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Escape Fire (2012)
Friday, October 5, 2012
Some thematic material.
Don Berwick, Shannon Brownlee, Steve Burd
Susan Frömke, Matthew Heineman
Escape Fire tackles one of the most pressing issues of our time: what can be done to save our broken medical system? Award-winning filmmakers Matthew Heineman and Susan Froemke follow dramatic human stories as well as leaders fighting to transform healthcare at the highest levels of medicine, industry, government, and even the US military. The film examines the powerful forces trying to maintain the status quo in an industry designed for quick fixes rather than prevention, for profit-driven care rather than patient-driven care. After decades of resistance, a movement to bring innovative high-touch, low-cost methods of prevention and healing into our high-tech, costly system is finally gaining ground. Escape Fire is about finding a way out. It's about saving the health of a nation
Escape Fire (2012) | Review
Doing More, Not Better
The film has plenty of statistics that are very interesting. (However, one should always keep Mark Twain [or Benjamin Disraeli] in mind when stats are brought up: "There are three kinds of lies: lies, damned lies, and statistics.") For example, the rest of the developed world pays $3000 per capita for healthcare. In the U.S. the per capita cost is $8000. Yet we are fiftieth on the list of life expectancy. Another example, if the cost of eggs has gone up as much as health insurance since the end of World War II, they would cost $55 a dozen.
The main problem, according to the filmmakers, is that we really don't have a healthcare system, we have a disease care system. The whole system is designed more to address sickness than health. We spend vast amounts of money on disease intervention but almost nothing on prevention. For example, if a doctor talks with a patient for five minutes and puts in a coronary stent, he or she will likely be paid about $1500. If the doctor spends 45 minutes talking to a patient to assist in lifestyle changes, they will be paid about $15. Which plan do you think doctors choose to follow? (A stent, by the way, does not increase life expectancy or prevent heart attack. A lifestyle change can have a very positive effect on life expectancy and preventing heart attack.) As one doctor says, they get paid for doing more, not for doing better.
There are many other issues the film brings out, some more clearly than others. An array of medical people speak to the issues, including Dr. Andrew Weil, who advocates integrated care involving lifestyle and nutrition care; Dr. Don Berwick, former head of Medicare and Medicaid; Dr. Steven Nissen, Chairman of Cardiovascular Medicine at the Cleveland Clinic; and Wendell Potter, former Director of Communication for insurance company CIGNA, who resigned from his job in a crisis of conscience.
The film spends most of its time with the problems. It could have used a bit more of the development of the problems that got us to this point so we would have a better idea how to respond. It does spend some time on changes, which require far more than just broader insurance coverage. The film's title comes from a story of smoke jumpers in a forest fire. When they were trapped most ran trying to escape, but one set a fire around him to burn up fuel (an "escape fire"). It was only the one who thought outside the box who survived. The filmmakers suggest that we are going to have to be just as counterintuitive if we are to fix a system that is seriously flawed.
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