Health Care Needs an Escape Fire

DPA Insights

The Broken State of Our Nation’s Health Care System

By Tony Rodriguez, President, Daniel Penn Associates, LLC

I attended the screening of Escape Fire: The Fight to Rescue American Healthcare, a sobering documentary about the broken state of our nation’s health care system.

Before I get into the movie, a quick plug for the evening’s host, the ReSet Social Enterprise Trust’s Design Lab, which brought it to Hartford to jump-start conversation on this critical issue. ReSet Founder Health Care Needs an Escape Fire is helping entrepreneurs leverage the power of their businesses to create public good. I encourage you to attend one of the organization’s upcoming events.

Escape Fire

Why did the movie choose the name Escape Fire? Read on.

But first, a few facts about the state of our health care system.

  • Medical errors are the third leading killer (yes, right behind heart disease and cancer) (CDC.gov; Health Affairs)
  • 30 percent of healthcare costs do not improve patients’ health (Institute of Medicine)
  • The average annual cost of healthcare in the US is $8,000 compared with $3,000 in other developed countries (oecd.org)
  • In the past five years, soldiers’ use of prescription drugs has tripled (DrugAbuse.gov)
  • 20 to 50 percent of medical scans on patients in the U.S. should not have been done (New York Times)
  • Primary care physicians earn half of what specialists do (bls.gov)
  • Smoking is responsible for one in five deaths in America (Morbidity and Mortality Weekly Report)
  • 75 percent of healthcare costs are spent on preventable diseases (cdc.gov)
  • The more a drug is marketed to US physicians, the more it is prescribed (Annals of Family Medicine)
  • Employer-sponsored health care plan costs have been rising 4 times as fast as employees’ earnings (Henry J. Kaiser Family Foundation)
  • For the first time in our history, life expectancy for many Americans is going down (New England Journal of Medicine)
  • Almost 40 percent of American hospitals have fast food services on their premises (Journal of Pediatrics)
  • Only one in 16,000 people have their lives saved or extended through advances in medical technology (American Journal of Public Health)
  • One half of all Americans with chronic illnesses are not getting enough time with their doctor during office visits to determine and treat the root cause. (Quality and Safety in Healthcare)
  • The average hospital visit in the U.S. costs $1,666 per day, four times more than the rest of the world. (Health Affairs)
  • The average cost of a drug-eluting stent procedure: $40,000 vs. $100 for the average cost of one cardiac rehab session. (New York Times)
  • Prevention vs. treatment.
  • Counseling and behavior change vs. procedure after futile procedure.
  • Innovative therapies (yoga, acupuncture, and yes, exercise!) vs. more drugs.
  • Incentives for both consumers and providers of health care.

There are bright spots in the movie. Health care pioneers such as Dr. Wayne Jonas, president and CEO of the Samueli Institute, Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, Dr. Dean Ornish, founder and president of the Preventive Medicine Research Institute and Dr. Andrew Weil, founder of the University of Arizona Center for Integrative Medicine provide a vision of a new system that focuses on care and attention, prevention and outcomes.

Perhaps Safeway Inc. President and CEO Steve Burd should be running our nation’s healthcare system. A business leader in health promotion, Burd implemented the Safeway Healthy Measures Program to incentivize his workers to lose weight and quit smoking. He says he decreased his company’s healthcare costs by about 13% in the first year.

“Making money and doing good in the world are not mutually exclusive,” Burd says.

Which brings us to the movie’s title. Here’s how the producers tell it:

Years before he took office as the head of Medicare and Medicaid, Dr. Don Berwick delivered a speech in which he drew a parallel between the broken healthcare system and a forest fire that ignited in Mann Gulch, Montana.

Just as the healthcare system lies perilously on the brink of combustion, the forest fire, which seemed harmless at first was waiting to explode. A team of fifteen smokejumpers parachuted in to contain the fire, but soon they were running for their lives, racing to the top of a steep ridge. Their foreman, Wag Dodge, recognized that they would not make it.

With the fire barely two hundred yards behind him, he did a strange and marvelous thing. He invented a solution. His crew must have thought he had gone crazy as he took some matches out of his pocket, bent down and set fire to the grass directly in front of him. The fire spread quickly uphill, and he stepped into the middle of the newly burnt area, calling for his crew to join him.

But nobody followed Wag Dodge. They ignored him, clinging to what they had been taught, and they ran right by the answer. The fire raged past Wag Dodge and overtook the crew, killing thirteen men and burning 3,200 acres. Dodge survived, nearly unharmed.

Dodge had invented what is now called an “escape fire,” and soon after it became standard practice.

As Berwick says in the film, “We’re in Mann Gulch. Healthcare, it’s in really bad trouble. The answer is among us. Can we please stop and think and make sense of the situation and get our way out of it?”

This is about all of us demanding change from our leaders and our providers. Realizing that it’s not about technology or tests or procedures or drugs or implants. It’s about healthy lifestyles and preventative health services and logic that will get us out of the spiraling mess we’re in.

What’s your escape fire?

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