Sunday, October 07, 2012

"Escape Fire": how to fix American health care (original theatrical release)


I attended a extended screening of “Escape Fire: The Fight to Rescue American Healthcare” late Sunday Oct. 7 at the West End Cinema in Washington DC before a nearly sold out house.  Director Susan Fromke (Matthew Heineman also directs),  journalist Shannon Brownlee, and Dr. Cho formed the panel.

The metaphor in the title is shown at the beginning, as a lone firefighter in a western mountain region sets a small backfire or “escape fire” to prevent the main fire from reaching him.  How the analogy works with health care becomes clear later.

The film starts out by showing the problems of the “fee for service” system, which leads to patients having excessive tests and procedures and treatments that harm them. The film presents some patients  (mostly in Virginia; a lot of the film is shot around Charlottesville VA and UVA) who have had multiple coronary artery stents placed and who still have heart attacks. Some of them are low-income and look, frankly, very ragged, and are shown smoking cigarettes at home.

The film moves on to the treatment of wounded veterans, particularly at Walter Reed  Army hospital in Washington DC.  It develops the concept of acupuncture in order to reduce the use of prescription narcotics by soldiers for pain.  The Air Force has developed this technique in Germany.  One particular character, Sgt. Yates, is really helped by this technique.  The “escape fire” concept comes from the fact that the body is diverted from perceiving severe pain in one area by very mild distracting irritation in another.

Dean Ornish appears, and covers the fight to have some nutritional counseling covered by Medicare and Medicaid.  The film moves on to the subject of employee wellness, interviewing the CEO of Safeway at its California headquarters.  Employees get discount on health insurance premiums based on their clinical numbers, and are heavily encouraged to join company exercise clubs.

The film makes a real case for the idea that physicians should be paid salaries, and not be compensated by the number of patient visits they do or the number of procedures they perform. And the pay scale for specialties has driven people away from being primary care physicians. 

Official site from Roadside Attractions, link



One thing is apparent. When you look at the health care systems in some other countries with private bit “universal” systems (like Germany or Switzerland) this is a problem we can solve, if only our partisan politics would let us. Or if the corporate lobbyists who control policy for short term bottom lines could be controlled. 

As they say, individuals mean well, but "the system" is broken.

Update: March 10, 2013

CNN recycled this film for its own health care series (essentially "Presents"), along with its own spin on the topic.  See the TV Blog March 10, 2013.

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