Title: Escape Fire: The Fight to Rescue American Healthcare
Directors: Matthew Heineman, Susan Froemke
As the United States stands on the precipice of another presidential election, with one major party committed to striking down legislation that provided the most reform on the issue in many generations, health care is again in the headlines — if frequently only tangentially, as Mitt Romney and President Barack Obama tangle over claims over what the Affordable Care Act will and will not provide when it goes fully into effect. A new documentary from Matthew Heineman and Susan Froemke, however, rather persuasively suggests a collective societal myopia on the subject — that a more accurate diagnosis of what ails the country can be found in a fee-for-service system which rewards doctors based not on patient outcomes or improvement but rather simply the number of patients they see.
“Escape Fire: The Fight to Rescue American Healthcare” premiered at the Sundance Film Festival this year, and picked up the Social Issue Award at Silverdocs. Its title — as explicated by Dr. Don Berwick, the head of Medicare and Medicaid from 2010-11, who years ago gave a speech later published under the same name — relates to the story of a group of Montana smokejumpers battling a particularly brutal forest fire in the 1940s. Trapped at the bottom of a steep ridge by the rapidly rising blaze, the foreman struck a match, set fire to the patch of grass in front of him and then took shelter in the newly burnt area, calling for his crew to join him. Clinging to old ideas and means of safety, they ran on. The fire spread quickly up the hill and overtook the crew, killing 13 men and destroying over 3,200 acres. The foreman survived, nearly unharmed.
The American health care system finds itself in a similar quandary, asserts Berwick, and “Escape Fire” offers up ample evidence in support of this point-of-view — that we’re looking past smart and effective solutions to problems, clinging to outdated models. The United States of course has enormous technological resources, and lots of people in the health care sector doing their jobs relatively well, the film argues, but it’s simply that the jobs were designed with a misplaced focus. Ergo, whereas other developed countries spend around $3,000 per person annually on health care, the average in America amounts to around $8,000. It’s a profitable “disease care” system that wants you neither to die or really get better, but instead keep coming back for the treatment of chronic and largely preventable illnesses.
The film has the requisite array of expert-in-field talking heads, along with statistics of gut-punch effectiveness: the United States spends more than $300 billion a year on pharmaceuticals, almost as much as the rest of the world combined; and if other prices had risen at the same rate as health care costs since 1945, a dozen eggs would cost $45 and a gallon of milk would be $48. Yet its greatest strength lies in some of its normal subjects. Dr. Erin Martin, the sole primary care physician in rural The Dalles, Oregon, struggles with patient volume, and decides to leave for another opportunity, while Robert Yates, a PTSD-addled soldier strung out on a cocktail of nearly three dozen pharmaceuticals, turns to acupuncture and meditation to help calm his mind and diminish his symptoms. Other interviewees — including Dr. Andrew Weil, a pioneer in “integrative medicine,” and Dr. Dean Ornish, the founder and president of the Preventive Medicine Research Institute — are more famous, but these figures help create an enormously sympathetic pull.
If there’s a qualm, it’s that “Escape Fire” suffers a bit from a jumbled focus, and hiccups in editing. A digression into the fight over shielded research for the widely diagnosed diabetes drug Avandia, and GlaxoSmithKline’s eventual $3 billion settlement, connects to the movie’s main thesis — that nearly 75 percent of the $2.7 trillion we spend on health care is on preventable diseases that could be more effectively treated by other means — but also comes across as rushed, and clipped. We live in a high-tech world, but if we’re serious about societal betterment we need to transform our medical care into a “high-touch” operation, to give patients and doctors more time to spend with one another, preventing disease rather than just managing its symptoms.
NOTE: In addition to its theatrical engagements, “Escape Fire” is also available on iTunes and across VOD platforms. For more information on the film, visit its Facebook page or www.EscapeFireMovie.com.
Written by: Brent Simon
A graduate of the University of North Carolina at Chapel Hill, Brent Simon is a three-term president of LAFCA, a contributor to Screen International and Magill's Cinema Annual, and film editor of H Magazine. He cannot abide a world without U2 and pizza.