Escape Fire (Doc of the Week #5)

escape fire

Escape Fire: The Fight to Rescue American Healthcare
Directed by Matthew Heineman and Susan Froemke—2012—91 minutes

Using the true-story metaphor of a firefighter who kept his wits while his colleagues panicked in the face of a fast-moving wildfire, this film makes a compelling argument for a levelheaded approach to fix a profligate and profit-driven American healthcare industry. This is a system devised so that it “doesn’t want you to die and doesn’t want you to get well”, instead relegating hundreds of millions of people to an expensive habit of suppressing symptoms while doing little in the way of preventative care.

Director Matthew Heineman (founder of the Young Americans Project and producer of HBO’s The Alzheimer’s Project) and veteran documentarian Susan Froemke (who made the Oscar-nominated LaLee’s Kin and was associate producer of Grey Gardens) do an admirable job of approaching this thorny subject with common-sense clarity and quiet compassion while distinctly avoiding the blame game. Through sections like “Good People, Bad System” and “The Dark Matter of Medicine” we watch demoralized doctors and overwhelmed patients being churned through a $2.7 trillion industry, while credible claims are made that three-quarters of that amount is for the treatment of preventable conditions. The directors point out how technological developments in medical devices and wonder drugs have evolved into an end in themselves, instead of being used as needed. “To a man with a hammer, everything looks like a nail,” offers one expert. This mindset is said to be compounded by the fee-for-service system of doctor compensation, a setup that guarantees a quantity-first/quality-second result.

The end game, of course, has been a crippling inflation of health costs for the patient. One graphic shows what prices of everyday items would be today if they had moved at the same rate of inflation as healthcare since 1945: imagine paying $48 for a gallon of milk! The people interviewed by Heineman and Froemke (like former head of Medicare/Medicaid Don Berwick, nutritionist Andrew Weil and soul-searching PCP Erin Martin) suggest dealing with this issue with a sense of commonality and an enlightened wellness approach. A telling segment dealing with the evolution of a traumatized soldier back from Afghanistan, who frees himself from a multiple-prescription drug regime and finds help with holistic remedies, illustrates the imaginative problem-solving suggested by the title.

Instead, in lobbyist-infected Washington’s we get polarizing healthcare debate of recent years—as depressing as it is predictable—where American’s sense of rugged individualism gets exploited and boiled down into shortsighted self-regard. Even with the passage of Affordable Care Act there is still a long way to go with this issue, not the least of which is the way that the very word “care” (as in “Obamacare”) has been reduced to a derogatory term. Escape Fire is an excellent place to start to get one’s bearing on a crucial societal dilemma that affects us all and needs to be put right in all haste.

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