"Escape Fire: The Fight to Rescue American Healthcare” signals to viewers that healthcare in this country is broken. The traditional delivery model no longer works. As President Abraham Lincoln once said, “We must think anew and act anew.” That's what healthcare needs now—a new way of thinking, not only by providers, payers and government, but patients and consumers, as well.
The documentary delivers some important messages along with vignettes on health insurance, military medicine and the challenges of being a primary-care practitioner. Its most critical statistic appears in the first three minutes: 75% of the $2.7 trillion the U.S. spends on healthcare annually goes to treat diseases that are entirely preventable.
This is not a new fact. But it's true. And you can't repeat it often enough. A large portion of the 30 million Americans to be covered by the Patient Protection and Affordable Care Act will need long-term treatment for the top five preventable diseases—heart disease, cancer, stroke, lung disease and diabetes. These are conditions that devour the most healthcare resources. These are the conditions that will burn through our national treasury unless they're controlled.
“Escape Fire” maps ballooning rates of obesity nationwide and tells us we'll soon be spending $1 trillion a year on the consequences of obesity alone. It associates the low cost of unhealthy fast foods to federal subsidies for some farm products (corn and sugar) and not others (carrots, celery and apples). It takes us inside Safeway, where CEO Steven Burd has built a health plan that rewards employees for healthy lifestyle choices. We hear inspiring stories from once-overweight employees who now lead happier and healthier lives.
“Escape Fire” also focuses on Cleveland Clinic. It shows our operating rooms, lobbies and Lifestyle 180 wellness center. We hear from Dr. Steven Nissen, chairman of cardiovascular medicine, on the perverse economic incentives that lead doctors and hospitals to give patients tests and treatments they don't need.
Dr. Leslie Cho, a cardiologist, is featured in a segment about a patient who was dangerously overtreated elsewhere, and came to Cleveland Clinic after being given no hope. “When you reward doctors for doing procedures and not talking to patients, that's what they're going to do—procedures,” Cho says. Cho and Nissen explain how the Cleveland Clinic model encourages teamwork and eliminates incentives to provide inappropriate tests and treatment.
Dr. Delos “Toby” Cosgrove is president and CEO of the Cleveland Clinic.
It's a challenge to give a complete picture of the American healthcare industry in a 90-minute documentary. For example, in its discussion of cardio-preventive diets, it focuses on one single ultra-low-fat diet and doesn't mention other diets, which might be easier to follow.
But directors Susan Froemke and Matthew Heineman give voice to a story that needs to be told and, more importantly, heard.
An “escape fire” is a small fire or firebreak that can provide a haven in the midst of a larger blaze that is burning out of control. If American healthcare is on fire, then the crisis is fueled by our own dangerous lifestyles. Government, insurers and employers must incentivize healthier choices. Wellness—weight loss, exercise, tobacco cessation—is the “escape fire” that will save us.