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Escape Fire 3/11/2013 7:30:45 AM
The advancing flames are closer all the time. Light the match. Last evening a remarkable documentary made its way onto CNN. Escape Fire (not fire escape) is an all too true story about the deep chasm we find ourselves in concerning health care in America. There was a time when people like Drs. Andrew Weil, and Dean Ornish may have been considered cranks, or alarmists, despite their credentials and the seeming sensibility of their statements, as shown on this well-crafted documentary. Watching Escape Fire was difficult for a number of reasons. The show brought the clash of reality versus fantasy into living rooms: The reality being that we Americans are in the weeds with our health care, waaaaaay down the list of developed countries in terms of quality of health care delivery and results, seventh of the eight developed countries, according to the Commonwealth Fund, and we’re getting in deeper all the time. One segment of the show starred a returning veteran of the ill-fated conflict in Afghanistan. The young fellow saw the hole his life had fallen into from a regimen of pain-killing drugs longer than anyone’s grocery list. To his great credit, the fellow decided to break away from his dependency, and he succeeded. Another character in the show, a dedicated smoker, confronted with his addiction decided otherwise; he would wait to quit smoking, he stated, “…until I figure out what’s wrong with me.” Much to her credit, his doctor held her tongue. The young veteran lit his own escape fire, in other words, and has a renewed, healthful outlook and a better life. The second fellow will likely smoke himself to death, partly at our collective expense.
According to Escape Fire, what is the problem with our health care system? As a former Air Medical pilot I was close to some aspects of this so called ‘problem’ for a long time, so I found myself nodding my head at the show’s revelations. We Americans eat too much of the wrong foods, we smoke, we ignore stress levels and our own genetic and familial history. Then, when our health deteriorates, we demand that the health care system ‘fix’ us. And here’s where the deep chasm becomes canyone-esque.
The health care system in America thrives on money. Lots of money. No surprise there. Health Care America Inc. is one of the largest industries the world has ever seen. We spend $2.26 trillion on health care, or $7,439 per person every year according to U.S. government actuarial data. There is at present very little incentive for this system to keep its customers healthy, thus driving them away. Do General Motors or Ford encourage mass transit? Does Hollywood urge us to spend more time outdoors watching fewer movies? Do the airlines subsidize train travel? No, no and no. The health care system in this country is, as the narrator of Escape Fire said, “A disease management system.”
In twenty years as an Air Med pilot I saw many patients. Most of them needed the transport and in-flight medical interventions they received. Many of them did not. Many of them needed transport away from a medical facility that lacked the expensive procedural mechanisms to diagnose and treat them. There is justification for flying medical patients. But the whole spectrum of medical care is oriented around ‘treating’ us, not keeping us healthy in the first place. What a lot of those patients, a lot of we Americans need, is a better diet, a smoke-free life, consistent exercise and a willingness to take care of our own health and the knowledge needed to do that.
The system we have is unsustainable. The worst foods are the most heavily subsidized; government reimbursements are targeted at the quantity of procedures given, numbers of patients seen per day, not the quality and long-term health benefits to the patient. Physicians are paid per patient, not for health maintenance provided to the community. Plus, fully 30% of expenditures on health care today is wasted.
The name Escape Fire is taken from those who fight forest fires. If those crews find themselves surrounded, or threatened by a rapidly moving wall of fire, they often ignite another fire around themselves to burn off fuel and thereby starve the advancing flames. Lighting these fires takes courage, dedication and a brazen disregard for powerful forces that would sweep us away. But those forces are looming; it’s time to light the match.
