American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. We spend $300 billion a year on pharmaceutical drugs––almost as much as the rest of the world combined. We pay more, yet our health outcomes are worse. About 65% of Americans are overweight and almost 75% of healthcare costs are spent on preventable diseases that are the major causes of disability and death in our society.
It’s not surprising that healthcare tops many Americans’ concerns and is at the center of a political firestorm in our nation’s Capitol. But the current battle over cost and access does not ultimately address the root of the problem: we have a disease-care system, not a healthcare system.
ESCAPE FIRE examines the powerful forces maintaining the status quo, a medical industry designed for quick fixes rather than prevention, for profit-driven care rather than patient-driven care. After decades of resistance, a movement to bring innovative high-touch, low-cost methods of prevention and healing into our high-tech, costly system is finally gaining ground. Award-winning filmmakers Matthew Heineman and Susan Froemke follow dramatic human stories as well as leaders fighting to transform healthcare at the highest levels of medicine, industry, government, and even the US military. ESCAPE FIRE is about finding a way out. It’s about saving the health of a nation.
The documentary followed, among others, a primary care doctor in her fight to spend more time with patients, Dr. Andrew Weil and his integrative medicine fellowship encouraging doctors to treat the root cause of the disease rather than treat the symptoms, Dr. Dean Ornish’s fight to get Medicare reimbursements for lifestyle treatment for heart disease, and Dr. Steven Nissen’s argument that doctors should be salaried instead of paid to perform, as many in the current system are.
The biggest issue Escape Fire brought to attention was the pay to treat model. Doctors in Escape Fire said they would be reimbursed at $15 per office visit if they simply talked a patient through their treatment plan. If they performed a procedure or gave a certain pharmaceutical, they would be reimbursed at a rate of over $1,000. The American Healthcare system is rewarded for managing symptoms instead of curing disease.
This is my frustration with my current doctors medicating my symptoms and not doing enough to find the root cause of the problem. When I ask questions about a root cause, I’m met with resistance and a prescription for another new drug. In my opinion this pay to perform model and reimbursement methods are why the American Healthcare system is broken.
On that same note, doctors are reimbursed for the number of patients they see. Dr. Erin Martin, the primary care doctor featured in the film, described primary care as a revolving door: see 30 patients in an hour, as directed by the business administrators to be reimbursed at a higher rate. I know this happens for a fact in the medical practices where I live. Spending more time with patients and therefore seeing fewer, means less money for the doctors.
What I loved about the film was the feature on the military’s new acupuncture and holistic practices for pain management. They showed soldiers returning from Afghanistan treating their war injuries with bags of narcotics. Escape Fire showed these prescription addicts find more relief with acupuncture and meditation. The argument was the route of military medicine is the future route of the country. I’d love to believe that, but I just can’t.
As Olivia wrote in her blog Turning Poison into Medicine, her rheumatologist dismissed her acupuncture treatments as a “placebo effect.” Why would western doctors do this when studies show that acupuncture is proven effective in the treatment of many diseases? Because acupuncture doesn’t make anyone any money! Acupuncture is not covered any insurance I’ve ever had, and I’ve dealt with many different insurance companies in the last five years. I think Olivia demonstrates this by explaining “I kid you not, he spent four hours with me. Contrast this with the 15 minutes I have with my rheumatologist every three months, where the whole time I feel rushed because I know he has several other patients who have also waited three months to see him.” Again an example of the pay to perform model.
The American Healthcare system is badly broken. Until we discourage the cut-throat medical school competition of picking a specialty and stop rewarding doctors for prescribing drugs and scans and lab tests, our people will not get better and not afford their care. Escape Fire did focus on Dr. Weil and Dr. Ornish’s natural treatment plans in eliminating a vast majority of chronic illnesses. I believe this is true for many, not for all. But, if we eliminate the need to medicate patients with preventable diseases we have more time to care for those who truly are sick and need care.