“Escape Fire: The Fight to Rescue American Healthcare,” from directors Susan Frömke and Matthew Heineman, spotlights the inherent flaws within the U.S. health care system. The 95-minute documentary uses patient and doctor testimonies, public research and reenactments to demonstrate the human toll taken by a lack of speedy and effective health care reform.
A flawed health care system
The film argues that health care’s myriad problems stem from the profit-driven system that insurance companies, drug manufacturers and care facilities fuel. The effect is not patient- centered health care but “sick care,” treating symptoms of conditions that could be better managed or even avoided with preventative care. To make matters worse, some poorer Americans only receive costly and untimely treatment in emergency departments.
“The history of how the American health care system grew is not one of order but of haphazard chaos,” Shannon Brownlee, medical journalist for U.S. News, argues in the film’s opening. “We have a disease care system, not a health care system. It wants patients to keep coming back for symptom relief of chronic care and not prevention- which is cheaper.”
Brownlee explains that the average per capita cost of health care in the developed world is about $3,000 annually. In the U.S., however, that number is about $8,000 a year. The $2.7 trillion a year cost, she says, is not translating into results.
According to Dr. Don Berwick, former Administrator of the Centers for Medicare and Medicaid Services, U.S. health care is superior in only specific circumstances. “If you need real serious technology today like a very complex cardiac surgery you’re lucky to be in this country. Rescue care is second to none,” Berwick says. “As an overall system, no, we’re not anywhere near the best in the world.”
Compared to other nations, the U.S. isn’t in the top 20 when measuring life span. The U.S. ranks at 50, behind Denmark and Portugal, according to the Organization for Economic Co-Operation and Development.
The drug companies
The film also addresses the pharmaceutical industry and the $300 billion Americans spend on drugs each year. That amount is almost as high as the rest of the world’s pharmaceutical spending combined. Dr. Andrew Weil, professor of medicine and public health at the University of Arizona, says that sometimes the body doesn’t require so many drugs. “There is this tremendous innate healing capacity that we all have. When I sit with a person that’s sick always at the back of my mind is the question, ‘What is blocking healing here?’ ”
As Weil notes, nutrition is almost omitted from medical education. Instead of prescribing another pill, communication about lifestyle changes could work better, he says.
Only in the U.S. and New Zealand are drug companies allowed to advertise on television.
A gut-wrenching scene involving a U.S. medical evacuation is perhaps the film’s most memorable. A seriously wounded soldier deployed to Afghanistan falls on the floor after attempting to get up and urinate. “Did he try to get up without anybody knowing? He’s not listening very well,” nurses aboard the flight note of the heavily drugged young man. “Let’s find out what he’s got left of the morphine, at some point he could stop breathing,” air personnel say.
The film connects the abundance of pain pills and the lack of holistic remedies, like acupuncture and meditation, to the growing problem of drug addiction among U.S. veterans.
Reaction to Escape Fire
“Escape Fire” draws its name from the practice of igniting a blaze to protect oneself from an oncoming one. By using all available vegetation, a fire’s fuel is starved. The film’s title offers that the solutions to health care are omnipresent, yet conveniently overlooked.
Mixed to positive film reviews have emerged. According to the Chicago Sun-Times’ Roger Ebert: “It argues that American medical treatment is largely focused on getting people into hospitals and giving them drugs, two profit centers that are hugely expensive and supported by massive lobbying campaigns. Considering that hospitalization itself is listed as the third leading cause of death in the United States, the industry’s track record is not convincing.” He describes the film as stunningly clear.
Some critics have noted the film’s lack of solutions and insistence upon healthy lifestyle choices. In fact, much of the last half of the film is devoted to Dr. Dean Ornish’s healthy lifestyle regimens he claims can reverse heart disease and even prostate cancer.
“By failing to equally address the other remedy for our current health care predicament—namely, the necessity of forcing drug companies and providers to charge less—Escape Fire winds up feeling like only one half of a larger argument,” writes the Village Voice’s Nick Schager.
The Boston Globe’s Wesley Morris takes issue with what he calls the film’s righteousness. “The whole thing ends with an urgent plea to visit the movie’s site, which is partially devoted to The Issues, which involve such topics as ‘overmedication,’ ‘overtreatment,’ and ‘reimbursement,'” Morris writes.
The film has won a number of film festival awards, including the Kathleen Bryan Edwards Award for Human Rights at the Full Frame Documentary Film Festival. It is playing in select theaters across the country.
“Escape Fire: The Fight to Rescue American Healthcare” is available now on iTunes