UNIDENTIFIED FEMALE: Just take a couple of minutes to kind of arrive. 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. I would probably leave healthcare before I went back to practicing the way I practiced last year. Or at least we think we do. What we don't know, is that a fundamental change? But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. It expands the artery to hold it open and allow the blood to flow. You are going to hear from many different voices with varying opinions and backgrounds tonight. The patient just fell off the litter. I mean, couple weeks, I felt like I was okay. Come back in a month or so? 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. UNIDENTIFIED MALE: Once I found out what was really wrong with me. (LAUGHTER) Infinitely. If you account for that, we do much better. Host virtual events and webinars to increase engagement and generate leads. 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. Smoke jumpers were parachuted in a team of 15 headed by a foreman named Wag Dodge. We pay hospitals to be full, so they try to be full. It is an IV like this, about $280 just for the IV bag. Are you incentivized to do more stents? 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. 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. OK, I can see what you can have for pain, all right? It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. And the fire spread around him. GUPTA: Sometimes the patients demand this stuff. From a patient perspective, from a physician perspective, you want to make sure obviously, that people are being educated correctly. CAPT. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. ORNISH: The program increased the telomere length. GUPTA: A lot of these stents are unnecessary? YATES: OK. And when we come back, just how much does profit play a role in all these treatment decisions. Doctor , let me start with you. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. I came to Walter Reed. That's the only reason we're making the change. Upload captions and transcripts. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. Escape Fire. SEN. MITCH MCCONNELL (R), MINORITY LEADER: Safeway Corporation, they've actually been able to bend the cost curve. Sit down and look at hospital bills through the perspective of, are any of these services that I don't understand what they are? STEVE BURD, CEO, SAFEWAY: In 2005 we had a billion-dollar health care bill rising at the rate of $100 million a year. Wag Dodge had an idea. Alice in Wonderland (1951)/Transcript. ROSS: If you had to? OK. It's all about the reimbursement. It's still a struggle. We're not talking about a handful of people here. MARTIN: I bill $213, let's say for a 45 minute face to face visit with a patient. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. These calories are cheap only when you buy them, but when you look at the overall cost to society, these cheap calories are just so junky, they are really the most expensive. If you go out and buy heart healthy diet food, it's going to cost you more money than anything. Incentivizing them to be healthy or not charging them as much if they're healthy. They can pretty much get away with increasing the rates as much as they want to. Our forefathers in medicine were really about patients. 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. 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. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. When you're in the inner circle of the health insurance company, what's most important is meeting Wall Street's expectations. And that was the first study showing that heart disease was reversible. OK. Bend down. I'm not interested in getting my productivity up. Hello, how are you? 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. YATES: I was on Parazasin just for nightmares. I'm one of the busiest surgeons in the country, however, I don't believe every men with prostate cancer needs immediate treatment. How to know if you are being prescribed unnecessary medications or procedures, that's next. OSBORN: I've started doing research about where in the United States do I have to go to get the best heart care. There's nothing else I can do. UNIDENTIFIED FEMALE: You know, I'm only 34 years old. WGRZ reported that crews encountered heavy fire and thick smoke coming from the building at 747 Main St., after they got the call at 10:08 a.m. A Mayday was called early in the operation. (END VIDEO CLIP) GUPTA: Dr. Erin Martin, that's a primary care doctor you just saw in the film. But this program has just inspired me to press forward. SGT. People eat what's cheap and what's available. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. BROWNLEE: If I think about what healthcare could be like, it would have a lot more care in it. It was a great life. Open your favorite browser and launch YouTube. WEIL: In Western medicine, all of our effort is on dispelling evil. (COMMERCIAL BREAK) SHANNON BROWNLEE, MEDICAL JOURNALIST: Dark matter is a discovery by astronomers that there is a huge amount of the universe that we can't see. (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. Is that a fair message? BURD: All right. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. That's not good medicine. Healthcare reform was a good place to start, but it will do little to address the root problems. Viewers will see this language when they . I was in the hospital for two weeks. No eastern medicine. Expand the Transcripts and captions section if closed, then select Upload. A heart cath, get another stent. Compared to having your chest cut open? NISSEN: Good morning. BURD: All right. UNIDENTIFIED MALE: I do it again on Friday. I mean, where did that idea come from? My energy level is up. Why do we care about covering the uninsured? 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. If you're on a fixed income, what are you going to do for your family? Can adding Avandia help you? We need to change the nature of medicine. I decided out of curiosity to go check this out. Physical Desc: What made you decide to do that? NARRATOR: The Great Fire of London destroyed three-fifths of the entire metropolitan area. It was with a huge amount of skepticism and resistance. 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 . So diabetics, (INAUDIBLE) costs. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. This is incentives the system so that patient have a less specifically to be of picking the right choice. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. The check that I get back from the insurance company after that was billed is $40. NISSEN: We do have a problem in America, and that is we have misaligned incentives. People eat what's cheap and what's available. BULLIS: Soldier know if they go to war and they get a leg blown off, your medic is going to take care of you and the same thing needs to apply that if you have post-traumatic stress. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: Insurance companies have always been able to regulate the rates they charge. UNIDENTIFIED MALE: Six and over. And I think those discussions that we between the patient and the provider about lifestyle disincentives. Also, Dr. Jeffrey Marshall, his specialty is implanting stents. 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. So at this point, we will administer the medication. We're really mortgaging the future. UNIDENTIFIED MALE: That's pretty good. Tom's Escape In The Fire Escape. What is really striking is how little they have written the last few years. There is no doubt, they always have. May everyone be well. . 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. UNIDENTIFIED FEMALE: He was issued this bottle today with 20 in it and 10 are missing. It is just tragic to think of the answer being there but just in the -- in the moment not able to see it. It doesn't reward them for doing a better job. What does that 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. 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. What do you think of that? When you start to look at kids 15 to 19, we know accidents and again violence. They did not tell physicians. CHO: Oh, my God. And here's the secret, healthier people cost less money too. And then, being paid, on top of that, a bonus if they can demonstrate, if they have improve the quality of care and have also may cause saving. 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. We want that. 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. This is just an unbelievable amount of stents and cardiac caths. They couldn't get insurance. Type the text of what was said in your video and save it as a plain text file (.txt). The Issues. But with regard to prevention, preventing disease, does that save us money? To a man with a hammer, everything looks like a nail. The folks who were there were not trying to shirk their responsibilities. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. I actually practice emergency medicine at the University of Virginia in Charlottesville. They have talked about a child between age of one and four, having the third most common causes of homicide. If we can prevent that and even reverse it, that's how we're going to make true health care, not just sick care available. 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. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. She's still taking her Lexapro, but it's obviously not doing the job. The Dartmouth study showed the patients in places like Miami were receiving more care. Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. 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. Aladdin (2019)/Transcript. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. It's much better to try to work at a deeper level. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. We want more specialists. Power your marketing strategy with perfectly branded videos to drive better ROI. Get educated on these issues and add your voice to a growing chorus for change. The bigger issue is how do you deal with his enormous prices, you were just talking about with Nancy? What would happen? And that model has continued until today. UNIDENTIFIED FEMALE: Yes. I think many of her cardiac catheterizations instead would not have been necessary. That simply means they get paid for each office visit. There has to be a different way of doing things. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. As an overall system, no, we're not anywhere near the best in the world. 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. It doesn't reward them for keeping their patients healthy. CARNES: Release the breath in a smooth, even stream out. 0. It just doesn't work out financially. ROSS: What do you think about that? 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. 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. It sounded like it was so bad that you basically had to leave your practice. Until my doctor said to me, I don't know what else to do for you. I need to speak with the crisis worker. That's it. UNIDENTIFIED MALE: What I'm arguing for is not to make things tough on industry, it's to make things safe for patients. BROWNLEE: Fee for service rewards physicians for doing more. UNIDENTIFIED FEMALE: When I was a kid. I became a doctor because I care about patients and working here, I can't help them. ORNISH: The limitations of high-tech medicine have never been clearer. (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. UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. I mean, the impression I think was a little misleading there, don't you think Nissen? Well, it drives demand. CARNES: We'll end the practice today with the completing statements. Our health care system. Let go of thinking, drop back in awareness and notice how a thought may show up, seemingly out of nowhere, or an image may show up and then disappear. He had -- he had Percocet then he has Marco which is Percocet. You almost forget that what you're doing is providing healthcare. I haven't touched my toes in months. There were even times, honestly, that I looked in the mirror and said, how did you get here? 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. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. Rescue care is second to none. POTTER: We have been trying to reform the health care system for a hundred years. 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. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. UNIDENTIFIED FEMALE: Take them away from him. She needs a follow-up within three month with an echo. The average per capita cost of healthcare in the developed world is about $3,000. We're the only providers for. And in fact turning on the genes that prevent disease, turning off the genes that promote breast cancer, prostate cancer and colon cancer. We say they don't prevent heart attacks, they don't lengthen life. If somebody has an infection, we give anti-infectious agents. The small wire cage you see there is the actual step. MARTIN: What's hot was that commercials on television, why do we need to wait, we can just take a pill right now. They did not tell the FDA, and they did not tell patients. 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. Escape Fire: The Fight to Rescue American Healthcare is a 2012 feature-length documentary directed by Matthew Heineman and Susan Froemke and released by Roadside Attractions. (LAUGHTER) NIEMTZOW: Hi. That was the message that, you know, I think was the you got from that documentary. So we're going to open up some chi? This is what you do for a living. To get people to eat different, to eat, you know, to lose weight, to exercise regularly, those are hard things to get people to do, and we need to be better at it. Everybody agrees on that. There's saving money and there's cost effective. MARTIN: What I do every day, buddy. You can export to TXT, DOCX, PDF, HTML, and many . ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. GUPTA: In the spirit of educating people out there, I think I have cardiac disease in my family. I mean, look at our results. Meditation takes the place of that. ROSS: How long ago was that? NISSEN: I do. And I think that's a good place to start. And, in fact, they were more likely to die. MARTIN: You used to cut? 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