It's your money. CARNES: Release the breath in a smooth, even stream out. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. BURD: All right. 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. We create a public expectation that more is better, which isn't actually true so people seek more. UNIDENTIFIED MALE: Haven't gotten near my toes in months unless I do this. They had to live with some of the new consumer protections in the bill that does make it illegal for companies to just cancel someone's policy because of a preexisting condition. Upload your own WebVTT captions and transcript file by selecting Video settings in the upper right of the web player. COSGROVE: Cleveland Clinic was founded by four physicians, and they realized they did better working as a team than as individual practitioners. We need to change the nature of medicine. And finally, keep in mind that what is charged and what is ultimately paid are two different numbers. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: All I hear is how we're going to give more people access to the present system and how we're going to pay for it. To see if lifestyle changes can affect your (INAUDIBLE) even telomeres. (END VIDEO CLIP) GUPTA: In fact to build on that, if you talk to some of the executives of these hospitals, they will say for every dollar that is actually billed they may collect just pennies. (COMMERCIAL BREAK). We pay doctors to see patients, so they see a lot of patients. GEN. RICHARD THOMAS, ASSISTANT SURGEON-GENERAL, U.S. ARMY: This is a national problem for us, you know, we're seeing the military just being a microcosm, I think, of the problems society is having. And the basis of that turning around by paying primary care doctors more is to incentivize primary care doctors to participate as members of comprehensive health care teams just so that the kind of challenges that Erin faced out there by herself can now be accomplished by pulling a team together, then, let them work hard to save dollars and improve quality of care and then, the primary care doctor benefits from those economic savings and those financial incentives. Fire Escape Transcript. If they are confirmed non-smoker, we give them a discount. UMBDENSTOCK: Why? You can't have a cafeteria that doesn't have calorie counts on it. We cut people open, re-bypass 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 cut them open, we bypass their bypass, sometimes multiple times. The medication depresses you, it makes you think that it's all you're ever going to be in. Determine, did you indeed have two MRI's during the course of one week? The fire exploded, it's moving over 600 feet a minute, faster than most people could ever run. The emergency department is the safety net of health care. OK, I can see what you can have for pain, all right? He's, like, clutching his head. (COMMERCIAL BREAK) DR. ERIN MARTIN, PRIMARY CARE: After I'd left La Clinica, I joined this new practice. We are going to take a short break. CAIN: Exactly. In our model, the physician acts as a quarterback. Doctor , let me start with you. It's not true in France and Germany. Yvonne Osborn began suffering from severe chest pain at the age of 34. He tried to get the other smoke jumpers to join him, and nobody did. Healthcare reform was a good place to start, but it will do little to address the root problems. Compared to having your chest cut open? We have to teach young physicians that prevention comes first. Came off the mountain with only eight. Meditation takes the place of that. I do it in my clinic all the time. If someone has compression of one of their lungs, they might need a chest tube like this, $1100. It is important to keep in mind. Never needed you. What do you say to people when they say look, pay Erin Martin a little more money, you guys are making $5 billion. Let me get right to it, Erin. Driven by these perverse economic incentives, we are doing a lot of procedures to people that they don't need. UNIDENTIFIED MALE: We moved you over here. That's my routine. People with chronic disease who come in and out of hospitals, bouncing in and out of ERs, that's what they need, someone to really take an interest. You know? How did -- what did think about that? May everyone be well. They'll say, it took years to develop something like this, the research and development costs are significant. Aladdin (1992)/Transcript. JONAS: What it first seems like strange bedfellows, healing oriented mind/body practices and sort of the hardcore military actually is an opportunity that they jumped at because of the pragmatic need and nature that the wars had driven them to respond to. I mean, give me a break. And when we work at that level, we find people are much more likely to make these sustainable changes and the patient learns how to empower themselves and to transform their lives. It was massively marketed, and by 2006, this drug became the largest selling diabetes drug in the world. She had had bypass surgery at an early age. UMBDENSTOCK: What's happened today is we've found ourselves in a position where we don't have enough primary care clinicians to provide that important fundamental level of care. more . And when we come back, just how much does profit play a role in all these treatment decisions. Insurance companies have always been able to regulate the rates they charge. The patient just fell off the litter. Your arteries around the heart. 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. Afghanistan? I just had been ignoring it, because I thought, you know, I'm only 34 years old. UNIDENTIFIED MALE: We all know there's things we can do and they make us feel good and we like to do them, but we're going to feel really bad if our doors close. It just wants you to keep coming back for your care of your chronic disease. Frederick Douglass forcefully advocated for others to escape slavery, and in doing so violated laws in southern states that specifically criminalized this speech. So, I went into the hospital and they told me I had had a heart attack. Format: DVD Edition: Widescreen. But, you know, we have the means to decrease disease. DR. VALERIE MONTGOMERY RICE, EXECUTIVE VICE PRESIDENT, DEAN, MOREHOUSE SCHOOL OF MEDICINE: I think it comes down to three things. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. You can export to TXT, DOCX, PDF, HTML, and many . It's hard to say good-bye to the patients. (BEGIN VIDEO CLIP) UNIDENTIFIED MALE: I got my blood sugar under control. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. But I decided to give it a shot. LT. COL. BETTY GARNER, RESEARCHER, U.S. ARMY: Welcome to Germany. WENDELL POTTER, FORMER HEAD OF COMMUNICATIONS, CIGNA: I don't recall any time telling a lie, but I know that there are many times that I didn't disclose full information, and I was the company's chief spokesman. Not very much, but a little. And if they have a relationship with you, feeling truncated. But, one of the best times to do that is when they have one of these catastrophic kind of things like a heart attack. 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. I imagine the other smoke jumpers thought the guy was crazy, but his idea was this. This is incentives the system so that patient have a less specifically to be of picking the right choice. And feel yourself observing all these constantly changing sensations and thoughts and feelings. CHO: 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. And chromosomes have all genetic information on them. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. These for- profit companies by law have to serve shareholders. Incentivizing them to be healthy or not charging them as much if they're healthy. 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 animal stalls and barns. And so, that's clearly one of the issues. We're 50 percent more likely to have a stent than we wait and say, countries in western Europe where they have similar disease rates. Sometimes I go to the hospital and that's the only health care I ever got. 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. YATES: I've chose to get off all narcotics, all medicine, everything. Carry a lot of weight because I'm infantry. 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. It's too much paying for it. UNIDENTIFIED FEMALE: Yes, that's why you don't want him to fall again. Healthcare, it's headed for really, really bad trouble. And, you know, you kind of get busy. Do you understand? My energy level is up. A lot of unnecessary stents? I'm not interested in getting my productivity up. It's not just we know it, we actually can go and visit it. ORNISH: We found that after a year, the men who made these intensive lifestyle changes, their physical heart disease improved. He's taken 10 tablets. BERWICK: The healthcare system isn't affordable anymore. UNIDENTIFIED MALE: The healthcare reform bill that was enacted achieved two of the insurance industry's major objectives. CARNES: Notice where you are in the room, the people around. People talk about two-minute doctors. The next 30 minutes are all about you, the patient, whether you're insured or not insured, it matters. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. Log in to your account. Her cholesterol was never well controlled, and her high blood pressure was never well controlled. UNIDENTIFIED FEMALE: Not in there? It's not visible, but it's there. MARTIN: Thyroid is a little bit big. Until my doctor said to me, I don't know what else to do for you. Going to go look for it. GUPTA: I want to point out something. Heart cath, get another stent. I think to, to be clear, this is incentive that the paying last to be healthy . RICE: And I was surprised about this, particularly the data. BROWNLEE: We spend a spectacular amount of money on healthcare. I mean, the average price tag for a single hospital admission can be really eye-popping. ORNISH: In medical school, I was learning to do bypass surgery with Michael DeBakey, the heart surgeon. What does that do? And that's the problem. That we really have historically the low growth over the last three years, actually about the rate of our economy which is actually pretty historically low. You have all these stents, and these stents, once they go in, they never come out and are part of you. But with regard to prevention, preventing disease, does that save us money? So he figured I was going to die because I was in such bad shape. ROSS: How long ago was that? Look at our results, our life span isn't even in the top 20. UNIDENTIFIED MALE: A platoon of 23. Here's a couple simple tips. And that's because our system reimburses people for doing tasks and doing procedures, not for necessarily making people healthier. It just doesn't work out financially. And it's got to the point where the pain's radiating from my back down to my hips and then down to my thighs. Still bothers me to this day. I could hardly just about walk three steps and I'd have to stop and rest. WEIL: Where are you from? 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. It's been a wild ride. CARNES: So feel yourself there in your safe place. I've spent more than 30 years of doing studies showing that heart disease can 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. UNIDENTIFIED FEMALE: How are you? YVONNE OSBORN, CALEDONIA, OHIO RESIDENT: Okay, ready? Try to break a sweat every day. And that is why, our first priority has to be to equalize that access and then move on. There are certain patients that are very motivated to say how do I go back and recapture the wellness I used to enjoyed? The New Zealand and the United States, only two countries in the world where you can advertise prescription drugs. UNIDENTIFIED MALE: Six and over. This is a chest tube. DR. ROBY COSGROVE, CEO, CLEVELAND CLINIC: I've never looked after a healthy person. But one evening, I sat straight up in bed with the worst chest pain. Not just the health, but healthcare, the health of a nation. DR. DON BERWICK, HEAD OF MEDICARE/MEDICAID, 2010-2011: It's scary how fast obesity is spreading in our country. These perverse incentives that you described? NISSEN: Because of the money that's involved, getting people to do the right thing for the American people has become extremely difficult. UNIDENTIFIED MALE: Soldiers' use of prescription drugs has tripled in the past five years. And it's just the last thing that you're really concerned about. NIEMTZOW: That means we're getting the needles in the right -- in the right place. And people do. Because they're not using health care now. DR. ANDREW WEIL, PROFESSOR OF MEDICINE AND PUBLIC HEALTH, UNIVERSITY OF ARIZONA: We only give lip service to prevention and we have to ask why as a society are we not working to prevent disease and promote health. There is no reason that exact approach can't be applied across the board to drugs, to other diagnostic tests. They are patients with heart failure, they are morbidly obese patients. That also happened in the 1990s. She had bypass surgery in her 30, 27 cardiac cauterization and well over seven stents before she went to the Cleveland clinic for treatment. GUPTA: Doctor Rice, What do you think about that. If we get Medicare to cover it, then everyone else will cover it and if everyone covers it then it becomes a standard of care. 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. I'd rather be shot again than go through withdrawals of coming off that medicine. She got her cholesterol under control, her weight under control and things were great for her after that. And yet the outcomes, the survival rates are at the highest levels. UNIDENTIFIED FEMALE: Prescriptions, you can see how many scripts in the under script. PROTESTERS: Healthcare. 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. (COMMERCIAL BREAK) WEIL: The American health care system, it's generating rivers of money that are flowing into very few pockets. It will require a huge effort. I'm not sure every country in the world does it perfectly. We see a lot of the chronic conditions that affect many Americans that have gone untreated for sometimes months, but sometimes years. Going back home. If you have that happen in Germany or England, they say, here's a list of instructions, if you have problems come back and see us. MARTIN: What I do every day, buddy. Thank you so much. You know, they'll actually fix it. If they are surgeons, they get paid for each procedure. Why do we care about covering the uninsured? So we're going to open up some chi? I started getting sick in my 30s. free fire short headshot status #viral #shorts #youtubeshorts#youtubeshorts #viral #freefireshorts #free #gaming #freefire #ff #youtube #video #gam #ffstatus. To get the best results, use these formatting tips: To force the start of a new caption . UNIDENTIFIED REPORTER: Safeway's healthcare costs have remained flat compared to a 40 percent jump for most other companies. See you soon. A stapler, this stapler that is often to used in surgery, like this? War's hell, it's always hell. I'm sorry, it's going to get pretty tight. BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. Got to push through it. We need a whole new kind of medicine. We've set up a system that often pushes physicians and hospitals in the entire health care system into doing more. I mean, where did that idea come from? Look at this. It's not true in the United Kingdom. John than, you'll have to excuse me because you're an economist I'm not. Six years ago before I became CEO, 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. (COMMERCIAL BREAK) BROWNLEE: The history of how the American healthcare system grew is not one of order, it's one of sort of happen hazard chaos. The problem with Yvonne's case, is she had all of those stents before she had the risk factors controlled. At a time when the medical system is so badly broken. They may keep the disease process going and they may strengthen it over time. OSBORNE: I have lost -- since last year I've lost 21 pounds. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. OSBORNE: I am great. DR. ERIN MARTIN, PRIMARY CARE: I got to go to work. If you look at a hospital bill, you might see an IV bag charge. I'm two and a half months out of combat. Also, Doctor Reed Tuckson, he is the chief medical officer for the united health group. It's wonderful. Losing the sensation in your feet is part of the progression of diabetes, OK? That may strike people as very high. YATES: I meditate, and it has opened up a whole new world for me. JOE BIDEN, VICE PRESIDENT: Good morning, folks, how are you? NISSEN: We're not saying that people are doing these procedures for profit. All my health issues have gone away. A secret tape recorded aboard the doomed space shuttle Challenger captured the final panic-stricken moments of the crew. (CROSSTALK) UNIDENTIFIED MALE: That's not -- yes. DR. RICHARD NIEMTZOW, DIRECTOR, ANDREWS AIR FORCE ACUPUNCTURE CENTER: Right there. So to make up that difference in the reimbursement rates decreasing we're changing the shorter appointments next week. Price tag for a single hospital admission can be really eye-popping escape fire video transcript to... 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