A woman had a heart attack at 34. Doctors did open-heart surgery and put stents in her arteries more than two dozen times. But her diabetes, cholesterol and blood pressure remained out of control.
A doctor showed that a program combining low-fat diet, exercise, stress reduction and social support can improve heart disease. It took him 16 years to convince Medicare to cover it.
The U.S. health care system is a disease care system that profits from procedures, not prevention, authorities note in a new documentary, “Escape Fire: The Fight to Rescue American Healthcare.”
The system “doesn’t want you to die, and it doesn’t want you to get well,” journalist Shannon Brownlee says. “It just wants you to keep coming back for your care of your chronic disease.”
If you care about health care, see this film. Through stories about patients and providers — including the Ohio woman treated repeatedly for heart disease and Dr. Dean Ornish’s lifestyle approach to reversing heart disease — it provides a clear look at shortcomings of the health care system and some possible solutions.
“Escape Fire” hit theaters in select markets (not including Madison) last month and is available through iTunes and cable TV on demand services. I saw a screening this month at UW School of Medicine and Public Health.
The title is from an anecdote relayed by Dr. Don Berwick, former head of the U.S. Centers for Medicare and Medicaid Services. When fire struck Mann Gulch, Mont., in 1949, smokejumper Wag Dodge did something unusual: He lit brush around him to burn fuel in advance of the blaze, and survived. Nearly all of those who ran, as was customary, died.
“We’re in Mann Gulch,” Berwick says in the film. “Can we please stop and think and make sense of the situation and get our way out of it?”
“Escape Fire” is mostly free of politics, unlike Michael Moore’s 2007 partisan treatise, “Sicko.”
That makes sense because most of the challenges presented in the film were largely left untouched by the controversial Affordable Care Act, or “Obamacare.” The 2010 law significantly expanded insurance coverage — which will help or harm many, depending on your point of view — but did relatively little to shift financial incentives in the delivery of health care.
Some sobering statistics: About 75 percent of the country’s $2.7 trillion health care spending last year was on preventable diseases. About 30 percent was for services that don’t help. We spend $8,000 per person each year but have worse outcomes than other developed countries, which spend $3,000.
The film shows Dr. Erin Martin, a primary care provider in rural Oregon who tries to address the psychosocial factors contributing to her patient’s illnesses. But she’s pressured to rush through appointments because she’s paid by the volume of people she sees.
Insurers are reluctant to invest in prevention because patients might not stay in their plans long enough to see a payoff, former insurance company executive Wendell Potter says.
Sgt. Robert Yates is a physical and mental wreck after returning from Afghanistan, clinging to a bag full of painkillers. But he tries an “escape fire,” or new approach — an acupuncture and meditation program at Walter Reed Army Medical Center. He’s surprised by the results.
Safeway grocery chain’s “escape fire” is a top-notch wellness program (with a workplace gym), which has kept employees’ health care costs stable as they continue to soar at other companies, according to CEO Steve Burd.
In a panel discussion after the medical school screening, Dr. Pat Remington suggested one “escape fire” would be to make the healthy choice the easy choice for people with hectic lives. One example would be cheaper healthy food or more expensive unhealthy food.
But that is easier said than done, acknowledged Remington, the medical school’s associate dean for public health.
“You’re swimming upstream, trying to change a system that has great incentives to stay just the way it is,” he said.