All language subtitles for Escape.Fire.The.Fight.to.Rescue.American.Healthcare.2012.1080p.AMZN.WEB-DL.AAC2.0.H.264-NOGROUP

CAPTIONING MADE POSSIBLE BY
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[TYPING, BEEPING]

IN 1949, A FOREST FIRE BROKE OUT
IN MAN GULCH, MONTANA.

SMOKE JUMPERS
WERE PARACHUTED IN,

A TEAM OF 15, HEADED BY
A FOREMAN NAMED WAG DODGE.

THE FIRE EXPLODED.

IT WAS MOVING
OVER 600 FEET A MINUTE,

FASTER THAN MOST PEOPLE
COULD EVER RUN

AND SO 15 FIREFIGHTERS
WERE TRAPPED.

WAG DODGE HAD AN IDEA.

HE KNEW THAT THEY
WOULD LOSE THE RACE

BACK TO THE TOP
OF THE RIDGE,

SO HE SUDDENLY STOPPED,

HE LIT A MATCH AND
HE LIT A FIRE AT HIS OWN FEET

AND THE FIRE
SPREAD AROUND HIM.

I IMAGINE THE OTHER
SMOKE JUMPERS THOUGHT
THE GUY WAS CRAZY,

BUT HIS IDEA WAS THIS--
IF I BURN THE FUEL AROUND ME,

THEN WHEN THE FIRE COMES
AND OVERTAKES ME, I'M SAFE.

I'LL BE IN WHAT CAME TO
BE KNOWN AS AN ESCAPE FIRE.

HE TRIED TO GET
THE OTHER SMOKE JUMPERS
TO JOIN HIM AND NOBODY DID.

THE FIRE OVERTOOK THE CREW,

KILLING 13 MEN
AND BURNING 3,200 ACRES.

WAG DODGE SURVIVED NEARLY
UNHARMED IN HIS ESCAPE FIRE.

IT'S JUST TRAGIC TO THINK
OF THE ANSWER BEING THERE,

BUT JUST IN THE MOMENT
NOT ABLE TO SEE IT.

THAT'S HOW IMBEDDED PEOPLE
GET IN THE STATUS QUO.

THEY CAN'T RECOGNIZE AN
INVENTION WHEN IT'S AMONG THEM

AND THEY CAN'T GIVE UP
THEIR OLD HABITS.

WE'RE IN MAN GULCH.

HEALTHCARE, IT'S HEADED
FOR REALLY, REALLY BAD TROUBLE.

THE ANSWERS AMONG US,
CAN WE PLEASE STOP

AND THINK AND MAKE SENSE
OF THE SITUATION

AND GET OUR WAY OUT OF IT?
IT'S THE SAME CHALLENGE.

WE HAVE HAD ENOUGH!

[CHEERING AND SHOUTING]

WHAT DO WE WANT?!

HEALTHCARE!

WHEN DO WE WANT IT?!NOW!

ALL I HEAR IS HOW WE'RE GONNA
GET MORE PEOPLE ACCESS

TO THE PRESENT SYSTEM AND HOW
WE'RE GONNA PAY FOR IT

AND TO ME THAT'S
NOT THE ONLY ISSUE.

THE PRESENT SYSTEM DOESN'T WORK
AND IT'S GONNA TAKE US DOWN.

WE NEED A WHOLE
NEW KIND OF MEDICINE.

HEALTHCARE REFORM WAS
A GOOD PLACE TO START,

BUT IT WILL
DO LITTLE TO ADDRESS
THE ROOT PROBLEMS.

[SIRENS]

WE DON'T HAVE A HEALTHCARE
SYSTEM IN THIS COUNTRY.

WE HAVE A DISEASE
MANAGEMENT SYSTEM.

PEOPLE OFTEN THINK IT HAS TO BE
A NEW DRUG OR A NEW LASER

OR SOMETHING REALLY
HIGH TECH AND EXPENSIVE

TO BE POWERFUL AND THEY
HAVE A HARD TIME BELIEVING

THAT THESE SIMPLE CHOICES THAT
WE MAKE IN OUR LIVES EACH DAY

CAN MAKE SUCH
A POWERFUL DIFFERENCE.

WE'RE IN THE GRIP
OF A VERY BIG INDUSTRY

AND IT DOESN'T WANT
TO STOP MAKING MONEY.

AT THE EXECUTIVE LEVEL,
WHAT'S MOST IMPORTANT

IS MEETING WALL STREET'S
EXPECTATIONS AND THEY HAVE TO.

THESE FOR PROFIT COMPANIES,

BY LAW, HAVE TO SERVE
THE SHAREHOLDERS.

YOU ALMOST FORGET
THAT WHAT YOU'RE DOING
IS PROVIDING HEALTHCARE.

THE HEALTHCARE SYSTEM
IS UNSUSTAINABLE.

WE'RE SPENDING ALMOST
TWICE AS MUCH IN AMERICA

AS ANY OTHER COUNTRY
ON EARTH.

WE'RE REALLY
MORTGAGING THE FUTURE.

NOT JUST THE HEALTH
OF HEALTHCARE,

WE'RE TALKING ABOUT
THE HEALTH OF THE NATION.

MOMMY, WHAT ARE
YOU GOING TO DO?

I GOTTA GO TO WORK.

WHAT ARE YOU GONNA
DO AT WORK?

WHAT I DO
EVERY DAY, BUDDY.

I LOVE YOU.

I LOVE YOU, TOO!

BYE.

BYE!

IN A COMMUNITY HEALTH CENTER
LIKE WHERE I WORK,

YOU SEE CHRONIC ILLNESS,

PEOPLE THAT AREN'T ABLE
TO AFFORD THEIR MEDICATIONS,

LOTS OF PSYCHIATRIC ILLNESSES,

BUT THE GOVERNMENT
PAYS YOU

BASED ON HOW MANY
PATIENTS YOU SEE.

I THINK WE HAVE
ABOUT 25 PATIENTS FOR
TODAY FOR DR. MARTIN.

I THINK 5 OR 6 OF THEM
ARE ON THE WAITING LIST.

IF THEY'RE
AN EASY 15 MINUTE,

I'M SURE WE CAN PROBABLY
SQUEEZE THEM INTO THE SCHEDULE.

HELLO, MR. FIELDS?

[SPEAKING IN SPANISH]

I NEED TO LISTEN TO YOU.

ALL RIGHT. WHO'S NEXT?

HELLO.
HI.

HOW ARE YOU?

WELL, FIRST OF ALL,

MY SON'S
IN THE AIR FORCE

AND HE'S GOING
TO BE 21 ON SUNDAY.

MM-HMM.
AND HE'S NOT HERE.

WHERE'S HE AT?

GERMANY.
YEAH?

AND YOU'RE MISSING HIM?

I AM.

AND I MOVED OUT FROM MY
BOYFRIEND IN DECEMBER

AND I WORK
6 DAYS A WEEK,

5:30 TO 7:30
AND I'M TIRED.

WHOA. YEAH.

SO, IT SOUNDS LIKE
YOU'RE FEELING REALLY
OVERWHELMED RIGHT NOW.

SORRY.

DON'T BE SORRY.

DID YOU HAVE ANYTHING IN MIND
WHEN YOU CAME IN HERE TODAY?

I WAS ON CELEXA
FOR A WHILE AND
THAT SEEMED TO HELP.

SO, YOU WERE THINKING
ABOUT MEDICATION?

IF YOU CAN THINK
OF ANYTHING ELSE.

I'M A LITTLE BIT WISHY WASHY
ON THE MEDICATION

BECAUSE MEDICATION
IS NOT THE PROBLEM.

IT'S NOT.
YEAH.

THE PROBLEM IN YOUR LIFE
IS THAT YOU'VE GOT

TOO MANY THINGS GOING
ON AND YOU'RE OVERTIRED.

INSTEAD OF BASING
THINGS ON OUTCOMES,

ON HOW GOOD
OF A JOB WE'RE DOING,

THE GOVERNMENT SETS
THE REIMBURSEMENT COMPLETELY

ON THE NUMBER
OF PATIENTS THAT WE SEE.

IT DOESN'T MATTER HOW
COMPLICATED THEY ARE,

HOW MUCH TIME
THAT WE SPEND ON THEM.

IT'S JUST A NUMBER--
ONE, 2, 3, 4, 5.

YOU HAVE TO PLAY
THIS GAME WITH, WHAT
DOES THIS PATIENT NEED

AND HOW MUCH TIME AM
I WILLING TO SPEND WITH THEM

BECAUSE THE ADMINISTRATION
IS TELLING YOU,

YOU NEED TO SEE MORE PATIENTS,
WE'RE IN THE RED.

AND IF YOU TRY AND BUCK
THE SYSTEM, SOMEONE SAYS,

WHAT CAN WE DO TO GET
YOUR PRODUCTIVITY UP?

I'M NOT INTERESTED IN GETTING
MY PRODUCTIVITY UP.

I'M INTERESTED
IN HELPING PATIENTS.

IN THE ERA OF
FOR PROFIT MEDICINE,

THE TIME ALLOWED FOR PATIENT
VISITS HAS SHRUNK TO A POINT

WHERE YOU'VE GOT
7 MINUTES WITH A PATIENT.

CAN YOU FEEL THIS?

YES.

BARELY?

YEAH.
OK.

LOSING THE SENSATION
IN YOUR FEET

IS PART OF THE PROGRESSION
OF DIABETES, OK?

Dr. Weil:
IT COULD GET WORSE.

PEOPLE TALK ABOUT
2-MINUTE DOCTORS...

HMM.

LITERALLY,
30 PATIENTS AN HOUR.

THINGS COULD MOVE
IN THAT DIRECTION HERE.

AND THIS IS NOT
THE CHOICE OF THE DOCTOR.

AS A PRIMARY CARE PHYSICIAN,
WE'RE SUPPOSED TO BE THE PEOPLE

THAT ARE MAKING SURE
THE PATIENTS DON'T GET SICK

AND THAT THEY HAVE
EVERYTHING THAT THEY NEED

TO MAINTAIN HEALTH...

BUT WE END UP BEING
THIS REVOLVING DOOR.

PEOPLE COME IN AND YOU
TRY AND FIX ONE THING

AND THEY COME BACK FOR THE SAME
THING OVER AND OVER AND OVER.

YOU JUST NEVER
GET TO THE BOTTOM

OF WHAT'S CAUSING ALL OF THESE
PROBLEMS THAT THEY'RE HAVING.

MICHELLE?

[WOMAN CRYING]

TELL ME WHAT HAPPENED.

I JUST TRIED
TO CUT MY ARM OFF.

WHAT WERE YOU TRYING TO DO?

I JUST WANTED TO JUST END IT
AND...I'M TIRED OF IT.

I'M SO TIRED OF IT.

ARE YOU TAKING
YOUR MEDICATION?
YES.

A GREAT DEAL OF WHAT'S DONE
IN CONVENTIONAL MEDICINE

IS TO PUT
BAND-AIDS ON THINGS
OR TO SUPPRESS SYMPTOMS.

HAVE YOU CUT YOURSELF BEFORE?

WHEN I WAS A KID...

YOU USED TO CUT?MM-HMM.

LEXAPRO IS THE ONLY THING
YOU'RE ON RIGHT NOW?

MM-HMM.

THIS IS A PROBLEM
WITH A LOT OF OUR
SUPPRESSIVE TREATMENTS.

THEY MAY KEEP
THE DISEASE PROCESS GOING

AND THEY MAY
STRENGTHEN IT OVER TIME.

IT'S MUCH BETTER TO TRY
TO WORK AT A DEEPER LEVEL.

I'M GONNA MAKE A PHONE CALL AND
TRY TO GET SOME WHEELS IN MOTION

SO THAT WE CAN GET YOU
THE HELP THAT YOU NEED, OK?

OK, SO, WE NEED
THE CRISIS COUNSELOR THEN.

YES, THIS IS DR. MARTIN
OVER AT LA CLINICA.

I NEED TO SPEAK
WITH THE CRISIS WORKER.

THERE'S NO CRISIS
WORKER AT LUNCH TIME?

I HAVE AN ACUTELY
SUICIDAL PATIENT

IN MY OFFICE
THAT I NEED HELP WITH.

SHE'S STILL
TAKING HER LEXAPRO,

BUT IT'S OBVIOUSLY NOT,
UH...NOT DOING THE JOB.

WHERE I'M AT
RIGHT NOW, PATIENTS ARE
IN DESPERATE NEED OF CARE

AND THE WAY THAT
THE SYSTEM IS SET UP,
YOU CAN'T BE EFFECTIVE.

I BECAME A DOCTOR BECAUSE
I CARE ABOUT PATIENTS

AND WORKING HERE,
I CAN'T HELP THEM.

[SIGHS]

TO FEEL THAT WAY
WHEN YOU COME HOME...

IS...DEMORALIZING.

THERE HAS TO BE A DIFFERENT
WAY OF DOING THINGS,

SO I DECIDED TO LEAVE.

IT'S HARD TO SAY
GOOD-BYE TO THE PATIENTS.

I TOOK CARE OF THEM AND
I WAS RESPONSIBLE FOR THEM

AND JUST WORRYING ABOUT IF
SOMEBODY ELSE IS GONNA DO

FOR THEM WHAT THEY NEED.

I WANT TO GIVE TO PEOPLE

AND I WANT TO HELP PEOPLE

AND I WASN'T ABLE
TO FIND THAT HERE.

I'M GONNA GO LOOK FOR IT.

THE HISTORY OF HOW
THE AMERICAN HEALTH
CARE SYSTEM GREW

IS NOT ONE OF ORDER,

IT'S ONE OF SORT
OF HAPHAZARD CHAOS.

EVERYBODY'S DOING WHAT MAKES
SENSE TO THEM INDIVIDUALLY.

WE PAY HOSPITALS TO BE FULL,
SO THEY TRY TO BE FULL.

WE PAY DOCTORS TO SEE PATIENTS,
SO THEY SEE A LOT OF PATIENTS.

WE CREATE A PUBLIC EXPECTATION
THAT MORE IS BETTER,

WHICH ISN'T ACTUALLY TRUE,
SO PEOPLE SEEK MORE.

EVERYBODY'S
DOING THEIR JOB.

WE JUST DESIGNED
THE JOBS WRONG.

PHYSICIANS ARE
WELL INTENTIONED.

EVEN WHEN BAD THINGS HAPPEN,

IT'S NOT BECAUSE PEOPLE
HAVE BAD INTENTIONS,

IT'S THAT OUR SYSTEM
IS ALL FOULED UP.

WE SPEND
A SPECTACULAR AMOUNT
OF MONEY ON HEALTHCARE.

JUST SHEER NUMBERS.

$2.7 TRILLION PER YEAR.

THE AVERAGE PER CAPITA
COST OF HEALTHCARE

IN THE DEVELOPED WORLD
IS ABOUT $3,000.

IN THE UNITED STATES IT WAS
AROUND $8,000 ANNUALLY.

WE SPEND ONE HECK
OF A LOT OF MONEY.

THE HEALTHCARE SYSTEM
ISN'T AFFORDABLE ANYMORE.

WHO PAYS FOR THAT?
WHERE DOES THAT MONEY COME FROM?

THIS ALL COMING
OUT OF OUR POCKETS.

IT'S YOUR MONEY.

THE REALLY ASTONISHING
PART ABOUT THE FACT

THAT WE SPEND MORE IS WE
HAVE WORSE HEALTH OUTCOMES.

IF YOU NEED REAL SERIOUS
TECHNOLOGY TODAY

LIKE A VERY COMPLEX
CARDIAC SURGERY,

YOU'RE LUCKY TO BE
IN THIS COUNTRY.

RESCUE CARE
IS SECOND TO NONE.

AS AN OVERALL SYSTEM, NO,

WE'RE NOT ANYWHERE NEAR
AT THE BEST IN THE WORLD.

I MEAN, LOOK AT OUR RESULTS,

OUR LIFE SPAN ISN'T
EVEN IN THE TOP 20.

WE HAVE
A DISEASE CARE SYSTEM

AND WE HAVE
A VERY PROFITABLE
DISEASE CARE SYSTEM.

AND THE DISEASE
CARE SYSTEM, ACTUALLY,
I MEAN,

IF IT WAS REALLY HONEST
WITH ITSELF,

IT DOESN'T WANT YOU
TO DIE AND IT DOESN'T
WANT YOU TO GET WELL.

IT JUST WANTS YOU
TO KEEP COMING BACK

FOR YOUR CARE OF
YOUR CHRONIC DISEASE.

MOST OF THIS HUGE EFFORT

OF THE HEALTHCARE INDUSTRY
IS DEVOTED TO INTERVENTION,

IN ESTABLISHED DISEASE,

AND THE MAJORITY
OF THAT DISEASE

IS LIFESTYLE RELATED
AND PREVENTABLE.

I MEAN, TO TALK ABOUT
HOW WE SHIFT TOWARD--

AWAY FROM DISEASE INTERVENTION
TOWARD DISEASE PREVENTION,

HEALTH PROMOTION,
I MEAN, THAT--THAT REQUIRES

A MASSIVE RETHINKING
ABOUT MEDICINE

AND HEALTHCARE AT
ALL LEVELS OF SOCIETY.

IT HAS TO DO WITH
EXPECTATIONS OF PATIENTS.

IT HAS TO DO WITH THE
TRAINING OF PHYSICIANS.

IT WILL REQUIRE
A HUGE EFFORT.

THERE IS THIS TREMENDOUS
INNATE HEALING CAPACITY
THAT WE ALL HAVE.

WHEN I SIT WITH
A PERSON WHO'S SICK,

ALWAYS AT THE BACK OF
MY MIND IS THE QUESTION,

WHAT IS BLOCKING HEALING HERE?
WHAT IS PREVENTING IT?

WHAT CAN I DO FROM OUTSIDE THAT
CAN FACILITATE THAT PROCESS?

THAT PERSPECTIVE IS MISSING

FROM THE TRAINING OF
OUR HEALTH PROFESSIONALS.

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.

I MEAN, AN OBVIOUS
ONE IS NUTRITION,

WHICH IS ALMOST OMITTED
FROM MEDICAL EDUCATION.

SO, IN 1994, I STARTED
A FELLOWSHIP FOR PEOPLE

WHO HAD COMPLETED MEDICAL
SCHOOL TO RETRAIN PHYSICIANS.

WE WANT TO EXPOSE
CLINICIANS TO A BROADER WAY

OF SEEING THE PATIENT.

A DEEPER UNDERSTANDING OF
HEALING AND A LARGER TOOLBOX

FROM WHICH TO CHOOSE
FOR THERAPIES.

MANY CLINICIANS COME
HERE FRUSTRATED,

THEY'RE OVERWORKED,
THEY'RE OVERWHELMED,

BURIED DEEP UNDERNEATH
INSURANCE FORMS

AND 10-MINUTE VISITS
AND 30 PATIENTS A DAY.

WHERE ARE YOU FROM?

I'M FROM VIRGINIA.

I ACTUALLY PRACTICE
EMERGENCY MEDICINE

AT THE UNIVERSITY OF VIRGINIA
IN CHARLOTTESVILLE.
GOOD.

THERE HAVE
BEEN SOME TRENDS

IN HEALTHCARE THAT
MAKE ME UNCOMFORTABLE.

I FELT LIKE THERE'S GOT TO
BE SOMETHING DIFFERENT,

SOMETHING BETTER.

ALMOST 40,000 PEOPLE
HAVE BEEN STUDIED...

MY MEDICAL TRAINING
WAS JUST FOCUSED ON

GIVING THESE PATIENTS
PHARMACEUTICALS OR GIVING

THEM EXPENSIVE TESTS
TO TREAT THE CONDITION
AFTER IT OCCURRED.

I HAD NO KNOWLEDGE OF WAYS
TO PREVENT A HEART ATTACK

OR STROKE OR CANCER
OR THINGS LIKE THAT.

I HAD TO DO THE FELLOWSHIP
BECAUSE IT WAS KIND

OF MY LITTLE RAY OF HOPE
THAT THINGS COULD BE BETTER,

THINGS CAN BE DONE DIFFERENTLY

AND SOMEBODY'S GONNA
TEACH ME HOW TO DO THAT,
SO I'M GONNA DO IT.

IN WESTERN MEDICINE,
ALL OF OUR EFFORT IS
ON DISPELLING EVIL.

IF SOMEBODY
HAS AN INFECTION,

WE GIVE
ANTI-INFECTIOUS AGENTS.

IF SOMEBODY
HAS HYPERTENSION,

WE GIVE ANTI-HYPERTENSION
DRUGS.

IT'S GETTING RID
OF THE BAD THING.

WE DO NOTHING ABOUT
SUPPORTING THE GOOD,

THAT THE BODY CAN
AND WANTS TO BE HEALTHY.

BOTH OF THESE APPROACHES
ARE NECESSARY,

BUT IT WOULD BE GREAT

IF WE HAD A BETTER BALANCE
IN WESTERN MEDICINE.

THE KINDS OF INTERVENTIONS
THAT WE HAVE COME TO FAVOR

IN THIS COUNTRY
ARE INHERENTLY COSTLY

BECAUSE THEY'RE DEPENDENT

ON EXPENSIVE TECHNOLOGY
AND THAT INCLUDES
PHARMACEUTICAL DRUGS.

I THINK THERE'S SOME VERY
GOOD DRUGS OUT THERE.

I THING DRUG TREATMENT
HAS ITS PLACE.

I TAKE A PHARMACEUTICAL
DRUG MYSELF,

BUT IF THERE'S ONE THING
THAT I WOULD LOVE TO SEE

YOU BEGIN TO IMPLEMENT
IN YOUR OWN PRACTICE

AND TEACH OTHERS ABOUT,
IT'S TO TRY TO CHANGE
THIS MINDSET

THAT HAS SO
COMPLETELY TAKEN
HOLD IN OUR CULTURE

ON THE PART OF BOTH
DOCTORS AND PATIENTS,

THAT DRUGS ARE
THE ONLY LEGITIMATE WAY
TO TREAT DISEASE.

I MEAN, WHERE DID
THAT IDEA COME FROM?

WE SPEND $300 BILLION A YEAR
ON PHARMACEUTICALS.

THAT'S ALMOST AS MUCH AS THE
REST OF THE WORLD COMBINED.

$300 BILLION ON DRUGS.

IN THE 1950s, AMERICANS
TOOK PHARMACEUTICAL MEDICATION

AT ABOUT 10% OF
THE RATE THAT THEY DO NOW.

WE'RE TAUGHT WITH THE
COMMERCIALS ON TELEVISION,

WHY DO WE NEED TO WAIT? WE CAN
JUST TAKE A PILL RIGHT NOW.

WHEN I WATCH THE NETWORKS,

HALF THE ADS ARE FOR
PHARMACEUTICAL AGENTS.

THAT ISN'T TRUE IN CANADA.

IT'S NOT TRUE
IN THE UNITED KINGDOM,

IT'S NOT TRUE
IN FRANCE AND GERMANY.

THE ONLY OTHER COUNTRY, BY
THE WAY, IS NEW ZEALAND.

NEW ZEALAND AND THE UNITED
STATES ARE THE ONLY

2 COUNTRIES IN THE WORLD
WHERE YOU CAN ADVERTISE
PRESCRIPTION DRUGS.

WHAT DOES THAT DO?
WELL, IT DRIVES DEMAND.

YOU KNOW,
THE ADS ALWAYS END

WITH THE SAME PHRASE--
ASK YOUR DOCTOR.

AND PEOPLE DO.

AND DOCTORS, WANTING TO
PLEASE THEIR PATIENTS,

WILL OFTEN PRESCRIBE IT.

Woman: OVERMEDICATING IS
A HUGE PROBLEM IN SOCIETY

AND THE MILITARY
IS NO EXCEPTION.

THIS IS A NATIONAL
PROBLEM FOR US.

YOU KNOW, WE'RE SEEING THE
MILITARY JUST BEING A MICROCOSM,

I THINK, OF THE PROBLEM
SOCIETY'S HAVING.

Man: SOLDIERS' USE OF
PRESCRIPTION DRUGS

HAS TRIPLED
IN THE PAST 5 YEARS.

Woman: THE ARMY SAYS
THIS IS ALL LINKED

TO THE RISING NUMBER
OF SOLDIER SUICIDES.

IN FACT, MORE SOLDIERS
DIED LAST YEAR

FROM NON-COMBAT INJURIES
THAN DURING WAR.

I CAN SEE WHY THERE'S
A LINK BETWEEN OPIATES,

DEPENDENCY,
MISUSE, AND SUICIDE.

I WAS TAKING
64 PILLS A DAY

OF COMBINATIONS OF
ROXICET AND OXYCONTIN.

THERE'S A CONTRADICTION
TO WHAT WE DO.

YOU AS CAREGIVERS
ARE TOLD,

YOU'VE GOT
TO KEEP ME PAIN FREE.

YOU'RE GONNA DO THAT.

AND WE HAVE TO BE
MINDFUL TO THOSE POINTS

IN TIME WHERE YOU
CAN INTERVENE AND SAY,
ENOUGH'S ENOUGH.

WE HAVE TO FIND THE
RIGHT MIX OF TREATMENTS

FOR THE GUYS AND
THE ANSWERS ARE NOT
IN A STACK OF PILLS.

IF IT HAPPENED TO ME, IT
HAPPENS TO A WHOLE LOT

MORE PEOPLE
THAT ARE ALMOST
INVISIBLE TO THE SYSTEM.

I'VE BEEN SHOT
THIS DEPLOYMENT.

8 I.E.D.'s JUST
THIS DEPLOYMENT.

I CARRY A LOT OF WEIGHT
BECAUSE I'M INFANTRY.

THE MOUNTAINS OF AFGHANISTAN

ARE NOT EASY TO CLIMB,
SO COMPRESSED MY BACK.

I WAS TREATED
FOR SCIATIC NERVE, BACK,

L-2, L-3, L-4, L-5,

SWELLING, LEFT
SIDE OF MY BRAIN,

AND EXTREME P.T.S.D.

WITH 10 YEARS
OF ONGOING WARS,

THE AMOUNT OF SUFFERING
THAT'S GOING ON

IN THE MILITARY RIGHT
NOW IS TREMENDOUS.

WHEN YOU GO OVER
INTO A WAR ZONE,

WHERE YOU SEE
YOUR BUDDIES DIE

OR YOU GET INJURED,

THAT'S GONNA
TAX ANYBODY.

AND WE SEE
THAT SUFFERING.

DURING THE AIR EVACS
OF WOUNDED SOLDIERS,

THE APPROACH TO PAIN
THAT CURRENTLY EXISTS
IS TO GET MEDICATIONS.

DO YOU HAVE
ANY PAIN RIGHT NOW?

OK, I CAN SEE WHAT YOU
CAN HAVE FOR PAIN, ALL RIGHT?

Woman: HE ASKED
FOR PAIN MEDICATION.

THEY DON'T SAY
HOW MUCH THEY GAVE HIM,

BUT HE CAN HAVE ANYWHERE

BETWEEN 5 AND 10
MILLIGRAMS OF MORPHINE.

I JUST WANT TO SEE
WHAT THEY'VE GIVEN HIM.

BECAUSE
HE'S REAL SLEEPY?
YEAH.

IT'S VERY HARD FOR US
AS NURSES TO TREAT FOR PAIN

BECAUSE THERE'S NO THERMOMETER
THAT WE CAN STICK IN

AND SAY, OH, IT'S
7 OUT OF 10 PAIN.

WE HAVE TO BASICALLY TREAT THE
PATIENT FOR WHATEVER THEY SAY.

AND A LOT OF TIMES
PATIENTS BECOME SO DROWSY

THAT THEY'RE NOT AWARE
OF HOW MUCH THEY'RE TAKING.

ARE YOU OK?I'M SO UNCOMFORTABLE.

AND I NEED TO PEE AGAIN.

YOU NEED TO GET UP AND PEE?
ALL RIGHT.

OK, I NEED SOME
HELP OVER HERE.

THE PATIENT JUST FELL
OFF THE LITTER.

WAIT, WHAT?

DID HE TRY TO GET UP
WITHOUT ANYBODY KNOWING?

NO, I TRIED GETTING HIM UP AND
HE JUST ROLLED HIMSELF OUT.

HE'S LIKE REALLY
NOT LISTENING VERY WELL.

YEAH, THAT'S WHY YOU DON'T
WANT HIM TO FALL AGAIN.

PROBABLY PUT HIM ON THE
BOTTOM ON THE OTHER SIDE.

I'M GONNA CHECK
HIS CHART REAL QUICK

AND FIND OUT
WHAT HE GOT AT THE CASF.

LET ME GET THAT
JACKET AWAY FROM HIM.

HE'S LIKE
CLUTCHING HIS MEDS.

HERE YOU GO. THIS IS WHAT HE'S
GOT LEFT OF THE MORPHINE.

HE WAS ISSUED
A BOTTLE TODAY

WITH 20 IN IT
AND 10 ARE MISSING.

HE'S TAKEN 10 TABLETS.

THAT'S WHY.OH, MY GOD.

THAT IS RIDICULOUS.

THAT'S WHY HE'S
A LITTLE HIGH RIGHT NOW.

THAT'S THE POINT.

HE COULD STOP BREATHING
IF HE TOOK TOO MUCH

NARCOTIC AND WE'RE
GONNA BE DOING C.P.R.

ON THE PATIENT,
SO AT THIS POINT,

WE WON'T ADMINISTER
THE MEDICATION.

WE MOVED YOU OVER HERE.

TAKE THEM AWAY FROM HIM.

DO YOU WANT TO DO
A PILL COUNT WITH ME?

WE'LL DO IT UP AT THE FRONT.

OK.

OK, SO, WE HAVE 10 DILAUDID.

OK, THIS IS PRAZOSIN.

HE'S GOT LUNESTA.

AND HE ALSO HAS VALIUM.

RIGHT HERE'S THE LORTAB,
NAPROXEN.

HE HAS PERCOCET AND HE HAS
NORCO, WHICH IS PERCOCET.

I'M NOT SURE WHAT IS WHAT.

UM...

THEY'RE NOT IN THERE?

THESE ARE ALL NAME BRANDS.OH.

THE ONLY THING WE CAN DO
IS SEPARATE THEM OUT

BECAUSE THERE'S
NO WAY FOR US TO TELL
WHICH ARE WHICH.

THESE ARE ALL ONE PERSON'S?

BUT THEY'RE COMBINED, SO WE
DON'T KNOW WHAT THEY ARE.

WHERE ARE YOU
COMING FROM?

AFGHANISTAN.

AFGHANISTAN.
HOW LONG WERE YOU THERE?

9 MONTHS.
9 MONTHS?

WE'RE GLAD TO HAVE YOU HOME.

YOU WANNA TELL ME ABOUT SOME
OF THOSE THAT YOU LOST?

A PLATOON OF 23.

CAME OFF
THE MOUNTAIN WITH 8.

OFF THE MOUNTAIN WITH ONLY 8?

YOU'VE SEEN A LOT.

LIFT, LIFT! LIFT!

[INDISTINCT] GO!

DARK MATTER IS
A DISCOVERY BY ASTRONOMERS

THAT THERE IS A HUGE
AMOUNT OF THE UNIVERSE
THAT WE CAN'T SEE.

IT'S NOT VISIBLE,
BUT IT'S THERE.

WE KNOW IT'S THERE.

AND IN SOME WAYS
I THINK OF A LOT

OF WHAT'S HAPPENING
IN HEALTHCARE IS KIND
OF DARK MATTER.

IT'S UNSEEN,
BUT IT'S THERE,

AND IT'S VERY,
VERY POWERFUL.

WE TEND TO SEE JUST
THE LIGHT OF HEALTHCARE.

WE SEE THE GOODNESS
OF HEALTHCARE,

THE POTENTIAL
FOR HELPING.

WHEN I WAS AT "U.S.
NEWS AND WORLD REPORT,"

I WROTE COVER STORIES
ABOUT HOW GREAT

THE NEWEST
AND GREATEST TREATMENT

AND PILL
AND PROCEDURE WAS.

BUT, IN FACT,
THE MORE I LOOKED,

THE MORE I FOUND THAT
THERE'S ALL THIS STUFF

IN MEDICINE THAT WE
DON'T THINK ABOUT THAT
IS ACTUALLY HARMFUL.

WHEN A TEAM FROM
DARTMOUTH MEDICAL SCHOOL

MAPPED MEDICARE
PAYMENTS, IT FOUND SOME

DISCONCERTING DIFFERENCES
FROM ONE PART

OF THE COUNTRY
TO ANOTHER.

FOR EXAMPLE, IN 2007,

THE AVERAGE MEDICARE
RECIPIENT IN MIAMI

TALLIED MORE THAN $15,000
IN HEALTHCARE BILLS,

WHEREAS A RECIPIENT
IN MINNEAPOLIS ONLY COST

THE GOVERNMENT
ABOUT HALF THAT AMOUNT.

AND IT WASN'T
BECAUSE PROCEDURES

WERE MORE EXPENSIVE IN MIAMI
THAN IN MINNEAPOLIS.

THE DARTMOUTH STUDY
SHOWED THAT PATIENTS

IN PLACES LIKE MIAMI
WERE RECEIVING MORE CARE,

MORE TESTS, MORE DRUGS,

MORE TIME IN THE HOSPITAL,

MORE INVASIVE OPERATIONS,

THAN PATIENTS IN OTHER PARTS
OF THE COUNTRY,

EVEN THOUGH
THE PATIENTS IN MIAMI

WEREN'T ANY SICKER
THAN THEIR NEIGHBORS.

BUT SO WHAT, RIGHT?

WE WANT MORE SPECIALISTS.

WE WANT MORE PROCEDURES.

WE WANT MORE TESTS
OR AT LEAST WE THINK WE DO.

AND THAT'S THE PROBLEM

BECAUSE WHAT WE THINK IS
BEST FOR US OFTEN ISN'T.

WHAT THE DARTMOUTH GROUP
DISCOVERED

IS THAT THE PATIENTS
IN THE MOST COSTLY REGIONS,

WHERE MEDICARE SPENT
MORE MONEY ON PATIENTS,

THOSE PATIENTS DID NOT HAVE
BETTER HEALTH OUTCOMES.

AND, IN FACT, THEY WERE
MORE LIKELY TO DIE.

IF YOU LOOK AT
HEALTHCARE IN AMERICA,

YOU'RE TWICE AS LIKELY
TO GET YOUR KNEE REPLACED

AS YOU ARE
IN WESTERN COUNTRIES

WITH THE SAME
STANDARD OF LIVING.

YOU'RE 2 OR 3 TIMES
AS LIKELY TO GET

A HEART CATHETERIZATION

OR HAVE A STENT
IN YOUR CORONARIES.

WE'VE SET UP A SYSTEM
THAT OFTEN PUSHES

PHYSICIANS AND HOSPITALS

AND THE ENTIRE HEALTHCARE
SYSTEM INTO DOING MORE.

DRIVEN BY THESE PERVERSE
ECONOMIC INCENTIVES,

WE ARE DOING A LOT
OF PROCEDURES TO PEOPLE
THAT THEY DON'T NEED.

TO A MAN WITH A HAMMER,

EVERYTHING
LOOKS LIKE A NAIL.

Woman: OK, READY?

NOW, I'M GOING
TO GET THE SCISSORS.

Girl: YEAH.

I STARTED GETTING
SICK IN MY 30s.

I STARTED HAVING REALLY,
REALLY BAD CHEST PAIN.

THERE WE GO,
A FLOWER FOR YA.

OH, IT'S SO BEAUTIFUL.

I JUST HAD BEEN IGNORING
IT BECAUSE I THOUGHT,

YOU KNOW, I'M
ONLY 34 YEARS OLD,

I CAN'T BE
HAVING HEART PROBLEMS.

BUT ONE EVENING
I SAT STRAIGHT UP IN BED

WITH THE WORST CHEST PAIN.

SO, I WENT INTO THE HOSPITAL

AND THEY TOLD ME
I'D HAD A HEART ATTACK.

I WAS 35 AT THE TIME

AND WAS SCHEDULED
FOR OPEN HEART SURGERY.

AND I THOUGHT,
ONCE I GET THIS,

I WON'T HAVE
THE BLOCKAGES ANYMORE,

YOU KNOW, THEY'LL
ACTUALLY FIX IT.

LITTLE DID I KNOW THAT
IT WAS FOLLOWED BY YEARS

OF THE SAME THING OVER
AND OVER AND OVER AGAIN.

A HEART CATH,
GET ANOTHER STENT.

HEART CATH,
GET ANOTHER STENT.

UNTIL MY DOCTOR SAID TO ME,

I DON'T KNOW WHAT
ELSE TO DO FOR YOU.

THERE'S NOTHING
ELSE I CAN DO.

CONTRARY TO WHAT
MOST PEOPLE BELIEVE,

GETTING A STENT
IN YOUR CORONARY,

IF YOU HAVE
STABLE CHEST PAIN,

WILL LIKELY
RELIEVE YOUR PAIN,

BUT IT WILL NOT HELP
YOU LIVE LONGER

AND IT WILL NOT PROTECT YOU
FROM HAVING A HEART ATTACK.

IT ONLY REDUCES SYMPTOMS.

AND THE PROBLEM IS, IS THAT
SOME OF THOSE PROCEDURES
WILL LEAD TO BAD OUTCOMES.

I HAD STARTED DOING RESEARCH
ABOUT WHERE IN THE UNITED STATES

DO I HAVE TO GO
TO GET THE BEST HEART CARE

AND, IRONICALLY,
IT WAS ONLY 2 HOURS AWAY
AT THE CLEVELAND CLINIC.

HOW ARE YOU?

I AM GREAT.

LOOK AT THE THINNESS.

I KNOW.
YOU LOOK REALLY GOOD.

I HAVE LOST--SINCE LAST YEAR
I HAVE LOST 21 POUNDS.

OH, MY GOD.

YVONNE CAME TO SEE ME
WHEN SHE WAS SORT
OF AT HER WIT'S END.

SHE HAD HAD A BYPASS
SURGERY AT AN EARLY AGE,

27 CARDIAC
CATHETERIZATIONS, AND
WELL OVER 7 STENTS.

DEEP BREATH.

THIS IS JUST
AN UNBELIEVABLE AMOUNT
OF STENTS AND CARDIAC CATHS.

I'M SORRY, IT'S
GONNA GET PRETTY TIGHT.

OH, IT'S ALL RIGHT.

I CAN'T TELL YOU HOW SHOCKED
WE WERE WHEN WE SAW HER

THE FIRST TIME BECAUSE
HERE WAS A YOUNG WOMAN,

WHOSE DIABETES WAS
NOT WELL CONTROLLED.

HER CHOLESTEROL WAS
NEVER WELL CONTROLLED

AND HER HIGH BLOOD PRESSURE
WAS NEVER WELL CONTROLLED.

BREATHE NORMALLY FOR ME.

IF SOMEONE HAD TALKED
TO HER, I THINK SOMEONE

HAD REALLY TEASED OUT
HER CHEST PAIN

AND HER SHORTNESS OF BREATH,

I THINK MANY OF HER
CARDIAC CATHETERIZATIONS

AND STENTS WOULD NOT
HAVE BEEN NECESSARY.

YOU KNOW, YOU
HAVE ALL THESE STENTS

AND, YOU KNOW, THESE
STENTS, ONCE THEY GO IN,

THEY NEVER COME OUT,
AND THEY'RE PART OF YOU.

NOW, WE'RE KIND OF DEALING
WITH THE CONSEQUENCES.

WHEN YOU REWARD PHYSICIANS
FOR DOING PROCEDURES,

INSTEAD OF TALKING
TO PATIENTS,

THAT'S WHAT THEY'RE GONNA
DO IS DO PROCEDURES.

THE VAST MAJORITY OF
DOCTORS IN THIS COUNTRY

ARE PAID BY A FEE
FOR SERVICE SYSTEM.

AND THAT SIMPLY MEANS
THAT THEY GET PAID FOR
EACH OFFICE VISIT.

IF THEY'RE SURGEONS, THEY
GET PAID FOR EACH PROCEDURE.

IF IT'S A RADIOLOGIST,

THEY GET PAID FOR EACH C.T.
SCAN THAT THEY DELIVER.

IF I SPENT
5 MINUTES WITH YOU

AND THEN PUT
IN ONE OF THESE STENTS,

PROBABLY GET PAID $1,500.

FOR ME TO SPEND 45 MINUTES
ON AN ESTABLISHED VISIT

WITH A PATIENT
TO MAKE SURE THEY'RE
DOING THEIR EXERCISE,

MAKE SURE THEIR
DIABETES IS GOING OK,

AND TO TRY TO FIGURE OUT
WHAT THEIR TRUE PROBLEM IS,

PROBABLY GET PAID $15.

IT'S A COMPLETELY
IRRATIONAL SYSTEM.

FEE FOR SERVICE REWARDS
PHYSICIANS FOR DOING MORE.

IT DOESN'T REWARD THEM
FOR DOING A BETTER JOB.

IT DOESN'T REWARD
THEM FOR KEEPING THEIR
PATIENTS HEALTHY.

IT REWARDS THEM FOR
DELIVERING MORE CARE.

I WAS TRYING TO FIGURE OUT
HOW MUCH YVONNE'S CARE

WOULD HAVE
BEEN OVER THE YEARS

AND I THINK IT'S
WELL OVER $1.5 MILLION...

BUT IT'S MORE THAN COST.

IT'S JUST
SO MUCH MORE THAN MONEY.

THE PSYCHOLOGICAL TRAUMA OF
EVERY ONE OF THOSE MULTIPLE
CARDIO CATHETERIZATIONS,

EVERY TIME SHE HAD A CHEST
PAIN, COMING INTO THE E.R.,

AND, UNFORTUNATELY,
THERE ARE LOTS
OF YVONNES OUT THERE.

ALTHOUGH WE'VE MADE PROGRESS
TECHNOLOGICALLY, YOU KNOW,

WE KNOW HOW TO DO
THINGS FOR DISEASES WE
COULDN'T HAVE DONE BEFORE,

WE HAVEN'T REALLY EXPERIENCED
THE SYSTEMIC IMPROVEMENT

THAT WE WANT THE NEW HEALTHCARE
SYSTEM, THAT WE'RE REALLY AFTER.

WE PAY FOR FRAGMENTS OF CARE.

A DOCTOR VISIT,
A HOSPITAL STAY,

A LAB TEST,
AN AMBULANCE TRIP,

SO BECAUSE WE PAY FOR PIECES,

WE HAVE PIECES AND
SO PEOPLE WHO REALLY NEED
A COORDINATED SYSTEM,

THEY DON'T GET THAT.

MEDICINE IS
VERY [INDISTINCT] NOW.

MEDICINE
IS VERY SPECIALIZED.

AND THIS IS REALLY
A BIG PROBLEM

WHEN YOU GO TO THE
HOSPITAL BECAUSE

THERE ARE SO MANY
DIFFERENT PEOPLE

WHO LAY THEIR HANDS ON
YOU AND IF THEY'RE NOT

TALKING TO EACH OTHER,
YOU CAN'T NECESSARILY
GET THE RIGHT DIAGNOSIS.

YOU CAN GET
REPEATED TESTS.

YOU CAN GET THINGS
HAPPENING TO YOU

THAT PUT YOU IN HARMS
WAY BECAUSE NOBODY'S
REALLY KEEPING TRACK

OF YOU AS
AN INDIVIDUAL PATIENT.

A RECENT STUDY FOUND
THAT 187,000 PATIENTS DIE

EACH YEAR FROM HARMFUL
CARE IN THE HOSPITAL,

WHICH INCLUDES
MEDICAL ERRORS AND
DEADLY INFECTIONS.

BASED ON THESE NUMBERS,

THIS WOULD BE THE THIRD
LEADING CAUSE OF DEATH

IN THE UNITED STATES,

JUST AFTER HEART
DISEASE AND CANCER.

HELLO. DR. ROSS.

I AM BACK IN
THE CHEST PAIN CENTER

WITH A PRETTY SICK PATIENT

AND I'M GONNA NEED YOU TO
CALL ATTENDING PHONE, TOO.

THE EMERGENCY
DEPARTMENT IS THE SAFETY
NET OF HEALTHCARE.

WE SEE A LOT OF THE CHRONIC
CONDITIONS THAT EFFECT

MANY AMERICANS THAT
HAVE GONE UNTREATED

FOR SOMETIMES MONTHS,
BUT SOMETIMES YEARS.

AND, OF COURSE,
THE NATURAL END POINT

IS GOING TO BE
IN THE EMERGENCY DEPARTMENT.

LET ME JUST
TAKE A LISTEN TO YOU.

IT WOULD BE SO WONDERFUL IF
THEIR CHRONIC HEALTH CONDITIONS

COULD BE PREVENTED THROUGH
EFFECTIVE PRIMARY CARE.

THERE'S A SAYING
IN HEALTHCARE POLICY

THAT 20% OF THE PATIENTS
ACCOUNT FOR 80% OF THE COSTS

AND THE MAJORITY
OF THOSE COSTS

ARE WHEN THEY ARE
REPEATEDLY HOSPITALIZED.

THEY'RE PATIENTS
WITH HEART FAILURE,

THEY'RE MORBIDLY
OBESE PATIENTS.

THEY ARE OFTEN POOR
PATIENTS, BUT NOT ALWAYS.

ONE OF THE WAYS TO
THINK ABOUT SAVING MONEY

IN HEALTHCARE IS TO FOCUS
OUR ENERGIES ON THAT 20%

OF PATIENTS AND
THINK ABOUT TREATING

THOSE PEOPLE IN A MORE
EFFECTIVE WAY.

I JUST WANT
TO REVIEW THIS PAIN.

IT'S HERE RIGHT IN THE
CENTER OF YOUR CHEST.

OK. AND IS IT
STILL TRAVELING
INTO YOUR NECK?

IT'S TRAVELING DOWN
MY ARM AND MY NECK,

AND MY HEAD AND EARS ARE
BUZZING AND RINGING.

OK. WHAT WAS IT,
MR. LITTON,

THAT FINALLY MADE YOU
SAY, OK, THAT'S IT?

I'M GOING TO THE
EMERGENCY DEPARTMENT.

YOU SEE, I'VE BEEN TO
THE EMERGENCY DEPARTMENT

A FEW TIMES BEFORE
AND THE LAST TIME I WAS
HAVING CHEST PAINS,

NOT LIKE THIS,
THIS IS A LOT WORSE,

THEY SENT ME HOME WITH THEM.

HOW LONG AGO WAS THAT?

THAT WAS A MONTH
AND A HALF AGO.

WHEN I HAD
MY FIRST HEART ATTACK,

DID THE CARDIAC
CATHETERIZATION, YOU KNOW,

PUT THE THING UP THERE AND
THEN PUT A STENT IN MY HEART

BECAUSE I HAD
A CLOGGED ARTERY,

AND THAT WORKED
FOR A WHILE.

I MEAN,
FOR A COUPLE OF WEEKS
I FELT LIKE I WAS OK,

AND THEN ALL
OF A SUDDEN I STARTED
GETTING CHEST PAINS.

SO, HERE I HAM GOING IN
AND OUT OF THE HOSPITAL

TO FIND OUT
WHAT'S GOING ON.

DO YOU HAVE ANY
EATING HABITS

THAT YOU THINK
MIGHT BE--

NO, I EAT THE REGULAR
FOOD AND STUFF.

WHAT'S THE REGULAR FOOD?

EGGS, SAUSAGE, GRITS, BACON.

WELL, WHAT DO YOU THINK
ABOUT YOUR DIET?

A HEALTHY DIET?YEAH.

WHAT DO YOU THINK
ABOUT THAT?

I'D DO IT IF I HAD TO.

IF YOU HAD TO.

WELL, YOU HAVE A STENT
IN YOUR HEART, RIGHT?

YEAH.
ALL RIGHT.

AND YOU'VE HAD HEART
ATTACKS AND YOU'RE HERE
TODAY WITH CHEST PAIN,

WHEN DO YOU THINK IT
WOULD BE GOOD TO TRY IT?

ONCE I FOUND OUT WHAT'S
REALLY WRONG WITH ME.

WE'VE BECOME A CULTURE
WHERE YOU DRIVE UP,

YOU GET WHAT YOU WANT,
YOU GET IT FAST,

YOU GET IT RIGHT AWAY,
AND YOU DRIVE OFF.

AND THAT BEING A CLIENT TO
HEALTHCARE JUST DOESN'T WORK.

MOST DISEASES DON'T
HAPPEN OVER NIGHT.

SOMETIMES THEY'RE RELATED
TO LIFESTYLE HABITS.

SOMETIMES IT'S RELATED
TO WHAT THE INDIVIDUALS
ACTUALLY HAVE ACCESS TO.

I HAVE NO HEALTH INSURANCE.

SOME DAYS I GO
TO THE HOSPITAL

AND THAT'S THE ONLY
HEALTHCARE I EVER GOT.

I NEVER HAD A PERSONAL
DOCTOR, FAMILY DOCTOR,

NOTHING, ALL MY LIFE.

I STOPPED TAKING
MY MEDICINE MONTHS AGO

BECAUSE IT WAS TOO MUCH,
CAN'T AFFORD IT.

IF YOU GO OUT AND BUY
HEART HEALTHY DIET FOOD,

IT'S GONNA COST YOU MORE
MONEY THAN ANYTHING.

HIPPOCRATES SAID, LET
FOOD BE YOUR MEDICINE

AND MEDICINE BE YOUR FOOD,

AND I THINK THAT'S
A GOOD PLACE TO START.

AS A SOCIETY WE HAVE TO MAKE IT
EASIER AND MORE AFFORDABLE

FOR PEOPLE TO MAKE
BETTER LIFESTYLE CHOICES
THAN WORSE ONES.

[DOOR DINGS]

THERE'S THE BRIGHT BLUE SLUSH.

THIS IS RESPONSIBLE
FOR INSULIN RESISTANCE

AND METABOLIC SYNDROME
AND OBESITY

AND THE ARTIFICIAL COLORS
ARE NOT GOOD FOR YOU.

THIS IS A MAJOR REASON
WHY WE SEE KIDS GETTING
FAT IN THIS COUNTRY.

LET'S SEE WHAT WE GOT HERE.

ONE OF THE GREAT CONTRIBUTIONS
IN AMERICA TO WORLD CUISINE,

YOU KNOW, FAKE BREAD.

WE TAKE GRAINS AND WE'VE
TURNED THEM INTO PRODUCTS

LIKE THIS WHICH RAPIDLY
RAISE BLOOD SUGAR,

PROVOKE INSULIN RESPONSES,

CAUSE INSULIN RESISTANCE
AND PROMOTE WEIGHT GAIN

IN GENETICALLY-SUSCEPTIBLE
PEOPLE, WHICH IS MOST OF US.

SOME PEOPLE, THIS IS ALL THEY
EAT IS FOOD OF THIS SORT.

IT'S NOT WHOLE FOOD
AS NATURE PRODUCES IT,

IT'S COMPLETELY CHANGED FOOD
AND, YOU KNOW,

AND OUR GRANDPARENTS DID
NOT EAT STUFF LIKE THIS.

WE HAVE MADE ALL
OF THIS UNHEALTHY FOOD

THE CHEAPEST AND
MOST AVAILABLE FOOD.

PEOPLE EAT WHAT'S CHEAP
AND WHAT'S AVAILABLE.

McDONALD'S PUT SALADS
ON THE MENU,

BUT AS IT TURNS OUT,
THE SALAD IS $6.00,

THE BURGER IS 99 CENTS,

AND IF YOU'RE ON
A FIXED INCOME,

WHAT ARE YOU GONNA DO
FOR YOUR FAMILY?

THESE CALORIES ARE CHEAP
ONLY WHEN YOU BUY THEM,

BUT IF YOU LOOK AT THE
OVERALL COST TO SOCIETY

OF THESE CHEAP CALORIES
THAT ARE SO JUNKY,

THEY'RE REALLY
THE MOST EXPENSIVE.

IT'S SCARY HOW FAST OBESITY
IS SPREADING IN OUR COUNTRY.

OBESITY LEADS TO HEART DISEASE
AND STROKES AND DIABETES.

IF TRENDS CONTINUE
THROUGH 2020,

UP TO 1/5
OF HEALTHCARE SPENDING,

OR ALMOST A TRILLION
DOLLARS ANNUALLY,

WILL BE DEVOTED
TO TREATING

THE CONSEQUENCES
OF OBESITY.

IF YOU WANT TO
UNDERSTAND HOW AMERICANS

ARE GETTING MORE
AND MORE OVERWEIGHT,

IT'S BECAUSE WE HAVEN'T
REALLY RETHOUGHT THINGS

THAT WERE PUT INTO PLACE
A LONG TIME AGO

WHEN NOBODY
REALLY THOUGHT

WHAT THE UNINTENDED
CONSEQUENCES MIGHT BE.

THE DEPARTMENT OF
AGRICULTURE SUBSIDIZES
ALL THE WRONG FOODS.

WE SUBSIDIZE CORN,
WE SUBSIDIZE SUGAR,
WE SUBSIDIZE WHEAT.

WE DON'T
SUBSIDIZE CARROTS.

WE DON'T SUBSIDIZE
CELERY AND WE DON'T
SUBSIDIZE APPLES.

YOU CAN LAY IT AT THE FEET
OF A GUY NAMED RUSTY BUTZ.

HE WAS THE SECRETARY OF
AGRICULTURE DURING THE
NIXON ADMINISTRATION.

HE WAS THE ONE WHO THOUGHT
THAT WE SHOULD SUBSIDIZE

COMMODITIES BECAUSE
IT WOULD ALLOW US TO SELL

THESE COMMODITIES
ON INTERNATIONAL MARKETS

AND WE'VE MADE ONE
HECK OF A LOT OF MONEY.

THE OTHER REASON WE
SUBSIDIZE CERTAIN THINGS

IS BECAUSE THEY HAVE
POWERFUL LOBBIES.

THE MONEY THAT'S
INVOLVED ENDS UP BEING

FUNNELED TOWARDS
CONGRESS AND CONGRESS
DOESN'T WANT TO FIX IT.

THE AMERICAN
HEALTHCARE SYSTEM,

IT'S GENERATING RIVERS
OF MONEY THAT ARE FLOWING

INTO VERY FEW POCKETS,

AND THOSE ARE THE POCKETS
OF THE MANUFACTURERS
OF MEDICAL DEVICES,

THE BIG INSURERS, THE
PHARMACEUTICAL COMPANIES,

AND THE OWNERS
OF THOSE POCKETS

DO NOT WANT ANYTHING
TO FUNDAMENTALLY CHANGE.

I DON'T RECALL
ANYTIME TELLING A LIE,

BUT I KNOW THAT
THERE WERE MANY TIMES

THAT I DIDN'T
DISCLOSE FULL INFORMATION.

I WAS THE COMPANY'S
CHIEF SPOKESMAN.

I WAS HEAD OF CORPORATE
COMMUNICATIONS,

WHICH MEANS I WAS
THE TOP PUBLIC RELATIONS
OFFICER FOR THE COMPANY.

WHEN YOU'RE IN THE INNER CIRCLE
OF A HEALTH INSURANCE COMPANY,

WHAT'S MOST IMPORTANT IS MEETING
WALL STREET'S EXPECTATIONS.

AND THEY HAVE TO, THESE
FOR-PROFIT COMPANIES, BY LAW,

HAVE TO SERVE THE SHAREHOLDERS.

PEOPLE GO IN AND
OUT OF HEALTH PLANS.

THEY MAY BE A MEMBER
OF A HEALTH PLAN FOR A YEAR
AND MAYBE NO LONGER.

YOU DON'T NECESSARILY
MAKE A LOT OF INVESTMENTS

IN PREVENTIVE CARE FOR SOMEONE
WHO'S NOT GOING TO BE A PART

OF YOUR HEALTH PLAN
FOR A LONG PERIOD OF TIME.

IT JUST DOESN'T
WORK OUT FINANCIALLY.

THE ONLY WAY THAT YOU CAN
CONTINUE TO MAKE THE PROFITS

THAT YOU ARE EXPECTED TO MAKE

IS TO CHARGE MORE
FOR THE POLICIES.

INSURANCE COMPANIES
HAVE ALWAYS BEEN ABLE

TO REGULATE
THE RATES THEY CHARGE.

THEY CAN PRETTY MUCH GET AWAY

WITH INCREASING THE RATES
AS MUCH AS THEY WANT TO.

YOU ALMOST FORGET
THAT WHAT YOU'RE DOING IS
PROVIDING HEALTH INSURANCE.

IT'S ALL ABOUT THE NUMBERS AND
HOW MANY MILLIONS OF DOLLARS,

IF NOT BILLIONS OF DOLLARS,
YOU'RE EARNING IN PROFITS.

IN THE SUMMER OF 2007, I READ
ABOUT A HEALTHCARE EXPEDITION

THAT WAS BEING HELD
BY REMOTE AREA MEDICAL

A FEW MILES
FROM WHERE I GREW UP.

I DECIDED OUT OF CURIOSITY
TO GO CHECK THIS OUT.

ALL THESE FOLKS HAVE DRIVEN
FROM 4 AND 500 MILES AWAY

WAITING TO GET CARE THAT'S
BEING PROVIDED TO THEM FREE.

THE FOLKS WHO WERE
THERE WERE NOT TRYING

TO SHIRK
THEIR RESPONSIBILITIES.

THEY COULDN'T GET INSURANCE.

THEY EITHER COULDN'T
AFFORD IT OR MANY OF THEM WORK

FOR SMALL EMPLOYERS
THAT HAD BEEN PURGED BY
BIG INSURANCE COMPANIES.

IT WAS EITHER COME AND GET CARE
THERE OR NOT GET CARE AT ALL

AND EVERY YEAR THEY
HAVE TO TURN PEOPLE AWAY.

IT WAS LIKE SOMETHING THAT
I COULD NEVER HAVE IMAGINED

THAT I'D EVER SEE
IN THIS COUNTRY.

AND I KNEW WHAT
I WAS DOING FOR A LIVING

WAS MAKING IT NECESSARY
FOR THOSE FOLKS

TO STAND IN LINE TO WAIT FOR
CARE IN OLD STALLS AND BARNS.

I, ULTIMATELY, HAD
A CRISIS OF CONSCIENCE

BECAUSE I WAS NOT AT ALL
PROUD OF WHAT I WAS DOING.

I HAD DIFFICULTY
SLEEPING AT NIGHT.

THERE WERE
EVEN TIMES, HONESTLY,

THAT I LOOKED
IN THE MIRROR AND I SAID,
HOW DID YOU GET HERE?

I JUST COULD NOT CONTINUE
DOING WHAT I WAS DOING.

GOOD MORNING.

GOOD MORNING.

OUR FOREFATHERS IN MEDICINE
WERE REALLY ABOUT PATIENTS.

IT WAS ABOUT
A PASSION FOR HEALING.

WHEN MEDICINE
BECAME A BUSINESS,

WE LOST OUR MORAL COMPASS
AND I THINK WE'VE GOTTEN

INTO A GREAT DEAL OF
TROUBLE BECAUSE OF THAT.

SINCE I HAVE TYPE 2 DIABETES,
I TRY TO DO WHAT MY DOCTOR SAYS.

Announcer: MANAGING TYPE 2
DIABETES CAN BE HARD.

ADDING AVANDIA CAN HELP.

THERE WAS A DRUG
ON THE MARKET, AVANDIA.

IT GOT FAST TRACKED
BY THE FDA.

IT GOT APPROVED
VERY QUICKLY.

IT WAS MASSIVELY
MARKETED.

AND BY 2006,
THIS DRUG BECAME
THE LARGEST SELLING

DIABETES DRUG
IN THE WORLD.

WE'RE TALKING ABOUT
A $3 OR 4 BILLION
A YEAR DRUG.

I GOT MY BLOOD SUGAR
UNDER CONTROL.

HE REALLY DID.

CAN ADDING
AVANDIA HELP YOU?

I WAS DOING
A GOOGLE SEARCH AND WHAT
I FOUND WAS A WEBSITE

IN THE UNITED KINGDOM WHERE
THE CLINICAL TRIALS DONE

WITH AVANDIA WERE ACTUALLY
PARTIALLY DISCLOSED.

AND WHAT I SAW, IT ACTUALLY
MADE ME PHYSICALLY ILL.

AS I LOOKED
AT TRIAL AFTER TRIAL,

THERE WERE
MORE HEART ATTACKS
IN THE AVANDIA GROUP.

IT WAS SO CONSISTENT.

YOU DIDN'T HAVE TO BE
STATISTICIAN OR IN THE WORDS

OF MY OLD FRIEND BOB DYLAN,

"YOU DON'T HAVE TO BE
A WEATHER MAN TO KNOW
WHICH WAY THE WIND BLOWS."

THERE WAS OBVIOUSLY
A PROBLEM,

ABOUT A 30%
INCREASE IN THE RISK

OF HEART ATTACK
AND RELATED COMPLICATIONS.

AND THE COMPANY DID NOTHING.

THEY TOLD NO ONE.

THEY DID NOT
TELL PHYSICIANS.

THEY DID NOT TELL
THE FDA AND THEY DID
NOT TELL PATIENTS.

Man:
CLEVELAND CLINIC CARDIOLOGIST
DR. STEVEN NISSEN

DECIDED TO DO HIS OWN REVIEW.

NOW, THE LEADING
CAUSE OF DEATH IN DIABETES
IS HEART DISEASE.

70% OF ALL THE DEATHS
IN DIABETES ARE DUE
TO HEART DISEASE.

HAVING A DIABETES
DRUG THAT INCREASES

THE RISK OF HEART ATTACK
BY NEARLY 1/3

IS A PUBLIC
HEALTH CATASTROPHE.

AND THE COMPANY
DIDN'T TELL ANYBODY.

Woman:
A SENATE INVESTIGATION
ACCUSES THE FOOD

AND DRUG ADMINISTRATION
OF IGNORING RESEARCH.

FINALLY, THE FDA
PUT SEVERE RESTRICTIONS
ON THE DRUG.

Woman: YOU DO HAVE, YOU KNOW,
A LOT OF MONEY AT STAKE HERE.

Second Woman:
GLAXOSMITHKLINE WORKED
VERY HARD TO KEEP

THESE NUMBERS
FROM THE PUBLIC.

Brian Williams:
AN FDA ADVISORY COMMITTEE
STARTING HEARING EVIDENCE

ON WHETHER AVANDIA
IS SO UNSAFE

IT SHOULD BE PULLED OFF
THE MARKET ALTOGETHER.

THERE'S LITIGATION
INVOLVED AND THE COMPANY

SET ASIDE $6 BILLION
TO SETTLE LAWSUITS.

THE DOCUMENTS ARE COMING OUT
IN THESE COURT SUITS.

IT LOOKS WORSE AND WORSE.

THE INDEPENDENT SAFETY
OFFICIALS AT THE FDA

ESTIMATES SOMEWHERE BETWEEN
50 AND 200,000 DEATHS

OR HEART ATTACKS
DUE TO THE DRUG.

WE'RE NOT TALKING ABOUT
A HANDFUL OF PEOPLE HERE.

THIS DRUG WAS THE NUMBER
ONE SELLING DIABETES DRUG
IN THE WORLD IN 2006.

IT'S JUST A TERRIBLE
TRAGEDY FOR PATIENTS.

IT IS VERY HARD
TO GET LEGISLATIVE ACTION
TO IMPROVE THE FDA

AND TO BETTER REGULATE
THE--PARTICULARLY, THE
PHARMACEUTICAL INDUSTRY.

IT IS THE ASSUMPTION
THAT PEOPLE WHO RUN

GOVERNMENT
ARE ELECTED OFFICIALS,

ARE MEMBERS OF CONGRESS,
BUT IT'S NOT TRUE
IN MANY CASES.

THE POWER LIES
WITH CORPORATIONS

AND CORPORATE INTERESTS
AND THE LOBBYISTS THAT THEY BUY.

GOOD MORNING, FOLKS,
HOW ARE YA?

[BELL DINGS]

I WAS ALMOST SURPRISED AS
ANYBODY TO SEE THE REPORTS

THAT I WAS THE
MOST FREQUENT VISITOR

TO THE WHITE HOUSE DURING
THE HEALTH REFORM DEBATE.

IT WAS IMPORTANT
TO KEEP EXPRESSING
THE HOSPITALS' POSITION.

IT'S AN EXPENSIVE
WORLD TO LIVE IN,

IN TERMS OF GETTING
YOUR VOICE HEARD IN D.C.,

BUT THAT'S THE WHOLE
FUNCTION OF ADVOCACY.

HOW POWERFUL
ARE LOBBYISTS IN THE
HEALTHCARE SYSTEM?

[LAUGHING]

INFINITELY.

WHAT GIVES LOBBYISTS POWER
IS THE AMOUNT OF MONEY

THEY HAVE FOR CAMPAIGN
CONTRIBUTIONS.

WE HAVE BEEN
TRYING TO REFORM

THE HEALTHCARE SYSTEM
FOR 100 YEARS.

IT GOES BACK
TO TEDDY ROOSEVELT.

BUT THESE COMPANIES WILL DO
WHATEVER IT TAKES

TO MAKE SURE THERE ARE
NO NEW LAWS OR REGULATIONS

THAT WILL HINDER
THEIR PROFITS.

I WAS A PART
OF EFFORTS GOING BACK

TO THE CLINTON ADMINISTRATION
TO MAKE SURE

THERE WAS NO PATIENT'S
BILL OF RIGHTS PASSED

BECAUSE IT WOULD
HAVE EXPANDED PATIENT'S ABILITY

TO SUE THEIR INSURANCE COMPANY

OR THEIR EMPLOYER
IF THEY HAD BEEN DENIED
NEEDED COVERAGE.

SO, WE CREATED A FRONT
GROUP CALLED THE HEALTH
BENEFITS COALITION.

I'D LIKE TO WELCOME YOU TO
THE FIRST PRESS CONFERENCE

OF THE HEALTH
BENEFITS COALITION.

CORPORATIONS ARE VERY
CAREFUL TO CHOOSE NAMES

FOR THESE ORGANIZATIONS
TO MAKE PEOPLE THINK

THAT THEY REALLY
ARE GRASSROOTS ORGANIZATIONS

AND THEY'RE REALLY
NOTHING OF THE KIND.

PART OF THE WHOLE EFFORT IS TO
GET PEOPLE ULTIMATELY TO VOTE

AGAINST THEIR
OWN SELF-INTEREST.

THE SPIN WAS TO SCARE PEOPLE
INTO THINKING THAT PREMIUMS

WOULD GO UP BECAUSE
MORE PEOPLE WOULD BE FILING

FRIVOLOUS LAWSUITS,
BUT, OF COURSE, THESE PEOPLE

HAD NO IDEA THAT THEY
WERE BEING MADE TO BELIEVE

THIS BY THE
INSURANCE INDUSTRY.

THE PATIENT'S BILL OF RIGHTS
HAD BIPARTISAN SUPPORT,

SENATOR JOHN McCAIN AND SENATOR
TED KENNEDY WERE CO-SPONSORS,

BUT IT WAS SO
OPPOSED BY THE POWERFUL
INSURANCE INDUSTRY,

NO BILL WAS EVER PASSED.

[APPLAUSE]

THE HEALTHCARE REFORM
BILL THAT WAS ENACTED

ACHIEVED 2 OF THE INSURANCE
INDUSTRY'S MAJOR OBJECTIVES.

IT INCLUDES THE MANDATE,
THE REQUIREMENT,

THAT WE ALL HAVE
TO BUY THEIR COVERAGE.

THAT WAS JOB NUMBER
ONE FOR THEM.

JOB NUMBER 2 WAS
TO MAKE SURE THAT THERE
WAS NOT A PUBLIC OPTION.

THEY DIDN'T WANT
TO HAVE A NEW COMPETITOR.

THEY HAD TO LIVE WITH
SOME OF THE NEW CONSUMER
PROTECTIONS IN THE BILL.

IT DOES MAKE IT ILLEGAL
FOR COMPANIES

TO JUST CANCEL
SOMEONE'S POLICY

BECAUSE OF A PRE-EXISTING
CONDITION.

WHAT THE INSURANCE
INDUSTRY'S OBJECTIVE IS,

IS TO TRY TO WEAKEN THOSE
CONSUMER PROTECTIONS OVER TIME

AND TO TRY TO INFLUENCE HOW
THE LAW IS BEING IMPLEMENTED.

BECAUSE OF THE MONEY
THAT'S INVOLVED,

GETTING PEOPLE
TO DO THE RIGHT THING

FOR THE AMERICAN PEOPLE HAS
BECOME EXTREMELY DIFFICULT.

[CROWD CHEERING]

PEOPLE NOW, THEY HIT
THE PITCH WE THROW.

IF WE CHANGE THE PITCH,
THEY'LL HIT THAT ONE, TOO.

BETWEEN
THE HEALTHCARE WE HAVE

AND THE HEALTHCARE
WE COULD HAVE

LIES NOT JUST
A GAP BUT A CHASM.

THAT'S HOW BIG
THE DIFFERENCE IS

BETWEEN WHAT WE COULD BE DOING
AND WHAT WE ARE DOING.

I THINK WE HAVE
TO RECOGNIZE AS A COUNTRY,

WE COULD HAVE A CARE SYSTEM THAT
WE CAN SUSTAIN FOR THE LONG HAUL

AND IT WILL BE FAR
MORE BETTER PERFORMING

THAN WHAT WE HAVE NOW IF WE GET
TOGETHER AND WORK ON IT.

I DON'T BLAME ANYBODY, THEY'RE
JUST DOING WHAT MAKES SENSE,

AND WE HAVE TO CHANGE
WHAT MAKES SENSE.

IF OUR CIVILIAN HEALTHCARE
SYSTEM IS SMOLDERING

AND WE SEE IT'S GONNA CATCH
ON FIRE AND BURN PRETTY SOON

AND IS GONNA
BE UNSUSTAINABLE

BECAUSE OF THE COSTS,
THE MILITARY SYSTEM
IS ALREADY ON FIRE.

IT IS A BURNING PLATFORM
AND THEY SEE THIS.

THE COSTS ARE GOING THROUGH
THE ROOF AND THE ABILITY

TO HELP THESE SERVICE
MEMBERS AND THEIR FAMILIES

RECOVER AND REPAIR AND COME
BACK TO A FUNCTIONAL LIFE

IS GETTING LESS AND LESS.

I WAS IN THE WORST PLACE
IN AFGHANISTAN.

THE KORENGAL, THE WATERPUR,

IT'S THE MOST
INTENSE BATTLEGROUND
THAT YOU CAN EVER BE IN.

I LOST A LOT OF GOOD MEN.

IT STILL BOTHERS ME
TO THIS DAY.

I'M 2 1/2 MONTHS
OUT OF COMBAT.

MY VERY BEST FRIEND FROM
WAR, HE WAS ON NARCOTICS.

HE OVERDOSED,
RESPIRATORY SHUT DOWN.

I LOST HIM...

AND FROM THAT POINT ON,

I REALIZED THAT I DON'T
WANT TO BE ON THIS SIDE.

I DON'T WANT TO GO DOWN
THE SAME PATH.

I CAME TO WALTER REED.

I WAS ON VALIUM
JUST FOR THE ANXIETY.

I WAS ON ANTIDEPRESSANTS.

I WAS ON TRAZODONE,
CLONIDINE.

I WAS SO DEPENDENT
ON MY PAIN MEDICATION.

THIS...

IS THE MEDICATIONS
I WAS ON.

DO YOU UNDERSTAND?

THAT IS HOW MANY
MEDICATIONS I WAS ON.

WHEN YOU'RE INJURED,
THEY FEED YOU, FEED YOU,
FEED YOU ALL THIS STUFF.

IT'S ADDICTIVE.
IT IS SO ADDICTIVE.

I'D RATHER BE SHOT AGAIN

THAN GO THROUGH
WITHDRAWALS OF COMING
OFF THAT MEDICINE.

NO SOLDIER SHOULD HAVE
TO GO THROUGH THIS.

AS WE'VE PUSHED MEDICAL
INNOVATION AND CAPABILITY

TO THE LEADING EDGE
OF THE BATTLEFIELD,

WHERE WE CAN SAVE THEIR LIFE,
WE'VE GOT SOME GUYS THAT HAVE

SOME HORRIFIC INJURIES
AND THEY'RE GETTING NARCOTICS
FOR LONGER PERIOD OF TIME.

THEY CERTAINLY ARE AT RISK
TO DEVELOP DEPENDENCY.

AND THAT'S WHAT
WE'RE TRYING TO AVOID.

THE ARMY SURGEON GENERAL
DIRECTED THAT WE ESTABLISH

THE PAIN MANAGEMENT TASK FORCE

TO TAKE A LOOK AT
ALTERNATIVES TO NARCOTICS.

Dr. Jonas:
THERE'S VERY LARGE,
RANDOMIZED TRIALS

DONE AT MULTIPLE CENTERS

THAT HAVE DEMONSTRATED
THAT ACUPUNCTURE WORKS,

SO WE PUT TOGETHER
A STUDY TO SEE

IF WE CAN ACTUALLY
INSERT THIS SIMPLE
ACUPUNCTURE TECHNIQUE

DURING THE AIR EVACS
OF WOUNDED SOLDIERS
INTO WALTER REED

AND OTHER MEDICAL CENTERS
IN THE UNITED STATES.

THE QUESTION WAS,
CAN WE RELIEVE THEIR PAIN

AND REDUCE THE AMOUNT OF
MEDICATIONS THAT THEY'RE ON,

SO BY THE TIME
THEY GET BACK,

THEY'RE NOT SNOWED UNDER
ON MULTIPLE MEDICATIONS.

GUTEN MORGEN.
WELCOME TO GERMANY.

AND WELCOME HOME.

I KNOW YOU ARE HEADING HOME
AND YOU ARE EXCITED.

WHAT IT FIRST SEEMS
LIKE STRANGE BED FELLOWS--

HEALING-ORIENTED
MIND/BODY PRACTICES

AND SORT OF
THE HARD-CORE MILITARY...

ACTUALLY IS AN OPPORTUNITY

THAT THEY JUMPED AT BECAUSE
OF THE PRAGMATIC NEED

IN NATURE THAT THE WARS HAVE
DRIVEN THEM TO RESPOND TO.

THERE'S A VERY,
VERY SMALL CHANCE

OF YOU HAVING INFECTION OR ANY
OF THOSE KIND OF PROBLEMS.

I AM VERY SKEPTICAL
ABOUT IT,

THIS IDEA THAT PUTTING
SOME LITTLE STICK PINS

IN YOUR EAR
IS GONNA CURE PAIN
ON A 9-HOUR FLIGHT.

IT WEARS ON YOUR LOWER
BACK WEARING, YOU KNOW,

A 40-POUND VEST AND IT'S GOT
TO THE POINT WHERE THE PAIN

IS RADIATING FROM MY BACK

DOWN TO MY HIPS AND THEN
DOWN INTO MY THIGHS.

THAT'S IT.

THAT'S MY DAILY ROUTINE.

THE FIRST ONE'S GOING IN.

HOW'S YOUR PAIN, SIR?

I FEEL LIKE I'M WARMING UP
A LITTLE BIT.

IT'S PRETTY IMPRESSIVE,

ESPECIALLY FOR IT
TO REACT THAT QUICKLY.

WHEN YOU PUT THE ACUPUNCTURE
NEEDLES IN THE EAR,

YOU SEE THE ACTIVITY
DROPS DOWN.

SO, WHAT HAS HAPPENED IS YOU
HAVE REDUCED THE SIGNALS,

OR THE PROCESSING,
OF THE PAIN.

WHEN YOU PROVIDE A SMALL
STIMULUS LIKE THAT,

THE BODY RESPONDS
BY TRYING TO HEAL ITSELF,
TRYING TO REPAIR ITSELF.

IT'LL GO RIGHT THERE.

OK.

GO AHEAD AND BEND DOWN.

THAT'S PRETTY GOOD.

ANY PAIN?

NOT WHEN I'M DOING THAT.

NORMALLY YOU WOULD?

OH, YES.

I HAVEN'T TOUCHED
MY TOES IN MONTHS.

THAT MEANS WE'RE GETTING THE
NEEDLES IN THE RIGHT PLACE.

OK.
I HAVEN'T EVEN GOTTEN
NEAR MY TOES

IN MONTHS, UNLESS
I DO THIS, YOU KNOW?

HOW ARE YOU DOING?

I'M DOING GOOD.

YEAH, ACTUALLY,
I WANT YOU THERE
WHEN I GO INTO SURGERY.

HI. HOW ARE YOU FEELING?

I HAVE PAIN, BUT IT'S MORE OF
AN ANNOYANCE THAN IT IS PAIN.

JUST SORE.

IF YOU DIDN'T HAVE
THE ACUPUNCTURE NEEDLES,

HOW DO YOU THINK YOU
WOULD BE FEELING NOW?

I'D BE CHOMPING NARCOTICS.

OH, YOU WOULD?
OH, YEAH.

OH, SO, YOU HAVEN'T
TAKEN ANYTHING?

NO.
BECAUSE OF THAT?

YEP.
THAT'S GOOD.

15 YEARS AGO WE DID
A CONSENSUS CONFERENCE

AT THE NATIONAL
INSTITUTES OF HEALTH

AND WE ASKED THE
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 POST-
OPERATIVE AND INJURY PAIN.

APPRECIATE IT.

THANK YOU VERY MUCH.

15 YEARS LATER,
YOU CAN'T WALK INTO YOUR
AVERAGE HOSPITAL TODAY

AND GET ACUPUNCTURE
AFTER AN OPERATION.

THE PROBLEM IS NOT
THAT IT DOESN'T WORK.

THE PROBLEM IS THAT
WE HAVEN'T FIGURED OUT

HOW TO GET IT INTO THE
SYSTEM SO THAT WE CAN MAKE

IT WIDELY AVAILABLE
TO THE POPULATION.

Woman: IN THE LAST FEW YEARS
A PROFOUND CHANGE HAS BEGUN
IN AMERICAN MEDICINE.

Man: DR. DEAN ORNISH
HAS STUDIED AND WRITTEN

ABOUT DIET AND HEART
DISEASE FOR DECADES.

IN MEDICAL SCHOOL I WAS LEARNING
HOW TO DO BYPASS SURGERY

WITH MICHAEL DEBAKEY,
THE HEART SURGEON.

WE CUT PEOPLE OPEN, WE BYPASSED
THEIR BLOCKED ARTERIES,

AND HE WOULD TELL THEM THEY
WERE CURED AND THEY'D GO HOME

AND MORE OFTEN THAN NOT,
EAT THE SAME JUNK FOOD,

SMOKE AND NOT MANAGE STRESS,

NOT EXERCISE, AND THEN OFTEN
THEIR BYPASSES WOULD CLOG UP.

SO, WE'D CUT THEM OPEN,

WE'D BYPASS THEIR BYPASS,
SOMETIMES MULTIPLE TIMES.

I SAID THERE'S
GOT TO BE A BETTER WAY.

WE SPEND SO MUCH TIME IN
MEDICINE MOPPING UP THE FLOOR

AROUND THE SINK
THAT'S OVERFLOWING

WITHOUT ALSO TURNING
OFF THE FAUCET.

IF WE JUST LITERALLY OR
FIGURATIVELY BYPASS THE PROBLEM

WITH ANGIOPLASTIES AND STENTS
OR LIFETIMES OF DRUGS

OR OTHER KINDS
OF INTERVENTIONS,

THEN MORE OFTEN THAN NOT, THE
SAME PROBLEM COMES BACK AGAIN.

BUT WHAT WE'RE FINDING IS THAT
IF YOU TURN OFF THE FAUCET,

IF WE TREAT
THE UNDERLYING CAUSES,

WHICH TO A LARGE DEGREE
ARE NOT SO MUCH OUR GENES

BUT OUR LIFESTYLE,
THAT OUR BODIES HAVE
A REMARKABLE CAPACITY

TO BEGIN HEALING THEMSELVES
AND THESE CHRONIC DISEASES

CAN NOT ONLY BE PREVENTED,

BUT EVEN REVERSED
MUCH MORE QUICKLY THAN
WE HAD ONCE REALIZED.

WHEN I WENT
TO MEDICAL SCHOOL,

I STARTED READING
ALL THE MEDICAL LITERATURE

AND REALIZED
THAT IN DOGS AND CATS

AND PIGS AND RABBITS
AND MONKEYS,

YOU COULD CAUSE THEM
TO GET HEART DISEASE

IF YOU PUT THEM ON A BAD DIET
AND "X" DIDN'T LET THEM EXERCISE

AND PUT THEM
UNDER EMOTIONAL STRESS,

BUT YOU COULD REVERSE IT IF
YOU CHANGED THOSE SAME THINGS.

SO, I THOUGHT, WHY SHOULD
PEOPLE BE ANY DIFFERENT?

AND EVERYBODY SAID,
THAT'S A CRAZY IDEA.

THERE'S NO WAY
THAT'S GONNA WORK,

YOU KNOW, WHAT'S
THE MATTER WITH YOU?

I SPENT MORE THAN 30 YEARS
OF DOING THESE STUDIES,

SHOWING THAT HEART DISEASE
COULD BE REVERSED

BY CHANGING WHAT WE EAT,
HOW WE RESPOND TO STRESS,

HOW MUCH WE EXERCISE
AND HOW MUCH LOVE AND SUPPORT
WE HAVE IN OUR LIVES.

IN OUR MODEL THE PHYSICIAN
ACTS AS A QUARTERBACK

AND HE OR SHE ASSEMBLES A TEAM
OF 5 OTHER PEOPLE TO WORK WITH--

A NURSE, A YOGA TEACHER,

AN EXERCISE PHYSIOLOGIST,

A REGISTERED DIETITIAN,
AND A CLINICAL PSYCHOLOGIST.

AND WHEN WE WORK AT THAT LEVEL,

WE FIND THAT PEOPLE ARE
MUCH MORE LIKELY TO MAKE

THESE SUSTAINABLE CHANGES
AND THE PATIENT LEARNS

HOW TO EMPOWER THEMSELVES
AND TO TRANSFORM THEIR LIVES.

25 YEARS AGO I HAD 5
RESTAURANTS IN SAN FRANCISCO.

IT WAS A GREAT LIFE.

I SMOKED 6 CIGARS A DAY,
10 CUPS OF COFFEE,

AND A LOT OF WINE.

IT WAS WONDERFUL.

AND I HAD
A MASSIVE HEART ATTACK.

I WAS IN THE HOSPITAL
FOR 2 WEEKS.

I COULD HARDLY, UH...

JUST ABOUT WALK 3 STEPS
AND I'D HAVE TO STOP AND REST.

I WAS POPPING
20 OR 30 NITRATES A DAY.

BUT THEN DEAN ORNISH
WAS STARTING HIS PROGRAM

TO SEE IF YOU CAN
REVERSE HEART DISEASE

THROUGH A LIFESTYLE CHANGE

AND HE WENT TO MY DOCTOR AND
ASKED IF HE COULD APPROACH ME.

HE TOLD DEAN,
HOW LONG IS THE PROGRAM?

HE SAID IT WAS A YEAR.

AND MY DOCTOR TOLD HIM HE
WOULDN'T RECOMMEND TAKING ME

BECAUSE HE DIDN'T THINK
I WOULD LIVE THE YEAR.

SO, HE FIGURED I WAS GONNA DIE
'CAUSE I WAS IN SUCH BAD SHAPE.

AND NOW 25 YEARS LATER,
AND I'M IN PRETTY GOOD SHAPE.

HA HA HA HA.

WE FOUND THAT AFTER A YEAR,

THE MEN WHO MADE THESE
INTENSIVE LIFESTYLE CHANGES,

THEIR PHYSICAL
HEART DISEASE IMPROVED.

IT CAUSED THEIR BLOCKAGES

TO BECOME LESS BLOCKED
IN THEIR ARTERIES.

AND THAT WAS THE FIRST
STUDY SHOWN THAT HEART
DISEASE WAS REVERSIBLE,

BUT WHEN
YOU'RE DOING SOMETHING

THAT HAS NEVER
BEEN DONE BEFORE,

IT'S NOT UNIVERSALLY ACCEPTED,
TO SAY THE LEAST.

IT WAS, YOU KNOW,
THERE WAS A HUGE AMOUNT
OF SKEPTICISM AND RESISTANCE.

PEOPLE WOULD SAY, OH,
BUT YOU'RE DOING THIS RADICAL
INTERVENTION, YOU KNOW.

I SAY, RADICAL?
YEAH, LIKE COMPARED TO
HAVING YOUR CHEST CUT OPEN?

I MEAN, GIVE ME A BREAK.

WE NEED TO EMPOWER PEOPLE
TO CHANGE THEIR LIFESTYLE.

AND IF WE CAN MAKE
IT REIMBURSABLE,

THAT REALLY BRINGS IT
INTO THE MAINSTREAM.

NOW, AS YOU KNOW, HEART
AND BLOOD VESSEL DISEASES

KILL MORE AMERICANS
THAN VIRTUALLY EVERYTHING
ELSE COMBINED

AND IT'S TREATED WITH THINGS
LIKE ANGIOPLASTIES AND STENTS

AND BYPASS SURGERY AND YET, WHAT
DOES THE EVIDENCE REALLY SHOW?

UNLESS YOU'RE IN THE MIDDLE
OF HAVING A HEART ATTACK,

WHICH 95% OF PEOPLE
WHO GET THEM ARE NOT,

THEY DON'T PROLONG YOUR LIFE,

THEY DON'T EVEN
PREVENT HEART ATTACKS.

WE HAVE A MODEL THAT WORKS

SIMPLY BY MAKING CHANGES
IN DIET AND LIFESTYLES.

AND IN OUR STUDIES
FOR THE LAST 33 YEARS,

WE'VE USED VERY
HIGH TECH, EXPENSIVE,

STATE-OF-THE-ART MEASURES
TO PROVE HOW POWERFUL

THESE VERY SIMPLE
AND LOW TECH AND LOW COST
INTERVENTIONS CAN BE.

NOW, TO A NEW STUDY
THAT SHOWS DIET

MAY BE A KEY TOOL IN
THE FIGHT AGAINST CANCER.

THE STUDY WAS CONDUCTED
BY DR. DEAN ORNISH,

WHO LOOKED AT PATIENTS WITH
EARLY STAGE PROSTATE CANCER.

MORE THAN HALF OF MEN OVER
THE AGE OF 50, GET A P.S.A.

TEST EVERY YEAR
TO TRY TO DETECT
PROSTATE CANCER EARLY.

IT TURNS OUT LOTS AND
LOTS OF MEN WHO HAD A CANCER

THAT DIDN'T NEED
TO BE TREATED, BUT
THEY GOT TREATED ANYWAY

AND IT WAS CAUSING
A LOT OF HARM.

THERE'S
VERY LITTLE EVIDENCE

THAT THESE CONVENTIONAL
TREATMENTS MAKE YOU LIVE LONGER,

BUT THEY CAUSE MANY MEN TO BE
IMPOTENT OR INCONTINENT OR BOTH,

AND SO THERE'S A SUBSET
OF MEN WHO HAVE DIAGNOSED,

BIOPSY-PROVEN PROSTATE CANCER,

WHO ELECT NOT TO GET
TREATED CONVENTIONALLY.

MY PATH CROSSED WITH DEAN'S
BECAUSE WE BOTH WANTED HIM

TO TRY AND BRING RIGOROUS
CLINICAL TRIAL TESTING

TO THIS HYPOTHESIS
THAT LIFESTYLE INTERVENTION

COULD HAVE AN IMPORTANT
IMPACT IN MEN WITH EARLY
STAGE PROSTATE CANCER.

HOW ARE YOU?

STEVEN. NICE TO SEE YOU.

I'M ONE OF THE BUSIEST
SURGEONS IN THE COUNTRY.

HOWEVER,
I DON'T BELIEVE EVERY MAN

WITH PROSTATE CANCER
NEEDS IMMEDIATE TREATMENTS.

SO, I SIMPLY FOLLOW THEM
VERY CAREFULLY

AND YOU TREAT THEM AT THE
FIRST SIGN OF PROGRESSION.

IF YOU CAN DELAY TREATMENT,
THEN THAT MAN IS NOT AT RISK

FOR SIDE EFFECTS
DURING THAT PERIOD OF TIME.

HEY, LIZ.

COME ON IN.

DR. PETER CARROLL
AND I COLLABORATED WITH
DR. ELIZABETH BLACKBURN,

WHO WON
THE NOBEL PRIZE IN MEDICINE

AND SHE HAD DONE
A STUDY SHOWING

THAT STRESS CREATES
SHORTER TELOMERES.

SO, AS YOUR
TELOMERES GET SHORTER,
YOUR LIFE GETS SHORTER.

TELOMERES ARE THE ENDS
OF CHROMOSOMES

AND CHROMOSOMES
HAVE ALL OUR GENETIC
INFORMATION ON THEM.

WHEN TELOMERES
WEAR DOWN AND GET FRAYED,

THE GENETIC MATERIAL
WOULD GET MESSED UP.

THAT PREVENTS TISSUES
FROM RENEWING THEMSELVES

IN THE BODY AND
DISEASES TAKE HOLD.

I THOUGHT MOST THINGS
IN BIOLOGY GO BOTH WAYS,

SO IF BAD THINGS MAKE
YOUR TELOMERES SHORTER,

MAYBE GOOD THINGS
WILL MAKE THEM LONGER.

SO, WE TOOK THE MEN WITH
PROSTATE CANCER TO SEE

IF LIFESTYLE CHANGES
CAN AFFECT GENE EXPRESSION
AND EVEN TELOMERES.

Robin Roberts: THE RESEARCH
FOUND THAT EMBRACING

A LOW-FAT VEGETARIAN DIET,

EXERCISING
HALF AN HOUR A DAY,

AND TAKING PART IN DAILY
STRESS REDUCING ACTIVITIES

CAN ACTUALLY CHANGE
THE REGULATION OF GENES

THAT ARE KEY PLAYERS
IN CANCER DEVELOPMENT

AND CONTRIBUTE TO BETTER
OVERALL SURVIVAL.

WE FOUND THAT THE MEN
WHO UNDERWENT

LIFESTYLE INTERVENTION,
THEIR P.S.A. RATES

GENERALLY WENT DOWN AND
THEY WERE LESS LIKELY
TO REQUIRE TREATMENT.

THE PROGRAM INCREASED
THE TELOMERE LENGTH.

WE EVEN FOUND THAT WHEN
YOU CHANGE YOUR LIFESTYLE,

OVER 500 GENES
WERE CHANGED, AND IN FACT,

TURNING ON THE GENES
THAT PREVENT DISEASE,

TURNING OFF THE GENES
THAT PROMOTE BREAST CANCER,

PROSTATE CANCER,
AND COLON CANCER.

AND EVEN DRUGS, EVEN PHARMA,
HASN'T BEEN SHOWN TO DO THAT.

THIS PUTS
A LANGUAGE OF NUMBERS

AND MOLECULAR REDOX,
THROUGH DEAN ORNISH AND
THOSE INTERVENTIONS,

THAT MANY IN THE MEDICAL
FIELD, I THINK, FEEL
MORE COMFORTABLE WITH.

THESE LIFESTYLE CHANGES
CAN NOT ONLY WORK AS WELL
AS DRUGS AND SURGERY,

BUT OFTEN EVEN BETTER
AT A FRACTION OF THE COST

AND THE ONLY SIDE
EFFECTS ARE GOOD ONES.

ALMOST ONE YEAR
INTO THE FELLOWSHIP,

I JOINED THIS NEW PRACTICE.

HELLO. HOW ARE YOU?

THEY PROMISED ME THAT
I COULD MAKE THE PRACTICE

WHATEVER I WANTED IT TO BE

AND IF I DON'T WANNA
SEE 6 PATIENTS AN HOUR,

I DON'T HAVE TO SEE
6 PATIENTS AN HOUR.

WE'RE THE ONLY CLINIC
IN SKAMANIA COUNTY,

SO IT'S ABOUT 20,000
PEOPLE, OVERALL,

THAT WE'RE THE
ONLY PROVIDERS FOR.

[SPEAKING IN SPANISH]

WE'RE PART OF THE COMMUNITY.

ALL OF US LIVE HERE
AND WORK HERE.

HOW ARE YOU TODAY?

PRETTY GOOD, HOW ARE YOU?GOOD.

THERE'S BEEN
A LOT OF CHANGE IN ME

IN THAT
TRANSITION BETWEEN
LA CLINICA AND HERE.

I CAN ACT MORE
AS A GUIDE FOR PATIENTS,

TAKING THE TIME TO
EDUCATE THEM AND HAVING
THEM UNDERSTAND

THAT THERE ARE CHOICES
THAT THEY HAVE THE POWER
TO MAKE FOR THEMSELVES.

IF YOU HAVE THAT DESIRE
TO QUIT SMOKING, WE'LL
GET THERE EVENTUALLY.

YEAH.
OK?

WE JUST HAVE TO KEEP
WORKING TOWARDS THAT.

AND INTERESTINGLY, PATIENTS
REALLY RESPOND TO THAT.

DID YOU GO TO
THE DIABETES EDUCATION?

YES.

HOW DID THAT--WHAT
DID YOU THINK ABOUT THAT?

IT WAS OK. IT KIND OF GAVE ME
A MORE IDEA OF WHAT TO EAT.

OK. OK.
YOU LOST 5 POUNDS.

MM-HMM.
I QUIT DRINKING, TOO, SO...

HOW MUCH WERE YOU
DRINKING BEFORE?

6 AND OVER.
A DAY?

A DAY, FOR 25 YEARS, SO...

WOW. WHAT MADE YOU
DECIDE TO DO THAT?

WELL, THAT HAD TO BE SOMETHING
TO DO WITH MY DIABETES.

MM-HMM. I'M REALLY,
REALLY PLEASED.

YOU JUST LOOK DIFFERENT.

SO, THAT'S
REWARDING FOR ME.

I FEEL DIFFERENT.

[CHUCKLES]

I HAD TO DO SOMETHING.MM-HMM.

I GUESS I NEED TO COME
BACK IN A MONTH OR SO.

COME BACK IN ONE MONTH.

ALMOST EVERY STUDY
SAYS THAT THE DOCTOR

THAT HAS THE GREATEST
IMPACT ON YOUR HEALTH,

IN GENERAL,
THE GREATEST IMPACT

ON THE HEALTH
OF A POPULATION

IS PRIMARY CARE
DOCTORS. WE NEED
PRIMARY CARE DOCTORS.

YEAH, YOUR THYROID
IS A LITTLE BIT BIG. AH.

WHAT'S HAPPENED
TODAY IS WE FOUND
OURSELVES IN A POSITION

WHERE WE DON'T
HAVE ENOUGH PRIMARY
CARE CLINICIANS

TO PROVIDE THAT IMPORTANT
FUNDAMENTAL LEVEL OF CARE.

WHEN WAS YOUR LAST MAMMOGRAM
AND PAP SMEAR?

HAVE YOU...

UH, 2008.

WHY? WE HAVE UNDERPAID
ON A CHRONIC BASIS,

UNDER REWARDED
PRIMARY CARE.

SOME WOULD SAY
OVER REWARDED SPECIALTY
AND SUB-SPECIALTIES.

OK, SO, FIRST TOPIC--
MEDICAID REIMBURSEMENT.

ABOUT 3 WEEKS AGO BECAUSE
OF THE STATE BUDGET CRISIS,

WE GOT TOLD WITH
VERY LITTLE NOTICE

THAT MEDICARE AND
MEDICAID REIMBURSEMENT

WAS GONNA BE CUT
BY ABOUT 25%.

SO, TO MAKE UP
THAT DIFFERENCE

IN THE REIMBURSEMENT
RATES DECREASING,

WE'RE CHANGING
TO SHORTER APPOINTMENTS
NEXT WEEK,

WE'RE ON TRACK
FOR THAT ON TUESDAY.

SO, RIGHT NOW THE ONLY WAY
WE HAVE TO MAKE UP

THE DIFFERENCE IS BASICALLY
TO SEE MORE PEOPLE?

RIGHT.

[SIGHS]

THAT'S A LITTLE--IT
MIGHT BE A LITTLE BIT

OF A CULTURE SHIFT, TOO,
FOR THE PATIENTS.

AND IF THEY HAVE
A RELATIONSHIP WITH YOU,

FEELING TRUNCATED, THAT'S
GOING TO BE A LITTLE BIT

OF A CHANGE AND
A LITTLE UNFORTUNATE.

IT'S A FINANCIAL
NECESSITY.

THAT'S THE ONLY
REASON WE'RE MAKING
THE CHANGE, RIGHT?

I MEAN...

BUT YOU HAVE TO HAVE THE TIME
TO EDUCATE YOUR PATIENTS

AND THEY DON'T REIMBURSE
FOR NUTRITIONAL COUNSELING

OR ANYTHING LIKE THAT,

BUT WE'RE GONNA TALK TO
THEM ABOUT STILL, YOU KNOW.

WE ALL KNOW THERE'S
THINGS WE CAN DO

AND THOSE THINGS
MAKE US ALL FEEL GOOD

AND WE LIKE TO DO THEM,

BUT WE'RE GONNA
FEEL REALLY BAD

IF OUR DOORS CLOSE
AND THEN WE'RE NOT
GONNA HAVE ANYBODY.

CONVENTIONAL WISDOM
IS OVER THE NEXT 2 YEARS

WE WILL LIKELY GO
OUT OF BUSINESS.

WE'RE FIGHTING EVERYTHING
FOR THAT NOT TO HAPPEN,

BUT IT'S BECAUSE THERE
ISN'T THE FUNDING GOING

IN TO PRIMARY CARE, IT GOES
INTO THE OTHER AREAS

AND IT'S JUST
NOT SUSTAINABLE.

DR. MARTIN HAS
A LOT MORE TIME
WITH PATIENTS RIGHT NOW

BECAUSE SHE'S REALLY
RAMPING UP HER SCHEDULE,

BUT SHE'S
NOT COVERING HER COSTS,

SO THE REST OF THE
PHYSICIANS ARE COVERING
HER COSTS RIGHT NOW.

BECAUSE WE'RE
A PHYSICIAN-OWNED AND
A PHYSICIAN RUN PRACTICE,

SHE'S IN CHARGE
OF HER OWN SCHEDULE,

BUT IF
THAT REIMBURSEMENT
LEVEL IS SMALLER

AND SMALLER, SHE'S GONNA
HAVE A LOT LESS TIME

TO SPEND WITH PATIENTS,
SO THAT WE CAN AT LEAST

COVER OUR COSTS
AND STAY IN BUSINESS.

BECAUSE OF THE BOTTOM LINE,

BECAUSE OF THE CUTS
THAT ARE COMING THROUGH
THE GOVERNMENT,

IF IT CAME TO THE POINT
WHERE THEY COULDN'T PAY ME

ANYMORE, THAT WOULD SUCK,
BUT I'M NOT AFRAID

BECAUSE I'VE GOTTEN
A LOT OF INSPIRATION
FROM THE FELLOWSHIP,

A DIFFERENT PERSPECTIVE
THAT THERE'S A DIFFERENT WAY

OF DOING THINGS
THAT IS POSSIBLE.

DID YOU HAVE A GOOD DAY TODAY?

UH...YES.

YEAH?

I WOULD PROBABLY LEAVE
HEALTHCARE BEFORE I WENT

BACK TO PRACTICING
THE WAY I PRACTICED
LAST YEAR.

I CHOSE TO GET
OFF ALL NARCOTICS,

ALL MEDICINE,
EVERYTHING.

SO, JUST TAKE A COUPLE OF
MINUTES TO KIND OF ARRIVE.

ALL RIGHT, SO TAKE A BREATH.

[INHALING]

I'M A REDNECK,
SOUTH LOUISIANA BOY,

JUST AN OLD
HILLBILLY, YOU KNOW.

I DON'T BELIEVE
IN THAT STUFF, YOU KNOW,
IN EASTERN MEDICINE.

ANYBODY ELSE WOULD
LAUGH, YOU KNOW, BE LIKE
WHAT IS THAT FOR?

HOLD MY BEER WHILE
I SHOOT THIS GATOR,

YOU KNOW? BUT I DECIDED
TO GIVE IT A SHOT.

SO, WE GOING
TO OPEN UP SOME CHI?

WE GONNA OPEN UP SOME CHI.

THAT'S A GOOD WAY
TO THINK OF IT.

OH, WOW. [CHUCKLES] THAT'S
THE WAY I LIKE TO LOOK AT IT.

BECAUSE OF THIS PROGRAM
THAT'S HERE, THERE'S YOGA...

I'M JUST GOING
TO GO AHEAD AND PUT
THE LAST ONE IN...

I MEDITATE AND IT
HAS OPENED UP A WHOLE
NEW WORLD FOR ME.

I'M GOING TO LEAVE THESE IN
FOR ABOUT 5, 7 MINUTES,

SOMETHING LIKE THAT, OK?

ROGER THAT.

IT'S WONDERFUL.

[GUNFIRE]

Man: A NEW STUDY FINDS A GROWING
NUMBER OF COMBAT VETERANS

ARE BATTLING MENTAL ILLNESS,
BUT MANY ARE FINDING IT

DIFFICULT TO GET
THE HELP THEY NEED.

POST TRAUMATIC STRESS DISORDER,
OR P.T.S.D.,

IT'S AN INDIVIDUAL'S
REACTION TO THE EXPOSURES
AND EXPERIENCES OF WAR.

WAR IS HELL.
IT'S ALWAYS HELL.

SO, YOU PICK YOUR SPOT.

SOLDIERS KNOW
IF THEY GO TO WAR AND
IF THEY GET A LEG BLOWN OFF,

THAT YOUR MEDICS GOING
TO TAKE CARE OF YOU

AND THE SAME THING
NEEDS TO APPLY THAT IF YOU HAVE
POST TRAUMATIC STRESS,

INVISIBLE AS IT IS,
IT'S JUST AS SIGNIFICANT

AS A BULLET WOUND
TO THE HEAD OR CHEST.

THE FIRST THING I'D
LIKE TO DO IS TEACH YOU

A BREATHING EXERCISE
WITH A TARGETED EFFECT

ON POST TRAUMATIC STRESS.

ALL RIGHT, SO, INHALE.
[INHALING]

EXHALE. [EXHALING]

CATCHING IT VERY, VERY
EARLY AFTER THEIR EXPOSURE

AND ALLOWING
THEM TO PROCESS THAT

IS SO CRITICAL
IN THE LONG-TERM RECOVERY.

RELEASE
THE BREATH IN A SMOOTH,
EVEN STREAM OUT.

OK, SO, LET'S GO INTO
OUR MEDITATION PRACTICE.

MEDITATION
IS SCARY SOMETIMES.

SOMETIMES WHEN YOU GO,

YOU GO TO BAD PLACES
IN YOUR HEAD.

I WILL BE AT YOUR SIDE,
SHOULD ANYTHING CHALLENGING
COME UP FOR YOU.

THAT'S A HEALING
PROCESS BECAUSE YOU'RE
NOT BOTTLING UP.

IT'S GOING TO A
DIFFERENT SECTION

IN YOUR MIND
TO WHERE YOU CAN
START PROCESSING IT.

SO, FEEL YOURSELF THERE
IN YOUR SAFE PLACE.

AND REMEMBER THAT YOU CAN
RETURN TO THIS PLACE

AT ANYTIME DURING
THE MEDITATION.

LET GO OF THINKING.

DROP BACK IN AWARENESS
AND NOTICE HOW A THOUGHT
MAY SHOW UP,

SEEMINGLY OUT OF NOWHERE,

OR AN IMAGE MAY SHOW UP
AND THEN DISAPPEAR.

AND FEEL YOURSELF OBSERVING
ALL THESE CONSTANTLY

CHANGING SENSATIONS
AND THOUGHTS AND FEELINGS.

RECOGNIZE THAT YOU
ARE THIS SPACIOUS,

WELCOMING, OPEN AWARENESS.

NO MATTER WHAT THOUGHT,
NO MATTER WHAT FEELING,

NO MATTER WHAT SENSATION OR
CIRCUMSTANCE HAPPENS TO ARISE.

[SHUDDERING]

YOUR ARMS HEAVY,
YOUR LEGS HEAVY.

YOU'RE GOOD. YOU'RE GOOD.

I KNOW, I KNOW.

THAT'S SOME SWEAT.

YOU DONE SOME SWEATING.

I WAS ON PRAZOSIN
JUST FOR NIGHTMARES.

MEDITATION, IT TAKES
THE PLACE OF THAT.

NOTICE WHERE YOU ARE IN
THE ROOM, THE PEOPLE AROUND.

THE PAIN...IT'S HARD,
YOU KNOW, IT'S REALLY HARD.

YOU GOT TO PUSH THROUGH IT.

BUT THIS PROGRAM
HAS JUST INSPIRED ME
TO PRESS FORWARD.

THE MEDICATION
DEPRESSES YOU.

IT MAKES YOU THINK THAT...

IS ALL YOU'RE
EVER GONNA BE IN.

WE'LL END THE PRACTICE TODAY
WITH THE COMPLETING STATEMENTS.

MAY EVERYONE BE WELL...

MAY EVERYONE BE HEALTHY...

MAY EVERYONE BE HAPPY.

MAY EVERYONE BE HAPPY.

IF THE MILITARY
IS ABLE TO SUCCESSFULLY
INTEGRATE ACUPUNCTURE,

MEDITATION AND
MIND BODY, YOGA,

THEN WE'LL FIND
THAT THE CULTURE
AT LARGE WILL LEARN

HOW TO ADOPT IT
AND IT WILL HAVE

A TRANSFORMATIVE EFFECT
ON OUR HEALTHCARE SYSTEM.

READY?

YES, MA'AM.

THE LIMITATIONS
OF HIGH TECH MEDICINE
HAVE NEVER BEEN CLEARER,

AT THE SAME TIME
THAT THE POWER OF THESE
SIMPLE LOW TECH,

LOW COST INTERVENTIONS
IS ALSO BECOMING CLEARER.

WE COULD DO
A THOUSAND STUDIES
WITH A MILLION PATIENTS.

IT WOULD ALWAYS
REMAIN ON THE FRINGES.

IT'S ALL ABOUT
THE BENJAMIN'S, AS
THE RAPPERS WOULD SAY.

IT'S ALL ABOUT
THE REIMBURSEMENT.

IF WE CAN CHANGE
REIMBURSEMENT,
IT'S A GAME CHANGER.

WE CHANGE
MEDICAL PRACTICE

AND WE CHANG
MEDICAL EDUCATION.

TRYING TO GET
MEDICARE TO COVER THE
HEART DISEASE PROGRAM

HAS BEEN BY FAR
THE HARDEST THING I'VE EVER
DONE IN MY ENTIRE LIFE.

MOST INSURANCE COMPANIES
WILL FOLLOW MEDICARE'S LEAD,

SO I REALIZE THAT MEDICARE'S
THE ROSETTA STONE.

IF WE GET MEDICARE
TO COVER IT,

THEN EVERYONE ELSE
WILL COVER IT AND IF
EVERYONE COVERS IT,

THEN IT BECOMES
THE STANDARD OF CARE.

I WANTED TO BRING YOU
UP TO DATE ON OUR PROGRESS.

WE'VE BEEN MAKING A LOT.

MEDICARE FINALLY IS
GOING TO COVER OUR REVERSING
HEART DISEASE PROGRAM.

THAT WAS 16 YEARS
IN THE MAKING, AS YOU KNOW.

IT'S NOT LIKE THERE'S
ONE LIFESTYLE PROGRAM

FOR HEART DISEASE AND
ANOTHER ONE FOR DIABETES

AND ANOTHER ONE FOR CHANGING
YOUR GENE EXPRESSION,

ANOTHER ONE FOR PROSTATE
CANCER, IT'S ESSENTIALLY
THE SAME PROGRAM.

IT'S JUST A QUESTION
OF THE DEGREE THAT PEOPLE

ARE WILLING TO MAKE
THESE CHANGES.

THAT'S THE
KEY POINT, DEAN.

PEOPLE, SO TO SPEAK,
HAVE A CONSTITUTIONAL
RIGHT TO BE FOOLISH.

HA HA HA.WE HAVE TO RESPECT THAT.

BUT IF WE'RE REALLY TALKING
ABOUT TRUE FREEDOM OF CHOICE,

THEY ALREADY PAY
FOR THE DRUGS AND SURGERY,

WHAT WE ALSO WANT THEM
TO PAY FOR ARE

FOR THOSE PEOPLE
WHO ARE MOTIVATED AND
WHO WANT TO CHANGE,

TO GIVE THEM THE SUPPORT
THAT THEY NEED IN ORDER
TO BE ABLE TO DO THAT.

THAT'S PROBABLY TOO LOGICAL
FOR THE FEDERAL GOVERNMENT

TO PICK UP ON IMMEDIATELY,
BUT WE DIDN'T GET INTO THIS

SITUATION WITH
SO MANY AMERICANS OBESE,

WITH THIS LEVEL OF JUVENILE
DIABETES, BY ACCIDENT.

WE GOT INTO
BECAUSE THERE WERE
A WHOLE HOST OF POLICIES

THAT LED US DOWN THIS
PATH TO SICK CARE,

RATHER THAN THE FOCUS ON
PREVENTION AND WELLNESS.

NOW, THAT MEDICARE'S GONNA COVER
THE HEART DISEASE PROGRAM,

THE NEXT STEP
WILL BE TYPE 2 DIABETES.

HALF OF AMERICANS
WILL BE DIABETIC

OR PRE-DIABETIC IN
THE NEXT 10 YEARS. HALF.

IF WE CAN PREVENT THAT
AND EVEN REVERSE IT,

THAT'S HOW WE'RE GONNA
MAKE TRUE HEALTHCARE,

NOT JUST SICK CARE AVAILABLE,

AT A TIME WHEN THE MEDICAL
SYSTEM IS SO BADLY BROKEN.

Woman:
ONE COMPANY HAS FIGURED OUT

HOW TO LOWER HEALTHCARE COSTS
BY MORE THAN 40%.

IT'S AN IDEA THAT'S RECEIVED
NATIONAL ATTENTION.

FOLLOWING THE EXAMPLE
OF PLACES LIKE SAFEWAY.

Charlie Gibson: THE SAFEWAY
SUPERMARKET CHAIN LOOKED

FOR A WAY TO REIGN
IN SPIRALING PREMIUMS

AND HIT ON WHAT SEEMS
TO BE A WIN-WIN SOLUTION.

IN 2005, WE HAD A BILLION
DOLLAR HEALTHCARE BILL,

RISING AT THE RATE
OF $100 MILLION A YEAR.

THESE ARE THE COSTS OF ALL
OF OUR DRUGS IN ORDER,

SO DIABETICS ARE
ONE THE NUMBER ONE COST
OF PRESCRIPTIONS.

YOU CAN SEE HOW MANY SCRIPTS
AND THE AVERAGE SCRIPT.

WHAT WE DISCOVERED WAS THAT
70% OF HEALTHCARE COSTS

ARE DRIVEN
BY PEOPLE'S BEHAVIORS.

AT MY HEAVIEST,
I WAS OVER 200 POUNDS.

I'D HAVE MY PIZZA,
I'D HAVE MY COMICS,

I'D HAVE MY D.V.D.s
AND THAT WAS THE WEEKEND.

YOU REALIZE ONE DAY, WOW,
YOU KNOW, I HAVEN'T WORKED OUT,

I HAVEN'T EXERCISED AND,
YOU KNOW, YOU KIND OF GET BUSY

AND IT'S JUST
THE LAST THING THAT YOU'RE
REALLY CONCERNED ABOUT.

I WAS CHRONICALLY
COMING DOWN WITH COLDS

AND I KNEW THAT THERE
WAS A HISTORY OF CANCER

IN MY FAMILY AND DIABETES,
HEART DISEASE.

I WAS A WALKING DEAD MAN.

NOW, AS A BUSINESS GUY,
I THOUGHT IF WE COULD
INFLUENCE BEHAVIOR

OF OUR 200,000
PERSON WORKFORCE,

WE COULD HAVE A MATERIAL
EFFECT ON HEALTHCARE COSTS.

THE EASIEST STARTING
POINT WAS IN THE 30,000
NON-UNION WORKFORCE

AND I BELIEVE
THAT WITHIN 4 YEARS

ALL OF OUR EMPLOYEES
WILL GET THIS KIND
OF HEALTHCARE PLAN.

ALL AMERICANS HAVE ACCEPTED
FOR 50 OR MORE YEARS

IN THE AUTOMOBILE INSURANCE
INDUSTRY THAT DRIVING
RECORD DICTATE PREMIUM.

AND ALL INSURANCE
COMPANIES ARE SAYING

IS YOUR BEHAVIOR SHOULD
DRIVE THE PREMIUM.

AND HEALTHCARE DOESN'T NEED
TO BE IMMUNE TO THAT.

SO, WE PROVIDE INCENTIVES
FOR PEOPLE TO ENGAGE
IN HEALTHIER BEHAVIOR.

OUR HEALTHCARE
PREMIUMS STARTS HERE

AND IF YOU HAVE A BODY MASS
INDEX LESS THAN 30,

YOU GET A DISCOUNT.

IF THEY ARE A CONFIRMED
A NON-SMOKER,

WE GIVE THEM A DISCOUNT.

IF YOU HAVE CHOLESTEROL
UNDER CONTROL,

A DISCOUNT. BLOOD PRESSURE
UNDER CONTROL, A DISCOUNT.

AND SO BEHAVIOR BECOMES
A FORM OF CURRENCY

FOR PEOPLE TO ACCOMPLISH
THEIR LIFESTYLE CHANGES.

WITHOUT THE FINANCIAL
INCENTIVES,

THERE'S NO WAY
I COULD HAVE GOTTEN TO
THE POINT THAT I AM NOW.

IT'S SAVING LITERALLY
THOUSANDS OF DOLLARS

OVER THE PAST FEW YEARS
BY BEING HEALTHIER.

[INDISTINCT CHATTER]

ARE WE READY TO ROLL?

YES, WE ARE.

ALL RIGHT!
LET'S GO! WHOO!

ALL RIGHT.

WHOO!

I NEVER WAS A RUNNER

BEFORE I STARTED
THE SAFEWAY RUNNING GROUP.

LITTLE BY LITTLE AS
WE WERE HERE IN THE GYM,

THEY JUST KIND
OF DRAFTED US IN

AND WE'VE BEEN
RUNNING EVER SINCE.

ALL WE DID WAS FACILITATE
SMART CHOICES FOR PEOPLE

AND DEVELOPED THIS CULTURE
OF HEALTH AND FITNESS.

DID YOU BIKE TO WORK TODAY?

I DID YESTERDAY.

ALL RIGHT.

I'M GOING TO DO
IT AGAIN ON FRIDAY.

ALL RIGHT.

IF YOU TALK TO
THE EMPLOYEES AROUND HERE

THAT HAVE LOST 35,
50, 60, 100 POUNDS,

THEY WILL TELL YOU
WITHOUT A DOUBT

THEY HAVE A BETTER
QUALITY OF LIFE.

FOR A LONG PERIOD OF TIME,
I WAS HIDING.

I HAD A FULL BEARD.

I HAD DREADS DOWN
TO MY WAIST.

I WAS SHUTTING DOWN
EMOTIONALLY.

I NOT ONLY HAVE
A SECOND CHANCE,

I HAVE THE GREATEST
CHANCE BECAUSE I HAVE

A CHANCE TO MAKE
MY NEXT 50 YEARS

BETTER THAN
MY LAST 50 YEARS.

IT'S STILL A STRUGGLE.

WHEN I'M RUNNING
AND IT'S A HOT DAY

AND I FEEL LIKE GIVING
UP, IT NEVER FAILS,

I'LL LOOK UP AND
I'LL SEE A PERSON

WHO'S OVERWEIGHT
ACROSS THE STREET.

MY FIRST THOUGHT IS
THAT'S WHY I'M RUNNING

BECAUSE I KNOW
WHAT THAT PERSON'S LIKE,
IT USED TO BE ME.

LET ME HAVE
A SALMON STEAMER BASKET.

COMING RIGHT UP.

YOU CAN'T SAY YOU'RE
INTERESTED IN THE CULTURE

OF HEALTH AND FITNESS WITHOUT
PROVIDING A FIRST CLASS GYM.

YOU CAN'T HAVE
A CAFETERIA THAT DOESN'T
HAVE CALORIE COUNTS ON IT.

OUR APPROACH HERE
IS COMPLETELY HOLISTIC.

Woman: SAFEWAY'S HEALTHCARE
COSTS HAVE REMAINED FLAT

COMPARED TO A 40% JUMP
FOR MOST OTHER COMPANIES.

30% OF OUR SMOKERS HAVE QUIT.

21% OF OUR OBESE POPULATION
ARE NO LONGER OBESE.

AND SAFEWAY EMPLOYEES WILL BE
LESS OF A BURDEN ON THE MEDICARE

OF THE FUTURE
BECAUSE THEY HAVE ADAPTED

TO THIS CULTURE
OF HEALTH AND FITNESS.

YOU ALLOW AND ENCOURAGE YOUR
EMPLOYEES TO BECOME HEALTHIER.

THEY BECOME MORE PRODUCTIVE.

YOUR COMPANY BECOMES
MORE COMPETITIVE.

I MEAN, I CAN'T THINK OF
A SINGLE NEGATIVE IN DOING THIS.

IF I'M FRUSTRATED BY ANYTHING,

IT'S THAT MORE OF THE
NATION HASN'T ADOPTED THIS.

SAFEWAY CORPORATION,
THEY'VE ACTUALLY BEEN ABLE
TO BEND THE COST CURVE,

THOSE ARE THE KIND OF THINGS
THAT ACTUALLY HAVE AN IMPACT.

MAKING MONEY AND DOING
GOOD IN THE WORLD ARE NOT
MUTUALLY EXCLUSIVE.

I LOST ABOUT 120 POUNDS
OVER THE COURSE OF 3 YEARS.

EVEN IF I LOSE 30 MORE POUNDS,

WHICH PROBABLY
IS MY ULTIMATE TARGET,

I'M NOT GONNA
STOP DOING THIS.

MY ENERGY LEVEL IS UP.

ALL MY HEALTH ISSUES
HAVE GONE AWAY.

IT'S NICE TO KNOW THAT I'VE
GOT A LONG TIME TO SPEND

WITH MY FAMILY AND I'M GOING
TO GET SEE MY SON GROW OLDER

AND GO TO COLLEGE AND
ALL THAT FUN STUFF.

IF WE REALLY CAN,
PUBLIC AND PRIVATE SIDE,

BEGIN TO MIGRATE PAYMENT
FROM PAYING FOR VOLUME,

PAYING FOR HOW MUCH YOU DO,

TO PAYING FOR OUTCOMES,

PAYING FOR HOW WELL YOU DO,
HOW WELL THE PATIENT DOES...

THAT WILL CHANGE THE GAME.

PEOPLE WILL START TO SAY, WELL,
NOW THE MONEY IS IN HEALTH

AND WELL BEING AND
SAFETY AND VITALITY,

NOT IN MORE, MORE, MORE, MORE.

THERE ARE ANSWERS.

WE KNOW WHAT SAFE CARE
LOOKS LIKE.

IT'S NOT JUST WE KNOW IT, WE
ACTUALLY CAN GO AND VISIT IT.

YOU CAN VISIT A HOSPITAL
THAT STOPPED INFECTIONS.

YOU CAN VISIT A HOSPITAL
THAT'S ENDING WASTE SLOWLY
BUT DOING IT.

YOU CAN VISIT SYSTEMS
THAT COORDINATE CARE,
NEARLY PERFECTLY.

THE CLEVELAND CLINIC
WAS FOUNDED BY 4 PHYSICIANS

AND THEY REALIZED THEY DID
BETTER WORKING AS A TEAM

THAN THEY DID
AS INDIVIDUAL PRACTITIONERS

AND THEY FORMED
A GROUP PRACTICE.

THEY DECIDED THAT WOULD
PAY THEMSELVES A SALARY

AND THE MONEY THAT WAS LEFT
OVER WOULD GO BACK

INTO GROWING THE ORGANIZATION.

AND THAT MODEL HAS
CONTINUED TO THIS DAY.

WE'RE ALL SALARIED,

SO THE DECISION ON WHAT WE DO
FOR A PATIENT IS DEPENDENT

UPON WHAT THE PATIENT NEEDS,
NOT ON OUR FINANCIAL INCENTIVES.

6 YEARS AGO, BEFORE
I BECAME C.E.O.,

I WAS SITTING DOWN SAYING,
WHAT PROFESSION AM I IN?

AND I SAID, WELL, I'M
IN THE HEALTHCARE PROFESSION.

AND THEN I STOPPED TO THINK,

I'VE NEVER LOOKED
AFTER A HEALTHY PERSON

AND MAYBE IT WOULD BE EASIER

TO TAKE CARE OF PEOPLE

AND KEEP THEM
FROM GETTING SICK

BEFORE THEY ACTUALLY
DID GET SICK.

HOW ARE YOU?
HI.

HOW ARE YOU?

YOU KNOW HOW PEOPLE
SAY IT TAKES A VILLAGE
TO RAISE A CHILD?

IT TAKES A VILLAGE
TO MAKE AN UNHEALTHY
PATIENT HEALTHY,

IT REALLY DOES.

SHE NEEDS A FOLLOW-UP WITH ME
IN 3 MONTHS WITH AN ECHO BEFORE.

PEOPLE WITH CHRONIC
DISEASE, WHO COME IN
AND OUT HOSPITALS,

BOUNCED IN
AND OUT OF E.R.s,

THAT'S WHAT THEY
NEED, SOMEONE TO REALLY
TAKE AN INTEREST,

HOLD THEM ACCOUNTABLE
AND THEN TALK TO THEM,

YOU KNOW,
ON A WEEKLY BASIS.

SOMETIMES WE'RE TALKING
TO YVONNE ON A DAILY BASIS.

THAT REQUIRES SO MUCH WORK,

BUT WE DO IT BECAUSE WE'RE
COMMITTED TO HAVING HER STAY

OUT OF THE HOSPITAL,
COMMITTED TO HER LIVING
LONGER AND BETTER.

[INDISTINCT]

WE'VE JUST
CREATED A COMPLETELY
DIFFERENT SYSTEM HERE

AND THE ACTUAL COSTS
FOR CARE HERE

IS AMONG THE LOWEST
IN THE COUNTRY

AND YET THE OUTCOMES,
THE SURVIVAL RATES,

ARE AT
THE HIGHEST LEVELS.

WE DON'T HAVE
TO SPEND OURSELVES INTO
POVERTY ON HEALTHCARE.

WE JUST HAVE
TO DO IT DIFFERENTLY.

IT'S REALLY EASY TO FIND
ARTICLES OR SPEECHES

FROM 30 YEARS AGO IN WHICH
LEADERS WERE CALLING FOR CHANGE,

UNSUSTAINABLE COSTS, PROBLEMS
AND OUTCOMES IN QUALITY,

BUT I THINK
THE ECONOMIC IMPERATIVES
ARE MUCH STRONGER NOW.

WE'RE DEALING WITH
THE HEALTH OF A NATION

WHEN WE DEAL WITH
WASTE IN HEALTHCARE.

WE ONLY GIVE LIP SERVICE
TO PREVENTION

AND WE HAVE TO ASK WHY
AS A SOCIETY WE ARE NOT

WORKING
TO PREVENT DISEASE
AND PROMOTE HEALTH

AND HOW DO
WE SHIFT THIS HUGE
ENTERPRISE OF DISEASE

INTERVENTION
IN THAT DIRECTION.

WE NEED TO CHANGE
THE NATURE OF MEDICINE

AND I HOPE OUR NEW GENERATION
OF HEALTH PROFESSIONALS

WILL CATALYZE
THE SOCIAL MOVEMENT

THAT'S NECESSARY AND ENOUGH
PEOPLE GET AROUSED ENOUGH

ABOUT THE SITUATION AND
SEE IT FOR WHAT IT IS

AND THEN START SOME KIND
OF GRASSROOTS MOVEMENT

TO CHANGE THE POLITICAL
BALANCE OF POWER.

WHAT I'M ARGUING
FOR IS NOT TO MAKE THINGS
TOUGH ON INDUSTRY,

IT'S TO MAKE THINGS
SAFE FOR PATIENTS,
PUTTING PATIENTS FIRST.

WE HAVE A MOTTO IN MEDICINE,
PRIMUM NON NOCERE.

IN LATIN IT MEANS
"ABOVE ALL, DO NO HARM."

IF I THINK ABOUT WHAT
HEALTHCARE COULD BE LIKE,

IT WOULD HAVE
A LOT MORE "CARE" IN IT.

IT WOULD BE A VERY
DIFFERENT SYSTEM

THAT PROBABLY WOULD
BE LESS HIGH TECH...

AND MORE HIGH TOUCH.

WE HAVE A LOT MORE POWER
OVER HOW HEALTHY WE ARE

THAN WE ARE WILLING
TO TAKE CREDIT FOR

OR WILLING TO TAKE
RESPONSIBILITY FOR.

AND THAT'S PART
OF WHAT A REALLY GREAT
HEALTHCARE SYSTEM

WOULD DO, IT WOULD
EMPOWER PATIENTS.

IT'S SO FRUSTRATING TO KNOW
HOW HIGH THE RISKS ARE

AND HOW EASY THE ANSWERS ARE.

THE ANSWER'S AMONG US
AND ONLY BY ACCEPTING THE FACT

THAT THE AMERICAN HEALTHCARE
SYSTEM IS BADLY BROKEN,

THAT THE STATUS
QUO ISN'T WORKING,

THAT IT'S BANKRUPTING
OUR NATION,

WILL WE BE ABLE TO SEEK
OUT THE ESCAPE FIRES,

THE POTENTIAL SOLUTIONS,

WE CREATE A SUSTAINABLE
AND PATIENT-CENTERED SYSTEM
FOR THE FUTURE.

HERE'S THE PAPER.

THAT'S EVERY SINGLE SIGNATURE

THAT SAYS THAT
YOU'RE GOOD TO GO

TO GET OUT OF WALTER REED
AND MOVE ON WITH MY TRAVEL.

RIGHT THERE.

I'M GOING BACK HOME.

HOME TO THE
INFANTRY DIVISION,
AIRBORNE, AIR ASSAULT.

I CAN'T WAIT TO BE THERE.

[CHUCKLES]

SEE YOU, DUDE.

I DON'T NEED YOU.

DON'T NEED YOU.

DON'T NEED YOU.

NEVER NEEDED YOU.

THEY DIDN'T FORESEE ME
EVEN TRYING TO WALK YET,

BUT I'M DOING IT,
MAINTAIN MY PAIN.

NOT HAVING TO
NEED ALL THESE PILLS.

IT'S BEEN A WILD RIDE,
STILL NOT OVER IT,

BUT IT'S BETTER FROM
GERMANY, I PROMISE YOU THAT.

LOOK AT THIS.

IT'S A HAPPY TIME
IN MY LIFE RIGHT NOW.

I'M SO EXCITED JUST TO
FINALLY LEAVE THIS HOSPITAL.

THIS PLACE ACTUALLY
GAVE ME THE TOOLS

TO PUT IN MY TOOL BAG SO I CAN
GO BACK AND STILL CONTINUE

MY PROCESS OF HEALING
AND RECOVERY.

[CELL PHONE BEEPS]

THE BOY FROM CAMPBELL...
SEE YOU SOON.

FROM NOAH.

I FEEL LIKE I'M CHANGING.

THANK YOU SO MUCH.

I'M NOT CHANGED...
BUT I'M CHANGING.

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