Sep 29, 2012

What is Your Escape Fire?

More than 50 schools and universities recently hosted a free screening of the feature length film, 'Escape Fire: The Fight to Rescue American Healthcare'. The film premieres nationwide on October 5, 2012. This is a 
documentary by filmmakers Heineman and Froemke looking at the current state of America's $2.7 trillion health care system.
The University of California Davis Student Interest Group in Health Care Quality hosted a screening of the film last week. In the audience were students in medicine, nursing and business, as well as faculty and staff.

The name of the film draws inspiration from Don Berwick's book- Escape Fire. The film opens with Berwick talking about the Mann Gulch wildfire of 1949. The firefighter, Wag Dodge, lights an escape fire - intentionally igniting grass around him. This basically eliminates all surrounding flammable vegetation, thereby saving his life. 
Berwick and the filmmakers argue that we need similar unconventional and drastic solutions to change America's health care system.
Some things from the film that stood out.
  • A startling statistic. The US spends $300 billion a year on medications - approximately as much as the rest of the world combined.
  • The critical point that we do not have a health care system. We have a disease care system.
  • Universal health care coverage is not the answer. Even with universal coverage, the health care system would continue spiraling out of control. The film proposes issues and solutions that need to be a part of the dialog on health care.
  • The story of a war veteran on dozens of painkillers at a time, who was ultimately treated with acupuncture, meditation and yoga at Walter Reed Army Medical Center.
  • 75 percent of health care costs are related to preventable diseases. A patient with repeated heart attacks and the significant social and environmental challenges he faces in changing his lifestyle.
  • Fee-for-service incentivizes physicians to see as many patients as they possibly can. A well-meaning but frustrated physician fights a losing battle against mounting pressures to increase her "productivity".
  • An employee wellness program at Safeway Corporation that motivates its workers to exercise and eat better with some very impressive results, in the process reducing the company's health care costs.
  • Auto insurance rates are tied to driving history. The concept of health insurance rates being tied to healthy lifestyle so that lifestyle improvements drive premiums.
At the end of the screening, the filmmakers ask the audience to identify their own escape fire. My escape fire is focusing more on system-level improvements in patient care, with the goal of larger scale improvements in patient health outcomes. 

What is your Escape Fire?
- Ulfat Shaikh, with Wendy Nugent.
(Wendy Nugent has been a nurse at UC Davis for 26 years. She recently retired from her position as Assistant Director of Hospital and Clinics)

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