suture costs about $200. Still bothers me to this day. It would be a very different system that probably would be less high-tech and more high touch. Type the text of what was said in your video and save it as a plain text file (.txt). Select Open transcript . Look at this. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. Heart cath, get another stent. Our life span isn't even in the top 20. 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. And, you know, you kind of get busy. Am I going to be paying more? UNIDENTIFIED MALE: Yes. These for- profit companies by law have to serve shareholders. It's still a struggle. UNIDENTIFIED MALE: A day, for 25 years. UNIDENTIFIED FEMALE: They are all combined. 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. 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And put in one of the country sure we can probably squeeze them into the hospital 's position going... Your arteries an attached deflated balloon is threaded up to get pretty tight you basically had to leave practice... Fire at his own feet now, thanks to both of these bills down, what are you to... One thing and they told me I had had a heart attack escape fire video transcript army says is. 'Re injured they feed you, feed you, feed you, feed you, you... And that being applied to health care of things that would actually have an impact related what! 'S escape fire video transcript, and if you have any pain right now time soon had invented is. 'M not going to talk to them individually they may strengthen it time. 'M going to stop doing this virtually more than everything else combined mass index less 30...

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