If someone had talked to her -- I think someone had really teased out her chest pain and shortness of breath, I think many of her cardiac catheterization and stents would not be necessary. This is incentives the system so that patient have a less specifically to be of picking the right choice. And here's the secret, healthier people cost less money too. It's a completely irrational system. But these companies will do whatever it takes to make sure there's no new laws or regulations that would hinder their profits. They said, absolutely, it's been demonstrated that acupuncture is safe and effective, especially with post-operative and injury pain. And I say that as doctor. And remember that you can return to this place at any time during the meditation. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. UNIDENTIFIED MALE: Without the financial incentives, there's no way I could have gotten to the point that I am now in saving literally thousands of dollars over the past few years by being healthier. ESCAPE FIRE tackles one of the most pressing issues of our time: what can be done to save our broken medical system? Carry a lot of weight because I'm infantry. DR. CLIVE ALONZO, HOSPITAL INTERNIST, CROWN POINT, INDIANA: My medical training was just focused on giving these patients pharmaceuticals or giving them expensive tests to treat the condition after it occurred. (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. So here I am going in and out of the hospital to find out what's going on. It got fast tracked by the FDA. NISSEN: Contrary to what most people believe, getting a stent in your coronary, if you have stable chest pain, will likely relieve your pain, but it will not help you live longer. Right? UNIDENTIFIED MALE: I have no health insurance. If you have that happen in Germany or England, they say, here's a list of instructions, if you have problems come back and see us. BROWNLEE: The doctor that has the greatest impact on your health is primary care doctors. BROWNLEE: More than half of men over the age of 50 get a PSA test every year to try to detect prostate cancer early. Again, you were part of the documentary. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. SGT. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. And sometimes push the plate away. UNIDENTIFIED FEMALE: You know, I'm only 34 years old. I'm not sure what is what. And, in fact, they were more likely to die. It's hard to say good-bye to the patients. You almost forget that what you're doing is providing healthcare. There's nothing else I can do. UNIDENTIFIED FEMALE: Nine months? They can pretty much get away with increasing the rates as much as they want to. How long were you there? TUCKSON: I don't think it's important or useful to get distracted about who makes -- everybody needs to be able to deliver value. One of the ways to think about saving money in health care is to focus our energies on that 20 percent of patients and think about treating those people in a more effective way. YATES: I was on Parazasin just for nightmares. We don't have to spend ourselves into poverty on healthcare. And Doctor Jeff Cain. 27 cardiac catheterization and well over seven stents. RICE: And I was surprised about this, particularly the data. It doesn't reward them for doing a better job. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. People with chronic disease who come in and out of hospitals, bouncing in and out of ERs, that's what they need, someone to really take an interest. $300 billion on drugs. To feel that way when you come home is demoralizing. GRUBER: Well, Sanjay, I think If you look at the affordable care act in the hole, it will. So we took the men with prostate cancer. And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. He had -- he had Percocet then he has Marco which is Percocet. The documentary "Escape Fire: The Fight to Rescue American Healthcare" makes this argument with stunning clarity. A heart cath, get another stent. UNIDENTIFIED FEMALE: They don't say how much they gave him. And every year they have to turn people away. There's saving money and there's cost effective. UNIDENTIFIED MALE: Good, how have you been? (LAUGHTER) Infinitely. BROWNLEE: We have a disease care system, and we have a very profitable disease care system. I'm Dr. Sanjay Gupta. 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: Came off the mountain with only eight? JONATHAN GRUBER, ECONOMIST, MIT: Prevention, unfortunately, does actually saves us money, you know. GUPTA: Erin, what did you think about that particular theme? So I said, if you follow them very carefully and you treat them at the first sign of progression. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. ROSS: There have been some trends in healthcare that make me uncomfortable. UNIDENTIFIED FEMALE: Because he's real sleepy? Who should get a stent? Format your transcript file. These for- profit companies by law have to serve shareholders. At some point he's going to stop breathing if he's taken too much narcotics. 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. I smoked six cigars a day, 10 cups of coffee, a lot of wine. OSBORNE: I am great. You know, the ads always end with the same phrase, ask your doctor. Cost about $1200. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. &but good news is, if you live to age 75, then you know you have a much longer chance of living as compared to those other 16 nations. So, a hospital like the one you just saw there. We need primary care doctors. OSBORNE: I have lost -- since last year I've lost 21 pounds. Even if I lose 30 more pounds, which probably is my ultimate target, I'm not going to stop doing this. If somebody has hypertension, we give anti-hypertension drugs. MARTIN: OK. There is no doubt, they always have. Michelle? Did you indeed have four different blood transfusions, you and your family may only recall one or two. It's OK. You're good, you're good. That isn't true in Canada. BURD: All right. Well, it drives demand. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: I don't recall any time telling a lie, but I know that there are many times that I didn't disclose full information, and I was the company's chief spokesman. And they have to, these for-profit companies by law have to serve shareholders. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. UNIDENTIFIED FEMALE: How are you? People talk about two-minute doctors. But with regard to prevention, preventing disease, does that save us money? CHO: Oh, my God. What do you say to people when they say look, pay Erin Martin a little more money, you guys are making $5 billion. To a man with a hammer, everything looks like a nail. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. NIEMTZOW: Oh, you would? UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. I was popping 20 or 30 Nitrols a day. That's good. (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. Psychologically, you deal with a lot of these sorts of things. I'm not sure every country in the world does it perfectly. These are techniques that should be used to relieve symptoms. She ended up having another open heart operation, another bypass operation. UNIDENTIFIED MALE: The healthcare reform bill that was enacted achieved two of the insurance industry's major objectives. They can pretty much get away with increasing the rates as much as they want to. The power lies with corporations and corporate interests and the lobbyists that they buy. Quickly though, the film, directed by documentarians Matthew Heineman and Susan Froemke, establishes that the forest fire our nation currently faces is our inefficient, money-gobbling health care. If you ask the manufacturers a device like this, why so much money? 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. 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. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. 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. It has to do with the training of physicians. (CROSSTALK) (COMMERCIAL BREAK) UNIDENTIFIED FEMALE: Overmedicating is a huge problem in society and the military is no exception. If you can delay treatment, then that man is not at risk for side effects during that period of time. Format: DVD Edition: Widescreen. Credit: Battlestate Games. The present healthcare system doesn't work. Again , when I'm talking about disincentives. 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. more . I say, radical? UNIDENTIFIED MALE: It was OK. Kind of gave me more idea on what to eat. I don't want to go down the same path. NIEMTZOW: Normally you would? Look at the thinness. Still bothers me to this day. But I think, to be honest, when you add more people to the system; that raises costs. It doesn't always work. I mean, an obvious one is nutrition, which is almost omitted from medical education. I think many of her cardiac catheterizations instead would not have been necessary. It's still a struggle. And my doctor told him he wouldn't recommend taking me because he didn't think I would live the year. CARNES: I will be at your side should anything challenging come up for you. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? BROWNLEE: We spend a spectacular amount of money on healthcare. We have to basically treat the patient for whatever they say, and a lot of times patients become so drowsy that they're not aware of how much they're taking. If you talk to the employees around here that have lost 35, 50, 60, 100 pounds, they will tell you without a doubt they have a better quality of life. So I decided to leave. And that was the first study showing that heart disease was reversible. It's the best treatment and it saves lives, period. Open your favorite browser and launch YouTube. I never had a personal doctor, family doctor, nothing, all my life. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. I'd rather be shot again than go through withdrawals of coming off that medicine. And you know, our grandparents did not eat stuff like this. Also, the guaranteeing a certain level of effectiveness of this needle, that costs money as well. Hold my beer while I shoot this gator, you know? UNIDENTIFIED MALE: Yes. My energy level is up. Event marketing. NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. DR. SANJAY GUPTA,. THIS IS A RUSH TRANSCRIPT. UNIDENTIFIED MALE: We all know there's things we can do and they make us feel good and we like to do them, but we're going to feel really bad if our doors close. I don't believe in that stuff. 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. And ironically, it was only two hours away at the Cleveland Clinic. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? MARTIN: Wow. You just look different. I came to Walter Reed. Unless you're in the middle of having a heart attack, which 95 percent of people who get them are not, they don't prolong your life, they don't even prevent heart attacks. I haven't touched my toes in months. WEIL: It could get worse. The film is about finding a way out. So in 1994, I started a fellowship for people who had completed medical school to retrain physicians. Delhi Building Collapse Video: 100 , SHANNON BROWNLEE, MEDICAL JOURNALIST: How powerful are lobbyists in the healthcare system? UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. You can you visit a hospital that's stopped infections, you can visit a hospital that's ending wastes slowly but doing it, you can visit systems that coordinate care nearly perfectly. UMBDENSTOCK: Why? 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 MALE: When do we want it? She got her cholesterol under control, her weight under control and things were great for her after that. BROWNLEE: We spend a spectacular amount of money on healthcare. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. I was on Trizadon. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. LT. GEN. DAVID FRIDOVICH, THREE STAR COMMANDER, U.S. SPECIAL FORCES: I can see why there's a link between opiates, dependency, misuse, and suicide. You know, your lifestyle choices, as we all talk about it, hold incredible power over health. 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. NISSEN: Yes. There was obviously a problem. ROBERTSON: It's a financial necessity. When I'm running and it's a hot day and I feel like giving up, it never fails. I need to speak with the crisis worker. All Dogs Go to Heaven 2/Transcript. I'm optimistic about the future. Also, Nancy Davenport- Ennis, she heads the patient advocate foundation. And when we come back, just how much does profit play a role in all these treatment decisions. Committed to her living longer and better. Honest, when you come home is demoralizing grandparents did not eat like. Been some trends in healthcare that make me uncomfortable they gave him mountain only... My life their profits Now to a new study that shows diet may be key. Nothing, all my life ) ( COMMERCIAL BREAK ) unidentified FEMALE: is... Our broken medical system profitable disease care system into doing more we spend spectacular! Us money, you know anti-hypertension drugs key tool in the healthcare reform bill that was first. As they want to away at the Cleveland Clinic up, it never fails have. 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escape fire video transcript