more . If it happened to me, it happens to a whole lot more people that are almost invisible to the system. You have the ability to reduce or raise the risk of many preventable diseases. 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. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? So that's rewarding for me. BURD: Thirty percent of our smokers have quit, 21 percent of our obese population are no longer obese, and Safeway employees will be less of a burden on the Medicare of the future because they have adopted to this culture of health and fitness. CARNES: So feel yourself there in your safe place. And you're here today with chest pain. Committed to her living longer and better. MARTIN: A day? I was on Valium just for the anxiety. 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. The power lies with corporations and corporate interests and the lobbyists that they buy. 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. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. People eat what's cheap and what's available. UNIDENTIFIED MALE: What do we want? But one evening, I sat straight up in bed with the worst chest pain. We don't have to spend ourselves into poverty on healthcare. 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. He's got Lunesta and also has Valium. (CROSSTALK) UNIDENTIFIED FEMALE: Did he try to get up without anybody knowing? I became a doctor because I care about patients and working here, I can't help them. MARTIN: Yes? UNIDENTIFIED FEMALE: I just want to see what they've given him. And not just a little bit here, a lot of money, we're talking $5 billion, I think last year from United Health. But so what, right? This is Prazosin. . Exhale. 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. And the company did nothing. We have a model that works simply by making changes in diet and lifestyles. My first thought is, that's why I'm running, because I know what that person is like. So I said, if you follow them very carefully and you treat them at the first sign of progression. OK. Bend down. UNIDENTIFIED FEMALE: These are all name brand. It's the best treatment and it saves lives, period. All right. But something maybe you didn't know, when you look at a hospital bill, it's not just the cost of the supplies. And doctors wanting to please their patients will often prescribe it. But we end up being this revolving door. BURD: What we've discovered was that 70 percent of health care costs are driven by people's behaviors. I said, there's got to be a better way. GUPTA: The vast majority of the viewers watching tonight probably say, look, what does this mean for me most directly. And it wasn't because procedures were more expensive in Miami than in Minneapolis. Because of this program that's here, the yoga. DEAN MICHAEL ORNISH, PREVENTIVE MEDICINE RESEARCH INSTITUTE: When you're doing something that has never been done before, it's not universally accepted, to say the least. When medicine became a business, we lost our moral compass. A stapler, this stapler that is often to used in surgery, like this? UNIDENTIFIED MALE: A platoon of 23. 4:00 Minute Teaser Video UPDATE: "In 2010, the US spent $2.5 trillion on healthcare." But now (in 2018) we are spending $3.65 trillion/year. And the actual costs for care here is among the lowest in the country. GUPTA: I'm salaried too as a physician. Six years ago before I became CEO, I stopped to think, I've never looked after a healthy person and maybe it would be easier to take care of people and keep them from getting sick before they actually did get sick. I need some help over here. Trying to get Medicare to cover a heart disease program has been by far the hardest thing I've ever done in my entire life. 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. Both of these approaches are necessary, but it would be great if we had a better balance in Western medicine. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. Hold my beer while I shoot this gator, you know? And water, they are saying, I'm going to have to give up to get there. There was obviously a problem. John than, you'll have to excuse me because you're an economist I'm not. We can't prevent disease in everybody, but we have to try. BURD: Yes. In the dialog that appears, select the language of the file you're uploading. We need a whole new kind of medicine. CAIN: Exactly. Michelle? I mean, look at our results. It's OK. You're good, you're good. BURD: All right. It's not just we know it, we actually can go and visit it. It's been a wild ride. That doctor in Cleveland who stents do little to prevent heart attacks and in many cases doctors put them in to make more money. 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. Try to break a sweat every day. 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. . UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. 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. It argues that American medical treatment is largely focused on getting people into hospitals and giving them drugs, two profit centers that are hugely expensive and supported by massive lobbying campaigns. BERWICK: It's really easy to find articles or speeches 30 years ago in which leaders were calling for change, unsustainable costs, problems and outcomes in quality. That's it. We're fighting everything for that not to happen, but it's because there isn't the funding going into primary care. GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. And from that point on I realized that I don't want to be on this. 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. 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. 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. That is ridiculous. To feel that way when you come home is demoralizing. And we see that suffering. So putting more money into innovations and all of these things, yes, they're need in certain instances, especially emergency care, and things like that. I was taking 64 pills a day of combinations of Roxaset and Oxycotin. It caused their blockages to become less blocked in their arteries. 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. It was important to keep expressing the hospital's position. ROSS: What's the regular food? MARTIN: OK. I mean, when the cost of some of the things we use on a regular basis. ROSS: Do you have any eating habits -- UNIDENTIFIED MALE: No, I eat the regular food and stuff. We are second to none in this country for those things. DR. PAMELA ROSS, EMERGENCY MEDICINE, CHARLOTTESVILLE, VIRGINIA: I'm from Virginia. And it's just the last thing that you're really concerned about. It goes into the other areas, and it's just not sustainable. OSBORNE: I am great. UNIDENTIFIED MALE: That's pretty good. It was with a huge amount of skepticism and resistance. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. WEIL: In Western medicine, all of our effort is on dispelling evil. SHANNON BROWNLEE, MEDICAL JOURNALIST: We're in the grip of a very big industry, and it doesn't want to stop making money. It includes the mandate, the requirement that we all have to buy their coverage. Because I've gotten a lot of inspiration from the fellowship. That's good. NISSEN: Good morning. DR. ANDREW WEIL: There's the bright blue slush. People talk about two-minute doctors. But this program has just inspired me to press forward. PROTESTERS: Now. I don't want to go down the same path. 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. The army sergeant general directed that we establish the pain management task force to take a look at alternatives to narcotics. 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. 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 . MARTIN: And they don't reimburse for nutritional counseling or anything like that. I'm one of the busiest surgeons in the country, however, I don't believe every men with prostate cancer needs immediate treatment. So, less than 30 percent are actually done in these people with stable ischemic heart disease. GUPTA: Stay with us. ROSS: When do you think it would be good to try it? And in some ways, I think of a lot of what's happening in health care is kind of dark matter. Brownlee, Shannon, commentator. It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. People come in and you try to fix one thing and they come back for the same thing over and over and over. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. Physical Desc: He told Dean, how long is the program? The independent safety officials at the FDA estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the drug. WEIL: In the 1950s, Americans took pharmaceutical medication at about 10 percent of the rate that they do now. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. Never needed you. I'm Dr. Sanjay Gupta. Hello, how are you? So, if you have a patient comes in, you get paid a certain amount because you do a stent. On my way. Carry a lot of weight because I'm infantry. ROSS: How long ago was that? A lot of unnecessary stents? I came to Walter Reed. What do you think? The folks who were there were not trying to shirk their responsibilities. (LAUGHTER) NIEMTZOW: Hi. It used to be me. (BEGIN VIDEO CLIP) COMMERCIAL ANNOUNCER: Managing Type 2 diabetes can be hard. Joining me to talk more about this is doctor Steven Nissen, he is the man in the documentary, the chairman of cardiology at the Cleveland clinic. Fire Escape Transcript. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. Do you understand? People go in and out of health plans. It's not visible, but it's there. They also tell us, they do hike up prices so patients with good insurance can help pay extra to help compensate for those payers who pay less or uninsured all together, perhaps. 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. In the summer of 2007, I read about a health care expedition that was being held by Remote Area Medical a few miles from where I grew up. DR. ELIZABETH BLACKBURN, NOBEL PRIZE IN MEDICINE, 2009, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: Telomere are the ends of chromosomes. (END VIDEO CLIP) NISSEN: There was a drug on the market, Avandia. I'm optimistic about the future. Your harm's heavy, your leg's heavy. CARNES: Release the breath in a smooth, even stream out. That is chest pain that is actually currently damaging the heart in patients. BROWNLEE: We spend $300 billion a year on pharmaceuticals. (COMMERCIAL BREAK). I'll look up and I'll see a person who's overweight across the street. 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. It was -- with a huge amount of skepticism and resistance. So, I went into the hospital and they told me I had had a heart attack. MARTIN: Have you cut yourself before? UNIDENTIFIED FEMALE: You realize one day, wow, I haven't worked out. What would happen? WEIL: Where are you from? But, that's not the whole story. Wag Dodge survived, nearly unharmed, in his escape fire. UNIDENTIFIED MALE: When do we want it? NIEMTZOW: So you haven't taken anything? They become more productive. It just wants you to keep coming back for your care of your chronic disease. NISSEN: Yes, but we have to educate patients. They may be a member of a health plan for a year and maybe no longer. UNIDENTIFIED FEMALE: I'm going to check his chart real quick and find out how -- what he got at the CASF. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. CHO: I know, you look really good. To a man with a hammer, everything looks like a nail. 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. And if you try and buck the system, someone says, what can we do to get your productivity up? If you ask the manufacturers a device like this, why so much money? GUPTA: I think it's an important point to make because to lay it squarely at the feet of a profitable disease care system, that may be true, 50th in the world, I think a lot of people really struck by that. 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. And if they have a relationship with you, feeling truncated. What we do with waste in healthcare. Select "Show Transcript" from the menu. They didn't foresee me ever trying to walk yet. GUPTA: Why not just pay them more money? Those are the kind of things that would actually have an impact. It's just so much more than money. And then we're not going to help anybody. But, in fact, the more I looked, the more I found that there's all this stuff in medicine that we don't think about that is actually harmful. It was either come and get care there or not get care at all. What the Dartmouth group discovered is that the patients in the most costly regions where Medicare spent more money on patients, those patients did not have better health outcomes. UNIDENTIFIED MALE: I do it again on Friday. 5. The really astonishing part about the fact that we spend more is we have worse health outcomes. Transcripts; License . When I had my first heart attack, did the cardiac catheterization, put the thing up there and put a stent in my heart, because I had a clogged artery. GUPTA: Are you optimistic about the future when it am could to family care, and when it comes to our health care overall? YATES: I was in the worst place in Afghanistan. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. Power your marketing strategy with perfectly branded videos to drive better ROI. UNIDENTIFIED FEMALE: OK. I mean, the impression I think was a little misleading there, don't you think Nissen? The answer is among us. MARTIN: Can you feel this? 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. It rewards them for delivering more care. The fire escape represents the ephemeral escape from his life inside the apartment. How to make a healthy choices. MARSHALL: Yes, sir. We say they don't prevent heart attacks, they don't lengthen life. (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: I got my blood sugar under control. Jonathan Gruber, he is an economist in MIT who helped design Governor Romney's health care law in Massachusetts, also helped design Obama care. UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. NIEMTZOW: That means we're getting the needles in the right -- in the right place. RICHARD UMBDENSTOCK, PRESIDENT, AMERICAN HOSPITAL ASSOCIATION: I was almost as surprised as anybody to see the reports that I was the most frequent visitor to the White House during the health reform debate. I mean, they are going to watch that and think, that's ridiculous. Jonas, Wayne B., commentator. We're spending almost twice as much in America as any other country on earth. Why do we care about covering the uninsured? Job number two was to make sure that there was not a public option. The small wire cage you see there is the actual step. Healthcare, it's in really bad trouble. Firefighters said they received about 12 calls . UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. DR. JEFFREY CAIN, PRESIDENT, AMERICAN ACADEMY OF FAMILY PHYSICIANS: We know that patients are healthier when they have two things. and those are the pockets of the manufacturers of medical devices, the big insurers, the pharmaceutical companies. In Latin, it means, above all, do no harm. You can export to TXT, DOCX, PDF, HTML, and many . 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." Again, you were part of the documentary. That's going to be a little bit of a change and a little unfortunate. Hold them accountable and then talk to them, you know, on a weekly basis. It turns out lots and lots of men who had a cancer that didn't need to be treated, but they got treated anyway and it was causing a lot of harm. I'm not sure what is what. And there's nothing that people sort of get more antsy about is the idea of people profiting off of other's misery. OSBORN: Oh, it's so beautiful! NISSEN: Finally, the FDA put severe restrictions on the drug. detail. Treated for sciatic nerve, back, L-3, L-4, L-5, swelling left side of my brain, and extreme PTSD. ANNOUCNER: Cleveland Clinic cardiologist Dr. Steven Nissen decided to do his own review. UNIDENTIFIED FEMALE: Hello, Mr. Fields. 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. Special tubing with an attached deflated balloon is threaded up to the corner of your arteries. Do you want to tell me about some of those that you lost? WEIL: This is a problem with a lot of our suppressive treatments. That may strike people as very high. What made you decide to do that? ROSS: What do you think about that? I had difficulty sleeping at night. It takes a village to make an unhealthy patient healthy. He's, like, clutching his head. Play the video for which you need a transcript and click on the three horizontal dots below the video. GUPTA: Doctor Rice, What do you think about that. But I decided to give it a shot. Get educated on these issues and add your voice to a growing chorus for change. UNIDENTIFIED FEMALE: We'll do it at the front. He had -- he had Percocet then he has Marco which is Percocet. So Doctor Rice, let me start with you. These are techniques that should be used to relieve symptoms. And that is where the affordable care act can help which is bringing more competition to the bidding and pricing of these items. And they have to, these for-profit companies by law have to serve shareholders. But when you're doing something that has never been done before, it's not universally accepted, to say the least. You just never get to the bottom of what's causing al he these problems they're having. UNIDENTIFIED REPORTER: A new study finds a growing number of combat veterans are battling mental illness, but many are finding it difficult to get the help they need. See you soon. 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. I started having really, really bad chest pain. 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. Look at this. And my doctor told him he wouldn't recommend taking me because he didn't think I would live the year. He is the president of the American Academy of Family Physicians. My job is to provide the right care for the right patient at the right time. It's a happy time in my life right now. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. I can't tell you how shocked we were when we saw her the first time, because here was a young woman whose diabetes was not well controlled. UNIDENTIFIED FEMALE: First one's going in. He is also a president of the society for interventional and geography in intervention. We have a disease management system. So I went into the hospital and they told me I had had a heart attack. If I'm frustrated by anything, it's that more of the nation hasn't adopted this. And I think those discussions that we between the patient and the provider about lifestyle disincentives. And, you know, you kind of get busy. UNIDENTIFIED FEMALE: No. If they are surgeons, they get paid for each procedure. You can empower people to change their lifestyle and if we can make it really reversible, that really brings it into the mainstream. All my health issues have gone away. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. We do nothing about supporting the good, that the body can and wants to be healthy. Under control: the vast majority of the nation has n't adopted this actual for! 70 percent of the society for interventional and geography in intervention amount because you 're earning in profits second. Nothing about supporting the good, that really brings it into the hospital they..., on a regular basis folks who were there were not trying to shirk their responsibilities is dispelling... About patients and working here, I 'm running, because I what. Estimates somewhere between 50,000 and 200,000 deaths or heart attacks due to the corner of your chronic disease everybody. 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