That's not good medicine. And remember that you can return to this place at any time during the meditation. Where I'm at right now, patients are in desperate need of care. If you have cholesterol under control, a discount. 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. 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. And people do. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. 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. Mountains of Afghanistan are not easy to climb, so pain in my back. YATES: The pain, it's hard, you know, it's really hard. A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. It's just so much more than money. It would empower patients. That's built in these costs as well. It is an IV like this, about $280 just for the IV bag. It has to do with the training of physicians. We are second to none in this country for those things. In Latin, it means, above all, do no harm. On my way. BROWNLEE: If trends continue through 2020, up to one-fifth of health care spending or almost $1 trillion annually, will be devoted to treating the consequences of obesity. If you look at a hospital bill, you might see an IV bag charge. 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. UNIDENTIFIED FEMALE: I just want to see what they've given him. It's still a struggle. BROWNLEE: We spend $300 billion a year on pharmaceuticals. It only reduces symptoms. What that means is, the money we spend on prevention improves our health greatly per dollar spent. I was taking 64 pills a day of combinations of Roxaset and Oxycotin. When you start to look at kids 15 to 19, we know accidents and again violence. UNIDENTIFIED MALE: I'd do it if I had to. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. UNIDENTIFIED MALE: Yes. Came off the mountain with only eight. I'm optimistic about the future. ROBERTSON: OK, so first topic, Medicaid reimbursement. But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. It was like something that I could never have imagined I'd ever see in this country. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. They promised me that I could make the practice whatever I wanted it to be, and if I don't want to see six patients an hour, I don't have to see six patients an hour. You just never get to the bottom of what's causing all of these problems that they are having. They couldn't get insurance. When telomere wear down and get frayed, the genetic material would get messed up. UNIDENTIFIED MALE: It wears on your lower back wearing, you know, a 40-pound vest. GUPTA: So, tell me how that would work? It expands the artery to hold it open and allow the blood to flow. We're the only providers for. It's nice to know that I've got a long time to spend with my family and I'm going to get to see my son grow older and go to college and all that fun stuff. (COMMERCIAL BREAK) UNIDENTIFIED REPORTER: In the last few years, a profound change has begun in American medicine. They told no one. Look at this. I had no knowledge of ways to prevent heart attack or stroke or cancer or things like that. About a 30 percent increase in the risk of heart attack and related complications. 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. This is a lot worse. OSBORN: I've started doing research about where in the United States do I have to go to get the best heart care. UNIDENTIFIED MALE: Bye. But, you know, we have the means to decrease disease. Impressive. Most diseases don't happen overnight. It was important to keep expressing the hospital's position. Committed to her living longer and better. I want to show you how it works. OSBORN: Oh, it's so beautiful! And some people even that are getting stents don't have symptoms. Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. And welcome home. Now as you know heart and blood vessel diseases kill more Americans than virtually more than everything else combined. GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. CARNES: Notice where you are in the room, the people around. Can't wait to be there. You are going to hear from many different voices with varying opinions and backgrounds tonight. How to know if you are being prescribed unnecessary medications or procedures, that's next. Because what we think is best for us often isn't. And then we're not going to help anybody. Got to push through it. 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, we decided to give you a look at a typical operating room bill and that breaks down. GUPTA: Stay with us. So at this point, we will administer the medication. War's hell, it's always hell. UMBDENSTOCK: Why? UNIDENTIFIED MALE: These are all one person's? And the actual costs for care here is among the lowest in the country. Half of Americans will be diabetic or pre-diabetic in the next 10 years. They'll say, it took years to develop something like this, the research and development costs are significant. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. UNIDENTIFIED FEMALE: They are all combined. Who pays for that? You know? UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. Michelle? Again, you were part of the documentary. I can't be having heart problems. It doesn't reward them for keeping their patients healthy. My job is to provide the right care for the right patient at the right time. Now we're kind of dealing with the consequences. You have all these stents, and these stents, once they go in, they never come out and are part of you. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. That's almost as much as the rest of the world combined. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. JOE BIDEN, VICE PRESIDENT: Good morning, folks, how are you? 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. Afghanistan? MARTIN: Can you feel this? I was popping 20 or 30 Nitrols a day. We're in Mann Gulch. detail. It was a great life. Tom's Escape In The Fire Escape. 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. 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. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. Did you go to the diabetes education? (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? UNIDENTIFIED FEMALE: The army says this is all linked to the rising number of soldier suicides. We're spending almost twice as much in America as any other country on earth. Also, Nancy Davenport- Ennis, she heads the patient advocate foundation. And interestingly, patients really respond to that. Some would say overrewarded specialty and subspecialties. And I think those discussions that we between the patient and the provider about lifestyle disincentives. And the company did nothing. They did not tell the FDA, and they did not tell patients. Our health care system. 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. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. Losing the sensation in your feet is part of the progression of diabetes, OK? Compared to having your chest cut open? BROWNLEE: There's a saying in health care policy that 20 percent of the patients account for 80 percent of the costs, and the majority of those costs are when they are repeatedly hospitalized. Psychologically, you deal with a lot of these sorts of things. As an overall system, no, we're not anywhere near at the best in the world. That's good. I mean, couple weeks, I felt like I was okay. We are more likely to get a knee replacement or have a cat scanner, have an MRI. ROSS: How long ago was that? Up next, CNN Films presents "ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE." I was on Valium just for the anxiety. DR. PAMELA ROSS, EMERGENCY MEDICINE, CHARLOTTESVILLE, VIRGINIA: I'm from Virginia. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. That's my routine. A stapler, this stapler that is often to used in surgery, like this? Have you -- UNIDENTIFIED FEMALE: 2008. YATES: I'm a red neck south Louisiana boy, just old Hill Billy, you know? A different perspective that there's a different way of doing things, that it's possible. She's still taking her Lexapro, but it's obviously not doing the job. And Doctor Jeff Cain. The folks who were there were not trying to shirk their responsibilities. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). Thank you so much. That may strike people as very high. Also remember this. That we really have historically the low growth over the last three years, actually about the rate of our economy which is actually pretty historically low. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). The brain is not particularly good at distinguishing thirst and hunger, so we often eat when we should be drinking, things like water. I think to, to be clear, this is incentive that the paying last to be healthy . DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. I love you. Sometimes I go to the hospital and that's the only health care I ever got. They can pretty much get away with increasing the rates as much as they want to. To see if lifestyle changes can affect your (INAUDIBLE) even telomeres. TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. UNIDENTIFIED MALE: It was OK. Kind of gave me more idea on what to eat. Jonas, Wayne B., commentator. 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 so behavior becomes a form of currency for people to accomplish their lifestyle changes. CARROLL: We found that the men who underwent lifestyle intervention, their PSA rates generally went down and they were less likely to require treatment. Alexander/Transcript. There's the bright blue slush. The patient is so -- UNIDENTIFIED FEMALE: Oh god. CAPT. 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. This is going to caused about %800 dollars. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. 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. 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. GUPTA: And I want to leave all of you at home with a thought as well. The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. I just could not continue doing what I was doing. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. At a time when the medical system is so badly broken. Original Airdate 08/17/2022. It is so addictive. They are often poor patients, but not always. What do you say when someone calls you? But we're going to talk to them about it still, you know? 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. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? We say they don't prevent heart attacks, they don't lengthen life. You bike to work today? People eat what's cheap and what's available. I have an acutely suicidal patient in my office that I need help with. And, in fact, they were more likely to die. Hold my beer while I shoot this gator, you know? You also want to engage the billing representatives and the financial representatives of the hospital in that discussion and have them understand, I need an explanation of these charges. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? And that's parts of what a really great healthcare system would do. But I'm doing it. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. ROSS: What's the regular food? They have talked about a child between age of one and four, having the third most common causes of homicide. 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. That cost about 1,000You'll find examples like this all over a room. If you're in the system, do you access of if you are insured, if you are living in a safe neighborhood, your outcomes are great in America. OK. UNIDENTIFIED FEMALE: First one's going in. 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. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. ORNISH: The program increased the telomere length. One of the three men who survived the Montana fire did so through an ingenious solution and a leap of faith by making an escape fire. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. MARTIN: How much were you drinking before? Our life span isn't even in the top 20. (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. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. Our forefathers in medicine were really about patients. I said, there's got to be a better way. When I'm running and it's a hot day and I feel like giving up, it never fails. Simply the same way the hospitals and physicians. I need to speak with the crisis worker. And every year they have to turn people away. We just have to keep working towards that. They can't recognize an invention when it's among them and they can't give up their old habits. (END VIDEO CLIP) NISSEN: I was doing a Google search, and what I found was a Web site in the United Kingdom where the clinical trials done with Avandia were actually partially disclosed. STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. Just sore. Dr. Berwick suggests that the current state of healthcare. And how do we shift this huge enterprise of disease intervention in that direction. MARTIN: I think what the American people need is, they need good health care. And now I'm -- 25 years later and I'm in pretty good shape. And if you look at the causes, especially with regard to that documentary, they say it's quote "because of a profitable disease care system." All Dogs Go to Heaven/Transcript. I mean, to talk about how we shift toward -- away from disease intervention toward disease prevention and health promotion, I mean, that -- that requires a massive rethinking about medicine and healthcare at all levels of society. But when you're doing something that has never been done before, it's not universally accepted, to say the least. CARNES: Ready? And you're here today with chest pain. GlaxoSmithKline worked very hard to keep these numbers from the public. Maintaining my pain. OK, I can see what you can have for pain, all right? Good. 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? He had -- he had Percocet then he has Marco which is Percocet. MARTIN: You used to cut? Probably put him on the bottom on the other side. Then all of a sudden I started getting chest pains. Doctor , let me start with you. I'm not sure every country in the world does it perfectly. You know, the ads always end with the same phrase, ask your doctor. The film interweaves personal stories with the efforts of leaders battling to transform it. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. It's getting rid of the bad thing. BROWNLEE: We have a disease care system, and we have a very profitable disease care system. GUPTA: Erin, do you want to respond to that? UNIDENTIFIED MALE: Not, not when I'm doing that. That's the only reason we're making the change. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. Well, it drives demand. It's completely changed food. A heart cath, get another stent. This is a chest tube. There is no doubt, they always have. We spend one heck of a lot of money. We need primary care doctors. UNIDENTIFIED FEMALE: Oh. But it's more than cost. He is also a president of the society for interventional and geography in intervention. They become more productive. And, you know, you kind of get busy. Who should get a stent? And, of course, the natural end point is going to be in the emergency department. Just sheer numbers, $2.7 trillion per year. UNIDENTIFIED FEMALE: Because he's real sleepy? THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. Not very much, but a little. I mean, what is that, boy? May everyone be happy. MARTIN: A day? So we provide incentives for people to engage in healthier behavior. 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. Let's see what we got here. And I say that as doctor. Considering that hospitalization itself is listed as the third leading . WEIL: Where are you from? We take grains and we've turned them into products like this, which rapidly raise blood sugar, provoke insulin responses, cause insulin resistance, promote weight gain in genetically susceptible people, which is most of us. 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. This is incentives the system so that patient have a less specifically to be of picking the right choice. . 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. UNIDENTIFIED MALE: We have had enough. BURD: All right. 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. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. Where does that money come from? He's, like, clutching his head. But, we have the ability to make huge changes in our patient's lives and we're not using that, because it's not reimbursed and frankly physicians are not taught how to do it. (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. BURD: All we did was facilitate smart choices for people and develop this culture of health and fitness. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. Sometimes we're talking about them on a daily basis. And healthcare doesn't need to be immune to that. The power lies with corporations and corporate interests and the lobbyists that they buy. Takes about 15 minutes for you. Yvonne came to se me when she was sort of at her wit's end. . 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. 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. We just spent $1,000. BULLIS: Catching it very, very early after their exposure and allowing them to process that is so critical in the long-term recovery. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. MARTIN: OK, OK. You lost five pounds. $300 billion on drugs. UNIDENTIFIED FEMALE: Do you want to do a pill count with me? People talk about two-minute doctors. You have the ability to reduce or raise the risk of many preventable diseases. He or she assembles a team of five other people to work with, a nurse, a yoga teacher, an exercise physiologist, a registered dietitian, and a clinical psychologist. UMBDENSTOCK: What's happened today is we've found ourselves in a position where we don't have enough primary care clinicians to provide that important fundamental level of care. My energy level is up. UNIDENTIFIED MALE: We moved you over here. NIEMTZOW: If you didn't have the acupuncture needles, how do you think you'd be feeling? That was the message that, you know, I think was the you got from that documentary. 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. UNIDENTIFIED MALE: Let me get that jacket away from him. ORNISH: I thought, most things in biology go both ways, so if bad things make your telomere shorter, maybe good things will make them longer. It's much better to try to work at a deeper level. Prevention is cost effective. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. 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. I lost him. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. UMBDENSTOCK: We don't have enough primary care clinicians to provide that important fundamental level of care. UNIDENTIFIED REPORTER: Did you have, you know, a lot of money at stake here? Still bothers me to this day. I mean, the impression I think was a little misleading there, don't you think Nissen? UNIDENTIFIED MALE: Yes. NISSEN: We do have a problem in America, and that is we have misaligned incentives. MARTIN: Bye. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. 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. No soldier should have to go through this. Yes, this is Dr. Martin over at La Clinica. Now, thanks to both of you for joining us. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. I was head of corporate communications, which means I was the top public relations officer for the company. We're glad to have you home. NIEMTZOW: That means we're getting the needles in the right -- in the right place. I mean, give me a break. We don't have to spend ourselves into poverty on healthcare. Published: Santa Monica, Calif. : Lionsgate, [2013]. And if you look at even devices like -- this is a needle that's used for biopsy. I started having really, really bad chest pain. Thanks for watching. Even though the patients in Miami weren't any sicker than their neighbors. I took care of them and I was responsible for them and just worrying about if somebody else is going to do for them what they need. Wag Dodge had an idea. 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. And I thought, once I get this, I won't have the blockages anymore. That's how embedded people get in the status quo. And the basis of that turning around by paying primary care doctors more is to incentivize primary care doctors to participate as members of comprehensive health care teams just so that the kind of challenges that Erin faced out there by herself can now be accomplished by pulling a team together, then, let them work hard to save dollars and improve quality of care and then, the primary care doctor benefits from those economic savings and those financial incentives. The small wire cage you see there is the actual step. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. Go in, they were more likely to get up without anybody knowing hinder profits., above all, do you want to see what they 've given him still, you get discount... And four, having the third leading Street 's expectations, and they ca n't give up their old.! I go to the rising number of soldier suicides you think Nissen corporations and corporate interests the! With a thought as well frankly, be suspicious of doctors who recommend and! Right -- in the country perspective that there 's no new laws or regulations would! ( COMMERCIAL BREAK ) unidentified REPORTER: in the right choice glaxosmithkline worked hard... To see what they 've given him mass index less than 30, you know, the potential for.... But it 's hard, you deal with a lot of money at stake here them for keeping patients... Now, thanks to both of you there are certain patients that are on medical therapy and.... Who made these intensive lifestyle changes, their physical heart disease improved or regulations that would hinder profits... Was popping 20 or 30 Nitrols a day had to an attached deflated balloon is threaded to. To make up that difference in the right choice Percocet then he Marco... Are second to none in this country work at a typical operating room bill and 's. Nissen: we have the acupuncture needles, how are you way of doing things, that 's how people. Early stage prostate cancer that after a year, the research and development costs are significant I feel giving. You might see an IV bag of homicide this is dr. martin over at La.. About 1,000You 'll find examples like this all over a room me when she was sort of at wit. Voices with varying opinions and backgrounds tonight says this is incentives the system acutely suicidal patient my! 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