Escape Fire - The Fight To Rescue American Healthcare - A Review
By Emma Suttie, D.Ac
Escape Fire is a documentary film that presents a sobering exploration of the US medical system, and how it is largely failing the American people. In a country that spends more on healthcare than any other country in the world ($2.7 trillion annually), it seems that there should be a direct correlation with the amount of money spent and the overall health of the population. Instead of being at the top of the list in life expectancy, the United States is number 50. The film states that in the US, 75% of healthcare costs go to treating chronic diseases that are largely preventable. It is also estimated that 30% of healthcare spending (roughly $750 billion annually) is wasted and does not improve health.
The film presents some of the reasons that the present system is not working and why, despite the enormous amount of money spent, Americans are so unhealthy. The first and most fundamental is that it is a system not based on health, but on disease. Disease is the focus of both medical education and practice and therefore, doctors are not taught basic things like nutrition and prevention and instead specialize into fields where the focus is on disease. This focus on disease means that the entire system does not even enter into the equation until the disease has already manifested, and is thus based on intervention after the problems have already developed.
A Design Flaw in the System
Another problem with the present system is pay structure. Doctors are paid not for having healthier patients, but by seeing as many patients as possible, making it a numbers game. This leads to frustration for many doctors, as there is not time to flush out the root of the problems they encounter with their patients, so they are only treating symptoms, which means that patients come back with the same problems, again and again. The system is not based on outcomes, no matter how complicated or how much time they spend with a patient, it is based solely on how many patients they see. Doctors are doing what they can, cramming their schedules, but this approach is about quantity, not quality. Everyone is doing what they think is right, the government pays hospitals to be full, so they try to be full, and pays doctors to see patients, so they try to see as many patients as possible. Everyone is doing their jobs, it is just that their jobs have been designed wrong.
Dr. Andrew Weil, Professor of Medicine and Public Health at the University of Arizona, says
“What’s wrong with medical education is that it simply doesn’t address whole subject areas that are absolutely essential to understanding human beings, health, illness, and treatment. An obvious one is nutrition which is almost omitted from medical education.”
In 1994 Dr. Weil started a fellowship to retrain people who had been through medical school. In the fellowship, he exposes them to a broader way of seeing their patients, and arms them with a deeper understanding of healing, thus giving them a wider range of tools that they can use to help their patients.
Lifestyle Chioces
Dr. Dean Ornish, President of the Preventative Medicine Research Institute has spent more than 30 years conducting studies that show that heart disease can be reversed by what we eat, how we respond to stress, how much we exercise and the amount of love and support we have in our lives. He believes that the underlying causes of chronic disease are largely lifestyle, and therefore both preventable and reversible. In his model, the doctor acts as quarterback and assembles a team to work with the patient - a nurse, yoga instructor, exercise physiologist, registered dietitian and clinical psychologist. In this way, the patients empower themselves to change their lives and regain their health.
After 16 years of trying to get Medicare to recognize his program, it was finally announced in August 2010 that Medicare would reimburse Dr. Ornish’s heart disease lifestyle program. Dr. Ornish said that getting Medicare to recognize his work and agree to cover his program was the hardest thing he had ever done in his life, but thanks to his tireless work, his program will be covered and the information and treatment will hopefully spread, giving people another option to surgery and drugs for not only heart disease, but eventually for all diseases.
The Pharmaceutical Industry
The US spends a staggering $300 billion a year on pharmaceuticals, almost the amount of the rest of the world combined. In the 1950’s people were taking pharmaceuticals at 10% the rate they are now. So, what happened? It turns out that there are only 2 countries that are allowed to advertise pharmaceuticals. The United States is one, and New Zealand is the other and these ads seem to drive demand. The ads always say, “Ask your doctor!” and apparently, people do. People ask their doctors about that new drug that is supposed to be wonderful for high cholesterol, or elevated blood pressure, and doctors, wanting to help their patients, prescribe it. As a result, the US has turned into a hugely overmedicated society, and the pharmaceutical industry is raking it in.
Prescription drugs have also become a huge problem in the military. Soldiers’ use of prescription drugs has tripled in the past 5 years and has lead to other problems like an increased number of suicides. In fact, according to Pentagon statistics, the US military set a record - 350 suicides among active-duty troops. That’s more than the number that died in combat in Afghanistan, and more than double the number of reported suicides from a decade ago.
Acupuncture in the Military
Dr. Wayne Jonas, President of the Samueli Institute for Military Medical Research says:
“15 years ago a consensus conference at the NIH (National Institute of Health) asked a question: “Do we have good evidence to show that acupuncture is safe and effective for any condition?” They said, “Absolutely, it’s been demonstrated that acupuncture is safe and effective, especially with postoperative and injury pain.” He continues, “Fifteen years later you can’t walk into your average hospital and get acupuncture. Its not that it doesn’t work, it is that we haven’t figured out how to get it into the system.”
Dr. Richard Niemtzow, who is Director of the US Air Force Acupuncture Center has been using auricular acupuncture (acupuncture of the ear) to reduce pain in troops, some of whom were originally on a number of painkillers and has experienced great success with this program.
The military is looking into using acupuncture on injured soldiers being evacuated to medical centers in the United States, as it would reduce pain and the number of medications needed, thus avoiding the risks of dependency and overdose.
It may seem strange that something like acupuncture, which comes from Eastern medicine with its emphasis on a holistic system that seeks to balance mind, body and spirit, could coexist inside an institution like the hard core military. The explanation, according to Dr. Jonas, is that the military has seen unprecedented numbers of soldiers suffering from drug addictions, psychological problems like PTSD, both of which have lead to an dramatic increase in the number of suicides. It was this alarming trend that drove the military to seek out other treatment options like acupuncture.
There is an exciting program that is showcased in the film at Walter Reed Army Medical Center where troops are sent when they return from combat with injuries. The program incorporates yoga, meditation and acupuncture in their recovery. The film follows one soldier who returned from Afghanistan where he lost many of his men and was suffering from physical injuries as well as PTSD. His journey through the program illustrates that healing is needed not just on a physical level, but on all levels and that the program at Walter Reed Army Medical Center is getting results.
A for profit business
All of these statistics lead us to believe that something is terribly wrong. Sick people are not getting the care they need, and despite the enormous amount of money spent, Americans are not healthier and do not live longer. So something needs to change, right? Well, to find out why that change has been so slow to arrive, we need to look at who is benefitting from the system in its present incarnation. In a for profit system, the emphasis will always be on profit, and not health. The ones benefiting are the insurance companies, the pharmaceutical companies and the lobbyists in Washington who have a huge influence on policy making due to their deep pockets and generous campaign contributions.
The Solution
It seems obvious that the present healthcare system is not fulfilling its job of caring for the health of the American people, so what is the solution? The film suggests that the problems are not small or easy to fix and that it would be a complete restructuring of the system from the ground up that is needed. Medical education needs to be reevaluated and changed from a disease focus to a focus on health and prevention, or perhaps a healthy balance of the two. And perhaps most importantly, the public needs to become engaged, and incite change with their actions and more importantly, their dollars. If patients go to their doctors asking for nutritional advice and information about vitamins and supplements, then doctors will be compelled to give it. As it stands, the system is broken, but the United States still has amazing resources, doctors and hospitals. It is second to none in critical care, emergency medicine and complicated surgeries and there is incredibly important medical research being done in this country. So it is not that it isn’t possible, it is how the care is being delivered, pay structure, and a lack of prevention or focus on a healthy patient. The present healthcare system tends to be implemented after there is already a problem which is in contrast to other models (like Chinese medicine) which are focused on prevention, and empower the patient to be the master of his own health.
The good news is that, despite the problems the United States faces with healthcare, one of the most amazing and powerful things that is built into its foundation is democracy and the ability for the people to enact change on a large scale. Even though it seems that large corporations like insurance companies, big pharma and lobbyists are holding all the cards, an engaged and educated public can change the entire system, and it seems that perhaps, that time has come. :)
