Suture, one that's used in every operating room in the world. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. ROSS: All right. To get the best results, use these formatting tips: To force the start of a new caption . But with regard to prevention, preventing disease, does that save us money? UNIDENTIFIED FEMALE: We'll do it at the front. She got her cholesterol under control, her weight under control and things were great for her after that. How to know if you are being prescribed unnecessary medications or procedures, that's next. He's, like, clutching his head. MEL LEFER, PETALUMA, CALIFORNIA: 25 years ago I had five restaurants in San Francisco. It is a burning platform and they see this. All Dogs Go to Heaven 2/Transcript. I'm going to the emergency department. A flower for you. And the fire spread around him. DAVENPORT-ENNIS: So, I think with some patients it clearly will. YATES: That's every single signature that says that you're good to go to get out of Walter Reed and move on with my travel right there. Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. It's still not over, but it's better from Germany, I promise you that. I stopped taking my medicine months ago. UNIDENTIFIED FEMALE: These are the costs of all of our drugs in order. Afghanistan? Things could move in that direction here, and this is not the choice of the doctor. You've done some sweating. Your company becomes more competitive. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. Committed to her living longer and better. Alexander/Transcript. NISSEN: Yes, but we have to educate patients. If someone had talked to her, I think someone had really teased down her chest pain and her shortness of breath. I started getting sick in my 30s. I became a doctor because I care about patients and working here, I can't help them. Get educated on these issues and add your voice to a growing chorus for change. The fire overtook the crew, killing 13 men and burning 3,200 acres. WEIL: This is a problem with a lot of our suppressive treatments. Cost about $1200. Maintaining my pain. It sounded like it was so bad that you basically had to leave your practice. Our automatic transcription software will convert your video to text in just a few minutes (depending on the length of your video). You almost forget that what you're doing is providing healthcare. 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. UNIDENTIFIED FEMALE: OK. MARTIN: So we need the crisis counselor, then. Or at least we think we do. JONAS: If the military is able to successfully integrate acupuncture, meditation, and mind body, yoga, then we'll find that the culture at large will learn how to adopt it, and it will have a transformative effect on our healthcare system. That is ridiculous. When you go over into a war zone where you see your buddies die or you get injured, that's going to tax anybody. ROSS: OK, what was it, Mr. Linton, that finally made you say, okay, that's it. ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? 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. 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. ROSS: What's the regular food? It used to be me. So, you want to take a look at that and find out what it is. (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. The film examines the powerful forces trying to . MARSHALL: Me, personally, I'm on a salary. And I think we're in a great deal of trouble because of that. We just have to keep working towards that. NISSEN: Yes. If you look at a hospital bill, you might see an IV bag charge. I think five or six of them are on the waiting list. We want more procedures. He is the president of the American Academy of Family Physicians. MARTIN: Wow. You know, the ads always end with the same phrase, ask your doctor. Thank you all. It's about saving the health of a nation. And you say that you can help negotiate the price of these bills down, what do you tell people? It was with a huge amount of skepticism and resistance. Going back home. I just could not continue doing what I was doing. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? Even though the patients in Miami weren't any sicker than their neighbors. 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. I have an acutely suicidal patient in my office that I need help with. 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. 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." DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: In 1949, a forest fire broke out in Mann Gulch, Montana. This is just an unbelievable amount of stents and cardiac caths. So, if you have a patient comes in, you get paid a certain amount because you do a stent. He had -- he had Percocet then he has Marco which is Percocet. And water, they are saying, I'm going to have to give up to get there. They sent me home with them. It's all about the reimbursement. Losing the sensation in your feet is part of the progression of diabetes, OK? UNIDENTIFIED FEMALE: These are all name brand. Event marketing. Came off the mountain with only eight. Meditation takes the place of that. And the company did nothing. We even found that when you change your lifestyle, over 500 genes were changed. I love you. Doctor , let me start with you. So tired of it. Log in to your account. Have you -- UNIDENTIFIED FEMALE: 2008. It doesn't reward them for doing a better job. How to make a healthy choices. BURD: Yes. BERWICK: The healthcare system is unsustainable. Got approved very quickly. Aliens in the Attic/Transcript. UNIDENTIFIED FEMALE: I'm just going to go ahead and put the last one in. UNIDENTIFIED FEMALE: They are all combined. GUPTA: I want to point out something. So, we decided to give you a look at a typical operating room bill and that breaks down. I could hardly just about walk three steps and I'd have to stop and rest. As an overall system, no, we're not anywhere near the best in the world. The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. Korengal, the (INAUDIBLE), it's the most intense battleground that you can ever be in. WEIL: Where are you from? And healthcare doesn't need to be immune to that. UNIDENTIFIED FEMALE: He was issued this bottle today with 20 in it and 10 are missing. A lot of that comes you spoke - we spoke about are driven by people who don't have access to the system. BERWICK: Everybody is doing what makes sense to them individually. UNIDENTIFIED MALE: I have no health insurance. Video: This tiny shape-shifting robot can melt its way out of a cage . A lot of unnecessary stents? She joins us now. It was either come and get care there or not get care at all. We've just created a completely different system here. DAN BULLIS, WALTER REED ARMY MEDICAL CENTER, DEPLOYMENT HEALTH CENTER: Post-traumatic stress disorder, PTSD, is an individual's reaction to the exposure and experiences of war. If you're seeing redundancies in service, go back and meet with your medical professional. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. If somebody has an infection, we give anti-infectious agents. I mean, give me a break. OK. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. 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. The kinds of interventions that we have come to favor in this country are inherently costly because they are dependent on expensive technology, and that includes pharmaceutical drugs. It's an expensive world to live in in terms of getting your voice heard in D.C., but that's the whole function of advocacy. Job number two was to make sure that there was not a public option. And chromosomes have all genetic information on them. UNIDENTIFIED MALE: Yes. It was a passion for healing. Who pays for that? Ten allotted. Let me get right to it, Erin. 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. But, the American people are going to want something like that and that is going to be their perception. They become more productive. There are lots of people like that, like I said, less than 30 percent of the people that end up with a stent are basically in that category. And you're here today with chest pain. And the owners of those pockets do not want anything to fundamentally change. The medication depresses you, it makes you think that it's all you're ever going to be in. UNIDENTIFIED MALE: What do we want? We could do 1,000 studies with a million patients, it would remain on the fringes, it's all about the Benjamins, as (INAUDIBLE) would say. The film interweaves personal stories with the efforts of leaders battling to transform it. If they are surgeons, they get paid for each procedure. But you end up being this revolving door. CINDY ROBERTSON, ADMINISTRATOR, MD-COLOMBIA FAMILY HEALTH CENTER: We're the only clinic in this community county, so it's about 20,000 people overall. It's hard to say good-bye to the patients. There was obviously a problem. GUPTA: United health care makes a lot of money. YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? That cost about 1,000You'll find examples like this all over a room. But I think the economic imperatives are much stronger now. What made you decide to do that? BURD: All right. In the dialog that appears, select the language of the file you're uploading. The check that I get back from the insurance company after that was billed is $40. These are techniques that should be used to relieve symptoms. Determine, did you indeed have two MRI's during the course of one week? Exhale. Why do we care about covering the uninsured? See you soon. We're part of the community. There's been a lot of change in me in that transition between La Clinica and here. 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. I mean, that sounds like a really dire situation. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). MARSHALL: So, anybody that's having a heart attack should get a stent. UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. Our forefathers in medicine were really about patients. It takes a village to make an unhealthy patient healthy. Now, thanks to both of you for joining us. DR. SANJAY GUPTA,. Tell me what happened. You know? And there's a lot of talk about who's going to pay for it, and that's really important. What do you think of that? It's And we will say, it is important you request the appointment not only through a telephone call, but if you have an e- mail address, to try to do that. She had had bypass surgery at an early age. It really does. It includes the mandate, the requirement that we all have to buy their coverage. ORNISH: The program increased the telomere length. NISSEN: There's litigation involved and the company set aside $6 million to settle lawsuits. All Americans have accepted for 50 or more years in the automobile insurance industry that driving record dictates premium. It is the largest health insurance company in the country. KATY KASCH, HEAD NURSE, AIR MOBILITY COMMAND: Yes. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. CHO: I was trying to figure out how much Yvonne's care would have been over the years, and I think it's well over $1.5 million. 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. Escape Fire Background.The video essay Escape Fire (2012) was heralded as a breakthrough in the understanding of and . Jonas, Wayne B., commentator. MARTIN: When was your last mammogram and pap smear? This place actually gave me the tools to put in my tool bag so I can go back and still continue my process of healing, recovery. GUPTA: The children dying before the age of five exceeds any of the other 16 richest countries. This point I'm in. We are going to take a short break. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. 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. CHO: Oh, my God. It's generating rivers of money that are flowing into very few pockets. UNIDENTIFIED MALE: I feel different. YATES: Meditation is scary sometimes. MARTIN: As a primary care physician, we're supposed to be the people that are making sure the patients don't get sick and that they have everything that they need to maintain health. What is really striking is how little they have written the last few years. "Escape Fire" airs March 10 on CNN. MARTIN: And they don't reimburse for nutritional counseling or anything like that. TUCKSON: Primary care doctors are being cared more. 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. ROBERT YATES, INFANTRY, U.S. ARMY: Been shot. 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. UNIDENTIFIED FEMALE: I just want to see what they've given him. UNIDENTIFIED FEMALE: No. The film is about finding a way out. That requires so much work, but we do it because we're committed to having her stay out of the hospital. PROTESTERS: Healthcare. If I'm frustrated by anything, it's that more of the nation hasn't adopted this. Hello, how are you? It doesn't always work. It's a happy time in my life right now. UNIDENTIFIED MALE: I lost about 120 pounds over the course of three years. I think many of her cardiac catheterizations instead would not have been necessary. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. It rewards them for delivering more care. Aladdin and the King of Thieves/Transcript. The patient just fell off the litter. It's too much paying for it. In our model, the physician acts as a quarterback. There were even times, honestly, that I looked in the mirror and said, how did you get here? 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: That was, what, a month and a half ago? Rescue care is second to none. You have all these stents, and these stents, once they go in, they never come out and are part of you. At the same time, the power of these simple low-tech, low- cost interventions is also becoming clearer. UNIDENTIFIED FEMALE: Now you pick your spot. And they formed a group practice they decided that they would pay themselves a salary and the money that was left would go back into growing the organization. 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. It is an IV like this, about $280 just for the IV bag. The way that the system is set up, you can't be effective. GUPTA: Can you actually get a-hold of those people? UNIDENTIFIED FEMALE: Prescriptions, you can see how many scripts in the under script. UNIDENTIFIED FEMALE: (INAUDIBLE) I'm tired of it. I mean, they are going to watch that and think, that's ridiculous. GUPTA: Stay with us. DR. ELIZABETH BLACKBURN, NOBEL PRIZE IN MEDICINE, 2009, UNIVERSITY OF CALIFORNIA SAN FRANCISCO: Telomere are the ends of chromosomes. We just spent $1,000. The study was conducted by Dr. Dean Ornish, who looked at patients with early stage prostate cancer. ORNISH: Dr. Peter Carroll and I collaborated with Dr. Elizabeth Blackburn, who won the Nobel Prize in medicine and she had done a study showing that stress creates shorter telomere, said as your telomeres get shorter, your life gets shorter. GUPTA: I think the numbers are surprising to a lot of people, even people who work in hospital. That's going to be a little bit of a change and a little unfortunate. (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. We have that technology, it's right there. MARTIN: OK? 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. And so, I think it points to the violence in our society. Most diseases don't happen overnight. I started having really, really bad chest pain. Do you want to tell me about some of those that you lost? You're two or three times as likely to get a heart catheterization or have a stent in your coronaries. Thanks all of you for joining us. NISSEN: When I watch the networks, half the ads are for pharmaceutical agents. Mountains of Afghanistan are not easy to climb, so pain in my back. There's saving money and there's cost effective. And how to know if you're being prescribed unnecessary procedures. I mean, I can't think of a single negative in doing this. The answers among us, and only by accepting the fact that the American healthcare system is badly broken and the status quo isn't working, is bankrupting our nation, will we be able to seek out the escape fires, the potential solutions, and create a sustainable and patient centered system for the future. Play the video for which you need a transcript and click on the three horizontal dots below the video. I felt like there's got to be something different, something better. (LAUGHTER) NIEMTZOW: Hi. But it's more than cost. This is a lot worse. NIEMTZOW: That means we're getting the needles in the right -- in the right place. He overdosed. And it wasn't because procedures were more expensive in Miami than in Minneapolis. 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. CARNES: Ready? It is important to keep in mind. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. One of the great contributions of America to world cuisine, you know, fake bread. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. All right, so take a breath. Most insurance companies will follow Medicare's lead, so I realize that Medicare is the Rosetta stone. I ultimately had a crisis of conscience, because I was not at all proud of what I was doing. 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. But this program has just inspired me to press forward. Sometimes they are related to lifestyle habits. UNIDENTIFIED MALE: Oh, yes. It doesn't reward them for keeping their patients healthy. 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. I don't want to go down the same path. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. YATES: I was in the worst place in Afghanistan. ROSS: There have been some trends in healthcare that make me uncomfortable. It will require a huge effort. I can't be having heart problems. Our health care system. It's a completely irrational system. . If we just change reimbursement, it's a game changer, we change medical practice and we change medical education. 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. About 70 percent of all angioplasty and stent procedures in this country are done in people actively having heart attacks, large heart attacks or smaller heart attacks or having what we call unstable angina. I need to speak with the crisis worker. Even when bad things happen, it's not because people have bad intentions, it's that our system is all fouled up. 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. That's the only reason we're making the change. He was featured in the film. Type the text of what was said in your video and save it as a plain text file (.txt). UNIDENTIFIED MALE: These are all one person's? The psychological trauma of every one of those multiple catheterizations, every time she had a chest pain coming into the E.R., and unfortunately, there are lots of Yvonnes out there. 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. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? And by the way, they are number in the world and life expectancy. I'm not changed, but I'm changing. ROBIN ROBERTS, ABC NEWS: Now to a new study that shows diet may be a key tool in the fight against cancer. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. GUPTA: Why not just pay them more money? Aladdin (1992)/Transcript. There's the bright blue slush. Simply the same way the hospitals and physicians. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. WARD: I was chronically coming down with colds, and I knew that there was a history of cancer in my family, diabetes, heart disease. UNIDENTIFIED FEMALE: Hello, Mr. Fields. UNIDENTIFIED MALE: No. This -- medications I was on. If I burn the fuel around me, then when the fire comes and it takes me, I'm safe. UNIDENTIFIED MALE: At the executive level, what's most important is hitting Wall Street's expectations, and they have to. Where I'm at right now, patients are in desperate need of care. What does that do? Because of this program that's here, the yoga. GUPTA: In the spirit of educating people out there, I think I have cardiac disease in my family. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. BERWICK: The healthcare system isn't affordable anymore. Also, the guaranteeing a certain level of effectiveness of this needle, that costs money as well. WEIL: It could get worse. I mean, look at our results. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. 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 . 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. UNIDENTIFIED MALE: I quit drinking, too. RICE: You know, I think, the biggest incentive for patients is that they are going to leave a higher quality at longer life. Results, use these formatting tips: to force the start of a nation: Well, what do tell... Background.The video essay Escape fire ( 2012 ) was heralded as a plain text file.txt... 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