1 00:00:03,960 --> 00:00:05,962 CAPTIONING MADE POSSIBLE BY LIONS GATE ENTERTAINMENT 2 00:00:15,276 --> 00:00:19,106 [TYPING, BEEPING] 3 00:00:45,436 --> 00:00:50,920 IN 1949, A FOREST FIRE BROKE OUT IN MAN GULCH, MONTANA. 4 00:00:50,963 --> 00:00:52,922 SMOKE JUMPERS WERE PARACHUTED IN, 5 00:00:52,965 --> 00:00:57,144 A TEAM OF 15, HEADED BY A FOREMAN NAMED WAG DODGE. 6 00:00:57,187 --> 00:00:59,102 THE FIRE EXPLODED. 7 00:00:59,146 --> 00:01:01,017 IT WAS MOVING OVER 600 FEET A MINUTE, 8 00:01:01,061 --> 00:01:03,411 FASTER THAN MOST PEOPLE COULD EVER RUN 9 00:01:03,454 --> 00:01:07,197 AND SO 15 FIREFIGHTERS WERE TRAPPED. 10 00:01:07,241 --> 00:01:08,633 WAG DODGE HAD AN IDEA. 11 00:01:08,677 --> 00:01:11,332 HE KNEW THAT THEY WOULD LOSE THE RACE 12 00:01:11,375 --> 00:01:13,160 BACK TO THE TOP OF THE RIDGE, 13 00:01:13,203 --> 00:01:14,639 SO HE SUDDENLY STOPPED, 14 00:01:14,683 --> 00:01:18,991 HE LIT A MATCH AND HE LIT A FIRE AT HIS OWN FEET 15 00:01:19,035 --> 00:01:22,125 AND THE FIRE SPREAD AROUND HIM. 16 00:01:22,169 --> 00:01:26,086 I IMAGINE THE OTHER SMOKE JUMPERS THOUGHT THE GUY WAS CRAZY, 17 00:01:26,129 --> 00:01:28,827 BUT HIS IDEA WAS THIS-- IF I BURN THE FUEL AROUND ME, 18 00:01:28,871 --> 00:01:31,656 THEN WHEN THE FIRE COMES AND OVERTAKES ME, I'M SAFE. 19 00:01:31,700 --> 00:01:34,833 I'LL BE IN WHAT CAME TO BE KNOWN AS AN ESCAPE FIRE. 20 00:01:34,877 --> 00:01:41,579 HE TRIED TO GET THE OTHER SMOKE JUMPERS TO JOIN HIM AND NOBODY DID. 21 00:01:41,623 --> 00:01:43,103 THE FIRE OVERTOOK THE CREW, 22 00:01:43,146 --> 00:01:47,107 KILLING 13 MEN AND BURNING 3,200 ACRES. 23 00:01:47,150 --> 00:01:53,461 WAG DODGE SURVIVED NEARLY UNHARMED IN HIS ESCAPE FIRE. 24 00:01:53,504 --> 00:01:56,899 IT'S JUST TRAGIC TO THINK OF THE ANSWER BEING THERE, 25 00:01:56,942 --> 00:02:00,294 BUT JUST IN THE MOMENT NOT ABLE TO SEE IT. 26 00:02:00,337 --> 00:02:03,645 THAT'S HOW IMBEDDED PEOPLE GET IN THE STATUS QUO. 27 00:02:03,688 --> 00:02:06,169 THEY CAN'T RECOGNIZE AN INVENTION WHEN IT'S AMONG THEM 28 00:02:06,213 --> 00:02:10,521 AND THEY CAN'T GIVE UP THEIR OLD HABITS. 29 00:02:11,435 --> 00:02:12,915 WE'RE IN MAN GULCH. 30 00:02:12,958 --> 00:02:18,181 HEALTHCARE, IT'S HEADED FOR REALLY, REALLY BAD TROUBLE. 31 00:02:18,225 --> 00:02:21,750 THE ANSWERS AMONG US, CAN WE PLEASE STOP 32 00:02:21,793 --> 00:02:24,013 AND THINK AND MAKE SENSE OF THE SITUATION 33 00:02:24,056 --> 00:02:27,973 AND GET OUR WAY OUT OF IT? IT'S THE SAME CHALLENGE. 34 00:02:28,496 --> 00:02:30,846 WE HAVE HAD ENOUGH! 35 00:02:30,889 --> 00:02:35,894 [CHEERING AND SHOUTING] 36 00:02:35,938 --> 00:02:37,592 WHAT DO WE WANT?! 37 00:02:37,635 --> 00:02:38,375 HEALTHCARE! 38 00:02:38,419 --> 00:02:40,943 WHEN DO WE WANT IT?!NOW! 39 00:02:44,903 --> 00:02:48,255 ALL I HEAR IS HOW WE'RE GONNA GET MORE PEOPLE ACCESS 40 00:02:48,298 --> 00:02:50,648 TO THE PRESENT SYSTEM AND HOW WE'RE GONNA PAY FOR IT 41 00:02:50,692 --> 00:02:52,215 AND TO ME THAT'S NOT THE ONLY ISSUE. 42 00:02:52,259 --> 00:02:56,088 THE PRESENT SYSTEM DOESN'T WORK AND IT'S GONNA TAKE US DOWN. 43 00:02:56,132 --> 00:02:59,744 WE NEED A WHOLE NEW KIND OF MEDICINE. 44 00:03:02,530 --> 00:03:05,272 HEALTHCARE REFORM WAS A GOOD PLACE TO START, 45 00:03:05,315 --> 00:03:09,145 BUT IT WILL DO LITTLE TO ADDRESS THE ROOT PROBLEMS. 46 00:03:09,189 --> 00:03:10,494 [SIRENS] 47 00:03:10,538 --> 00:03:11,974 WE DON'T HAVE A HEALTHCARE SYSTEM IN THIS COUNTRY. 48 00:03:12,017 --> 00:03:15,107 WE HAVE A DISEASE MANAGEMENT SYSTEM. 49 00:03:17,806 --> 00:03:21,201 PEOPLE OFTEN THINK IT HAS TO BE A NEW DRUG OR A NEW LASER 50 00:03:21,244 --> 00:03:23,159 OR SOMETHING REALLY HIGH TECH AND EXPENSIVE 51 00:03:23,203 --> 00:03:25,074 TO BE POWERFUL AND THEY HAVE A HARD TIME BELIEVING 52 00:03:25,117 --> 00:03:28,033 THAT THESE SIMPLE CHOICES THAT WE MAKE IN OUR LIVES EACH DAY 53 00:03:28,077 --> 00:03:30,210 CAN MAKE SUCH A POWERFUL DIFFERENCE. 54 00:03:33,256 --> 00:03:37,826 WE'RE IN THE GRIP OF A VERY BIG INDUSTRY 55 00:03:37,869 --> 00:03:41,133 AND IT DOESN'T WANT TO STOP MAKING MONEY. 56 00:03:41,177 --> 00:03:43,745 AT THE EXECUTIVE LEVEL, WHAT'S MOST IMPORTANT 57 00:03:43,788 --> 00:03:47,139 IS MEETING WALL STREET'S EXPECTATIONS AND THEY HAVE TO. 58 00:03:47,183 --> 00:03:48,271 THESE FOR PROFIT COMPANIES, 59 00:03:48,315 --> 00:03:50,012 BY LAW, HAVE TO SERVE THE SHAREHOLDERS. 60 00:03:50,055 --> 00:03:55,235 YOU ALMOST FORGET THAT WHAT YOU'RE DOING IS PROVIDING HEALTHCARE. 61 00:03:57,976 --> 00:04:00,805 THE HEALTHCARE SYSTEM IS UNSUSTAINABLE. 62 00:04:00,849 --> 00:04:03,852 WE'RE SPENDING ALMOST TWICE AS MUCH IN AMERICA 63 00:04:03,895 --> 00:04:05,549 AS ANY OTHER COUNTRY ON EARTH. 64 00:04:05,593 --> 00:04:07,377 WE'RE REALLY MORTGAGING THE FUTURE. 65 00:04:07,421 --> 00:04:08,639 NOT JUST THE HEALTH OF HEALTHCARE, 66 00:04:08,683 --> 00:04:11,642 WE'RE TALKING ABOUT THE HEALTH OF THE NATION. 67 00:04:37,625 --> 00:04:40,149 MOMMY, WHAT ARE YOU GOING TO DO? 68 00:04:40,192 --> 00:04:41,324 I GOTTA GO TO WORK. 69 00:04:41,368 --> 00:04:43,805 WHAT ARE YOU GONNA DO AT WORK? 70 00:04:43,848 --> 00:04:45,676 WHAT I DO EVERY DAY, BUDDY. 71 00:04:45,720 --> 00:04:47,112 I LOVE YOU. 72 00:04:47,156 --> 00:04:49,332 I LOVE YOU, TOO! 73 00:04:49,376 --> 00:04:50,333 BYE. 74 00:04:50,377 --> 00:04:51,682 BYE! 75 00:04:57,775 --> 00:05:00,561 IN A COMMUNITY HEALTH CENTER LIKE WHERE I WORK, 76 00:05:00,604 --> 00:05:02,650 YOU SEE CHRONIC ILLNESS, 77 00:05:02,693 --> 00:05:06,131 PEOPLE THAT AREN'T ABLE TO AFFORD THEIR MEDICATIONS, 78 00:05:06,175 --> 00:05:07,959 LOTS OF PSYCHIATRIC ILLNESSES, 79 00:05:08,003 --> 00:05:09,352 BUT THE GOVERNMENT PAYS YOU 80 00:05:09,396 --> 00:05:12,616 BASED ON HOW MANY PATIENTS YOU SEE. 81 00:05:21,190 --> 00:05:26,238 I THINK WE HAVE ABOUT 25 PATIENTS FOR TODAY FOR DR. MARTIN. 82 00:05:26,282 --> 00:05:28,676 I THINK 5 OR 6 OF THEM ARE ON THE WAITING LIST. 83 00:05:28,719 --> 00:05:30,330 IF THEY'RE AN EASY 15 MINUTE, 84 00:05:30,373 --> 00:05:33,333 I'M SURE WE CAN PROBABLY SQUEEZE THEM INTO THE SCHEDULE. 85 00:05:33,376 --> 00:05:35,204 HELLO, MR. FIELDS? 86 00:05:35,247 --> 00:05:37,728 [SPEAKING IN SPANISH] 87 00:05:37,772 --> 00:05:41,341 I NEED TO LISTEN TO YOU. 88 00:05:43,255 --> 00:05:45,954 ALL RIGHT. WHO'S NEXT? 89 00:05:49,697 --> 00:05:50,872 HELLO. HI. 90 00:05:50,915 --> 00:05:51,829 HOW ARE YOU? 91 00:05:51,873 --> 00:05:53,091 WELL, FIRST OF ALL, 92 00:05:53,135 --> 00:05:54,092 MY SON'S IN THE AIR FORCE 93 00:05:54,136 --> 00:05:55,572 AND HE'S GOING TO BE 21 ON SUNDAY. 94 00:05:55,616 --> 00:05:58,053 MM-HMM. AND HE'S NOT HERE. 95 00:05:58,096 --> 00:05:59,359 WHERE'S HE AT? 96 00:05:59,402 --> 00:06:00,664 GERMANY. YEAH? 97 00:06:00,708 --> 00:06:02,710 AND YOU'RE MISSING HIM? 98 00:06:02,753 --> 00:06:03,972 I AM. 99 00:06:04,015 --> 00:06:07,192 AND I MOVED OUT FROM MY BOYFRIEND IN DECEMBER 100 00:06:07,236 --> 00:06:08,629 AND I WORK 6 DAYS A WEEK, 101 00:06:08,672 --> 00:06:11,458 5:30 TO 7:30 AND I'M TIRED. 102 00:06:11,501 --> 00:06:13,111 WHOA. YEAH. 103 00:06:13,155 --> 00:06:16,463 SO, IT SOUNDS LIKE YOU'RE FEELING REALLY OVERWHELMED RIGHT NOW. 104 00:06:16,506 --> 00:06:17,681 SORRY. 105 00:06:17,725 --> 00:06:19,204 DON'T BE SORRY. 106 00:06:19,248 --> 00:06:22,207 DID YOU HAVE ANYTHING IN MIND WHEN YOU CAME IN HERE TODAY? 107 00:06:22,251 --> 00:06:26,690 I WAS ON CELEXA FOR A WHILE AND THAT SEEMED TO HELP. 108 00:06:26,734 --> 00:06:29,867 SO, YOU WERE THINKING ABOUT MEDICATION? 109 00:06:29,911 --> 00:06:33,349 IF YOU CAN THINK OF ANYTHING ELSE. 110 00:06:33,393 --> 00:06:36,657 I'M A LITTLE BIT WISHY WASHY ON THE MEDICATION 111 00:06:36,700 --> 00:06:40,400 BECAUSE MEDICATION IS NOT THE PROBLEM. 112 00:06:40,443 --> 00:06:41,531 IT'S NOT. YEAH. 113 00:06:41,575 --> 00:06:43,359 THE PROBLEM IN YOUR LIFE IS THAT YOU'VE GOT 114 00:06:43,403 --> 00:06:48,408 TOO MANY THINGS GOING ON AND YOU'RE OVERTIRED. 115 00:06:48,625 --> 00:06:51,454 INSTEAD OF BASING THINGS ON OUTCOMES, 116 00:06:51,498 --> 00:06:53,195 ON HOW GOOD OF A JOB WE'RE DOING, 117 00:06:53,238 --> 00:06:56,459 THE GOVERNMENT SETS THE REIMBURSEMENT COMPLETELY 118 00:06:56,503 --> 00:06:59,157 ON THE NUMBER OF PATIENTS THAT WE SEE. 119 00:06:59,201 --> 00:07:02,204 IT DOESN'T MATTER HOW COMPLICATED THEY ARE, 120 00:07:02,247 --> 00:07:03,640 HOW MUCH TIME THAT WE SPEND ON THEM. 121 00:07:03,684 --> 00:07:06,121 IT'S JUST A NUMBER-- ONE, 2, 3, 4, 5. 122 00:07:06,164 --> 00:07:10,517 YOU HAVE TO PLAY THIS GAME WITH, WHAT DOES THIS PATIENT NEED 123 00:07:10,560 --> 00:07:12,606 AND HOW MUCH TIME AM I WILLING TO SPEND WITH THEM 124 00:07:12,649 --> 00:07:14,477 BECAUSE THE ADMINISTRATION IS TELLING YOU, 125 00:07:14,521 --> 00:07:17,001 YOU NEED TO SEE MORE PATIENTS, WE'RE IN THE RED. 126 00:07:17,045 --> 00:07:20,222 AND IF YOU TRY AND BUCK THE SYSTEM, SOMEONE SAYS, 127 00:07:20,265 --> 00:07:22,572 WHAT CAN WE DO TO GET YOUR PRODUCTIVITY UP? 128 00:07:22,616 --> 00:07:26,794 I'M NOT INTERESTED IN GETTING MY PRODUCTIVITY UP. 129 00:07:26,837 --> 00:07:30,537 I'M INTERESTED IN HELPING PATIENTS. 130 00:07:31,538 --> 00:07:33,540 IN THE ERA OF FOR PROFIT MEDICINE, 131 00:07:33,583 --> 00:07:37,674 THE TIME ALLOWED FOR PATIENT VISITS HAS SHRUNK TO A POINT 132 00:07:37,718 --> 00:07:40,460 WHERE YOU'VE GOT 7 MINUTES WITH A PATIENT. 133 00:07:40,503 --> 00:07:42,940 CAN YOU FEEL THIS? 134 00:07:42,984 --> 00:07:44,028 YES. 135 00:07:44,072 --> 00:07:44,899 BARELY? 136 00:07:44,942 --> 00:07:45,856 YEAH. OK. 137 00:07:45,900 --> 00:07:47,031 LOSING THE SENSATION IN YOUR FEET 138 00:07:47,075 --> 00:07:51,558 IS PART OF THE PROGRESSION OF DIABETES, OK? 139 00:07:51,601 --> 00:07:53,211 Dr. Weil: IT COULD GET WORSE. 140 00:07:53,255 --> 00:07:55,518 PEOPLE TALK ABOUT 2-MINUTE DOCTORS... 141 00:07:55,562 --> 00:07:56,432 HMM. 142 00:07:56,476 --> 00:07:58,303 LITERALLY, 30 PATIENTS AN HOUR. 143 00:07:58,347 --> 00:08:00,567 THINGS COULD MOVE IN THAT DIRECTION HERE. 144 00:08:00,610 --> 00:08:02,264 AND THIS IS NOT THE CHOICE OF THE DOCTOR. 145 00:08:02,307 --> 00:08:05,528 AS A PRIMARY CARE PHYSICIAN, WE'RE SUPPOSED TO BE THE PEOPLE 146 00:08:05,572 --> 00:08:08,313 THAT ARE MAKING SURE THE PATIENTS DON'T GET SICK 147 00:08:08,357 --> 00:08:10,751 AND THAT THEY HAVE EVERYTHING THAT THEY NEED 148 00:08:10,794 --> 00:08:12,448 TO MAINTAIN HEALTH... 149 00:08:12,492 --> 00:08:15,538 BUT WE END UP BEING THIS REVOLVING DOOR. 150 00:08:15,582 --> 00:08:17,540 PEOPLE COME IN AND YOU TRY AND FIX ONE THING 151 00:08:17,584 --> 00:08:21,457 AND THEY COME BACK FOR THE SAME THING OVER AND OVER AND OVER. 152 00:08:21,501 --> 00:08:23,328 YOU JUST NEVER GET TO THE BOTTOM 153 00:08:23,372 --> 00:08:27,419 OF WHAT'S CAUSING ALL OF THESE PROBLEMS THAT THEY'RE HAVING. 154 00:08:27,463 --> 00:08:29,204 MICHELLE? 155 00:08:29,247 --> 00:08:31,249 [WOMAN CRYING] 156 00:08:31,293 --> 00:08:32,512 TELL ME WHAT HAPPENED. 157 00:08:32,555 --> 00:08:36,080 I JUST TRIED TO CUT MY ARM OFF. 158 00:08:36,124 --> 00:08:37,429 WHAT WERE YOU TRYING TO DO? 159 00:08:37,473 --> 00:08:43,566 I JUST WANTED TO JUST END IT AND...I'M TIRED OF IT. 160 00:08:43,610 --> 00:08:44,567 I'M SO TIRED OF IT. 161 00:08:44,611 --> 00:08:46,526 ARE YOU TAKING YOUR MEDICATION? YES. 162 00:08:46,569 --> 00:08:48,571 A GREAT DEAL OF WHAT'S DONE IN CONVENTIONAL MEDICINE 163 00:08:48,615 --> 00:08:53,968 IS TO PUT BAND-AIDS ON THINGS OR TO SUPPRESS SYMPTOMS. 164 00:08:54,011 --> 00:08:56,492 HAVE YOU CUT YOURSELF BEFORE? 165 00:08:56,536 --> 00:08:58,450 WHEN I WAS A KID... 166 00:08:58,494 --> 00:09:00,496 YOU USED TO CUT?MM-HMM. 167 00:09:00,540 --> 00:09:03,978 LEXAPRO IS THE ONLY THING YOU'RE ON RIGHT NOW? 168 00:09:04,021 --> 00:09:05,588 MM-HMM. 169 00:09:05,632 --> 00:09:07,590 THIS IS A PROBLEM WITH A LOT OF OUR SUPPRESSIVE TREATMENTS. 170 00:09:07,634 --> 00:09:10,811 THEY MAY KEEP THE DISEASE PROCESS GOING 171 00:09:10,854 --> 00:09:12,813 AND THEY MAY STRENGTHEN IT OVER TIME. 172 00:09:12,856 --> 00:09:15,511 IT'S MUCH BETTER TO TRY TO WORK AT A DEEPER LEVEL. 173 00:09:15,555 --> 00:09:21,212 I'M GONNA MAKE A PHONE CALL AND TRY TO GET SOME WHEELS IN MOTION 174 00:09:21,256 --> 00:09:24,738 SO THAT WE CAN GET YOU THE HELP THAT YOU NEED, OK? 175 00:09:24,781 --> 00:09:29,351 OK, SO, WE NEED THE CRISIS COUNSELOR THEN. 176 00:09:30,918 --> 00:09:34,617 YES, THIS IS DR. MARTIN OVER AT LA CLINICA. 177 00:09:34,661 --> 00:09:39,317 I NEED TO SPEAK WITH THE CRISIS WORKER. 178 00:09:39,361 --> 00:09:43,060 THERE'S NO CRISIS WORKER AT LUNCH TIME? 179 00:09:43,104 --> 00:09:45,933 I HAVE AN ACUTELY SUICIDAL PATIENT 180 00:09:45,976 --> 00:09:48,109 IN MY OFFICE THAT I NEED HELP WITH. 181 00:09:48,152 --> 00:09:50,198 SHE'S STILL TAKING HER LEXAPRO, 182 00:09:50,241 --> 00:09:55,507 BUT IT'S OBVIOUSLY NOT, UH...NOT DOING THE JOB. 183 00:09:56,726 --> 00:10:01,296 WHERE I'M AT RIGHT NOW, PATIENTS ARE IN DESPERATE NEED OF CARE 184 00:10:01,339 --> 00:10:04,995 AND THE WAY THAT THE SYSTEM IS SET UP, YOU CAN'T BE EFFECTIVE. 185 00:10:05,039 --> 00:10:09,957 I BECAME A DOCTOR BECAUSE I CARE ABOUT PATIENTS 186 00:10:10,000 --> 00:10:13,787 AND WORKING HERE, I CAN'T HELP THEM. 187 00:10:14,396 --> 00:10:16,572 [SIGHS] 188 00:10:16,616 --> 00:10:20,750 TO FEEL THAT WAY WHEN YOU COME HOME... 189 00:10:20,794 --> 00:10:25,363 IS...DEMORALIZING. 190 00:10:28,497 --> 00:10:32,849 THERE HAS TO BE A DIFFERENT WAY OF DOING THINGS, 191 00:10:32,893 --> 00:10:37,071 SO I DECIDED TO LEAVE. 192 00:10:38,115 --> 00:10:43,686 IT'S HARD TO SAY GOOD-BYE TO THE PATIENTS. 193 00:10:43,730 --> 00:10:45,993 I TOOK CARE OF THEM AND I WAS RESPONSIBLE FOR THEM 194 00:10:46,036 --> 00:10:49,126 AND JUST WORRYING ABOUT IF SOMEBODY ELSE IS GONNA DO 195 00:10:49,170 --> 00:10:50,867 FOR THEM WHAT THEY NEED. 196 00:10:50,911 --> 00:10:54,131 I WANT TO GIVE TO PEOPLE 197 00:10:54,175 --> 00:10:55,480 AND I WANT TO HELP PEOPLE 198 00:10:55,524 --> 00:10:58,483 AND I WASN'T ABLE TO FIND THAT HERE. 199 00:10:58,527 --> 00:11:01,356 I'M GONNA GO LOOK FOR IT. 200 00:11:18,721 --> 00:11:23,595 THE HISTORY OF HOW THE AMERICAN HEALTH CARE SYSTEM GREW 201 00:11:23,639 --> 00:11:25,032 IS NOT ONE OF ORDER, 202 00:11:25,075 --> 00:11:27,338 IT'S ONE OF SORT OF HAPHAZARD CHAOS. 203 00:11:27,382 --> 00:11:31,734 EVERYBODY'S DOING WHAT MAKES SENSE TO THEM INDIVIDUALLY. 204 00:11:31,778 --> 00:11:34,519 WE PAY HOSPITALS TO BE FULL, SO THEY TRY TO BE FULL. 205 00:11:34,563 --> 00:11:37,827 WE PAY DOCTORS TO SEE PATIENTS, SO THEY SEE A LOT OF PATIENTS. 206 00:11:37,871 --> 00:11:41,178 WE CREATE A PUBLIC EXPECTATION THAT MORE IS BETTER, 207 00:11:41,222 --> 00:11:44,007 WHICH ISN'T ACTUALLY TRUE, SO PEOPLE SEEK MORE. 208 00:11:44,051 --> 00:11:46,836 EVERYBODY'S DOING THEIR JOB. 209 00:11:46,880 --> 00:11:48,577 WE JUST DESIGNED THE JOBS WRONG. 210 00:11:48,620 --> 00:11:52,276 PHYSICIANS ARE WELL INTENTIONED. 211 00:11:52,320 --> 00:11:53,495 EVEN WHEN BAD THINGS HAPPEN, 212 00:11:53,538 --> 00:11:55,715 IT'S NOT BECAUSE PEOPLE HAVE BAD INTENTIONS, 213 00:11:55,758 --> 00:12:00,589 IT'S THAT OUR SYSTEM IS ALL FOULED UP. 214 00:12:02,939 --> 00:12:09,424 WE SPEND A SPECTACULAR AMOUNT OF MONEY ON HEALTHCARE. 215 00:12:09,467 --> 00:12:11,861 JUST SHEER NUMBERS. 216 00:12:11,905 --> 00:12:16,779 $2.7 TRILLION PER YEAR. 217 00:12:16,823 --> 00:12:20,652 THE AVERAGE PER CAPITA COST OF HEALTHCARE 218 00:12:20,696 --> 00:12:23,873 IN THE DEVELOPED WORLD IS ABOUT $3,000. 219 00:12:23,917 --> 00:12:28,095 IN THE UNITED STATES IT WAS AROUND $8,000 ANNUALLY. 220 00:12:28,138 --> 00:12:31,011 WE SPEND ONE HECK OF A LOT OF MONEY. 221 00:12:31,054 --> 00:12:33,796 THE HEALTHCARE SYSTEM ISN'T AFFORDABLE ANYMORE. 222 00:12:33,840 --> 00:12:35,755 WHO PAYS FOR THAT? WHERE DOES THAT MONEY COME FROM? 223 00:12:35,798 --> 00:12:37,408 THIS ALL COMING OUT OF OUR POCKETS. 224 00:12:37,452 --> 00:12:39,149 IT'S YOUR MONEY. 225 00:12:39,193 --> 00:12:42,762 THE REALLY ASTONISHING PART ABOUT THE FACT 226 00:12:42,805 --> 00:12:45,808 THAT WE SPEND MORE IS WE HAVE WORSE HEALTH OUTCOMES. 227 00:12:45,852 --> 00:12:48,942 IF YOU NEED REAL SERIOUS TECHNOLOGY TODAY 228 00:12:48,985 --> 00:12:51,074 LIKE A VERY COMPLEX CARDIAC SURGERY, 229 00:12:51,118 --> 00:12:53,381 YOU'RE LUCKY TO BE IN THIS COUNTRY. 230 00:12:54,164 --> 00:12:58,168 RESCUE CARE IS SECOND TO NONE. 231 00:12:58,908 --> 00:13:00,214 AS AN OVERALL SYSTEM, NO, 232 00:13:00,257 --> 00:13:02,825 WE'RE NOT ANYWHERE NEAR AT THE BEST IN THE WORLD. 233 00:13:02,869 --> 00:13:03,957 I MEAN, LOOK AT OUR RESULTS, 234 00:13:04,000 --> 00:13:08,570 OUR LIFE SPAN ISN'T EVEN IN THE TOP 20. 235 00:13:10,441 --> 00:13:12,052 WE HAVE A DISEASE CARE SYSTEM 236 00:13:12,095 --> 00:13:15,055 AND WE HAVE A VERY PROFITABLE DISEASE CARE SYSTEM. 237 00:13:15,098 --> 00:13:17,971 AND THE DISEASE CARE SYSTEM, ACTUALLY, I MEAN, 238 00:13:18,014 --> 00:13:19,973 IF IT WAS REALLY HONEST WITH ITSELF, 239 00:13:20,016 --> 00:13:25,239 IT DOESN'T WANT YOU TO DIE AND IT DOESN'T WANT YOU TO GET WELL. 240 00:13:25,282 --> 00:13:27,371 IT JUST WANTS YOU TO KEEP COMING BACK 241 00:13:27,415 --> 00:13:31,332 FOR YOUR CARE OF YOUR CHRONIC DISEASE. 242 00:13:34,074 --> 00:13:35,858 MOST OF THIS HUGE EFFORT 243 00:13:35,902 --> 00:13:39,470 OF THE HEALTHCARE INDUSTRY IS DEVOTED TO INTERVENTION, 244 00:13:39,514 --> 00:13:40,950 IN ESTABLISHED DISEASE, 245 00:13:40,994 --> 00:13:42,038 AND THE MAJORITY OF THAT DISEASE 246 00:13:42,082 --> 00:13:43,953 IS LIFESTYLE RELATED AND PREVENTABLE. 247 00:13:43,997 --> 00:13:47,087 I MEAN, TO TALK ABOUT HOW WE SHIFT TOWARD-- 248 00:13:47,130 --> 00:13:50,003 AWAY FROM DISEASE INTERVENTION TOWARD DISEASE PREVENTION, 249 00:13:50,046 --> 00:13:51,831 HEALTH PROMOTION, I MEAN, THAT--THAT REQUIRES 250 00:13:51,874 --> 00:13:55,399 A MASSIVE RETHINKING ABOUT MEDICINE 251 00:13:55,443 --> 00:13:57,532 AND HEALTHCARE AT ALL LEVELS OF SOCIETY. 252 00:13:57,575 --> 00:13:59,186 IT HAS TO DO WITH EXPECTATIONS OF PATIENTS. 253 00:13:59,229 --> 00:14:02,102 IT HAS TO DO WITH THE TRAINING OF PHYSICIANS. 254 00:14:02,145 --> 00:14:04,147 IT WILL REQUIRE A HUGE EFFORT. 255 00:14:09,718 --> 00:14:15,811 THERE IS THIS TREMENDOUS INNATE HEALING CAPACITY THAT WE ALL HAVE. 256 00:14:15,855 --> 00:14:17,987 WHEN I SIT WITH A PERSON WHO'S SICK, 257 00:14:18,031 --> 00:14:19,728 ALWAYS AT THE BACK OF MY MIND IS THE QUESTION, 258 00:14:19,771 --> 00:14:22,992 WHAT IS BLOCKING HEALING HERE? WHAT IS PREVENTING IT? 259 00:14:23,036 --> 00:14:27,692 WHAT CAN I DO FROM OUTSIDE THAT CAN FACILITATE THAT PROCESS? 260 00:14:27,736 --> 00:14:29,477 THAT PERSPECTIVE IS MISSING 261 00:14:29,520 --> 00:14:33,089 FROM THE TRAINING OF OUR HEALTH PROFESSIONALS. 262 00:14:34,308 --> 00:14:38,529 WHAT'S WRONG WITH MEDICAL EDUCATION IS THAT IT SIMPLY 263 00:14:38,573 --> 00:14:40,618 DOESN'T ADDRESS WHOLE SUBJECT AREAS 264 00:14:40,662 --> 00:14:43,012 THAT ARE ABSOLUTELY ESSENTIAL TO UNDERSTANDING 265 00:14:43,056 --> 00:14:47,495 HUMAN BEINGS, HEALTH, ILLNESS, AND TREATMENT. 266 00:14:47,538 --> 00:14:49,366 I MEAN, AN OBVIOUS ONE IS NUTRITION, 267 00:14:49,410 --> 00:14:52,761 WHICH IS ALMOST OMITTED FROM MEDICAL EDUCATION. 268 00:14:52,804 --> 00:14:57,244 SO, IN 1994, I STARTED A FELLOWSHIP FOR PEOPLE 269 00:14:57,287 --> 00:15:01,291 WHO HAD COMPLETED MEDICAL SCHOOL TO RETRAIN PHYSICIANS. 270 00:15:02,031 --> 00:15:07,167 WE WANT TO EXPOSE CLINICIANS TO A BROADER WAY 271 00:15:07,210 --> 00:15:08,603 OF SEEING THE PATIENT. 272 00:15:08,646 --> 00:15:12,781 A DEEPER UNDERSTANDING OF HEALING AND A LARGER TOOLBOX 273 00:15:12,824 --> 00:15:16,002 FROM WHICH TO CHOOSE FOR THERAPIES. 274 00:15:16,654 --> 00:15:19,266 MANY CLINICIANS COME HERE FRUSTRATED, 275 00:15:19,309 --> 00:15:21,268 THEY'RE OVERWORKED, THEY'RE OVERWHELMED, 276 00:15:21,311 --> 00:15:24,575 BURIED DEEP UNDERNEATH INSURANCE FORMS 277 00:15:24,619 --> 00:15:28,666 AND 10-MINUTE VISITS AND 30 PATIENTS A DAY. 278 00:15:28,710 --> 00:15:29,624 WHERE ARE YOU FROM? 279 00:15:29,667 --> 00:15:30,712 I'M FROM VIRGINIA. 280 00:15:30,755 --> 00:15:32,235 I ACTUALLY PRACTICE EMERGENCY MEDICINE 281 00:15:32,279 --> 00:15:34,542 AT THE UNIVERSITY OF VIRGINIA IN CHARLOTTESVILLE. GOOD. 282 00:15:34,585 --> 00:15:36,587 THERE HAVE BEEN SOME TRENDS 283 00:15:36,631 --> 00:15:39,982 IN HEALTHCARE THAT MAKE ME UNCOMFORTABLE. 284 00:15:40,026 --> 00:15:43,986 I FELT LIKE THERE'S GOT TO BE SOMETHING DIFFERENT, 285 00:15:44,030 --> 00:15:45,118 SOMETHING BETTER. 286 00:15:45,161 --> 00:15:46,249 ALMOST 40,000 PEOPLE HAVE BEEN STUDIED... 287 00:15:46,293 --> 00:15:47,772 MY MEDICAL TRAINING WAS JUST FOCUSED ON 288 00:15:47,816 --> 00:15:50,036 GIVING THESE PATIENTS PHARMACEUTICALS OR GIVING 289 00:15:50,079 --> 00:15:54,736 THEM EXPENSIVE TESTS TO TREAT THE CONDITION AFTER IT OCCURRED. 290 00:15:54,779 --> 00:15:58,870 I HAD NO KNOWLEDGE OF WAYS TO PREVENT A HEART ATTACK 291 00:15:58,914 --> 00:16:01,221 OR STROKE OR CANCER OR THINGS LIKE THAT. 292 00:16:01,264 --> 00:16:04,180 I HAD TO DO THE FELLOWSHIP BECAUSE IT WAS KIND 293 00:16:04,224 --> 00:16:07,792 OF MY LITTLE RAY OF HOPE THAT THINGS COULD BE BETTER, 294 00:16:07,836 --> 00:16:09,490 THINGS CAN BE DONE DIFFERENTLY 295 00:16:09,533 --> 00:16:13,537 AND SOMEBODY'S GONNA TEACH ME HOW TO DO THAT, SO I'M GONNA DO IT. 296 00:16:13,581 --> 00:16:17,585 IN WESTERN MEDICINE, ALL OF OUR EFFORT IS ON DISPELLING EVIL. 297 00:16:17,628 --> 00:16:19,979 IF SOMEBODY HAS AN INFECTION, 298 00:16:20,022 --> 00:16:22,155 WE GIVE ANTI-INFECTIOUS AGENTS. 299 00:16:22,198 --> 00:16:23,373 IF SOMEBODY HAS HYPERTENSION, 300 00:16:23,417 --> 00:16:24,548 WE GIVE ANTI-HYPERTENSION DRUGS. 301 00:16:24,592 --> 00:16:27,377 IT'S GETTING RID OF THE BAD THING. 302 00:16:27,421 --> 00:16:29,814 WE DO NOTHING ABOUT SUPPORTING THE GOOD, 303 00:16:29,858 --> 00:16:32,687 THAT THE BODY CAN AND WANTS TO BE HEALTHY. 304 00:16:32,730 --> 00:16:35,820 BOTH OF THESE APPROACHES ARE NECESSARY, 305 00:16:35,864 --> 00:16:37,083 BUT IT WOULD BE GREAT 306 00:16:37,126 --> 00:16:39,694 IF WE HAD A BETTER BALANCE IN WESTERN MEDICINE. 307 00:16:39,737 --> 00:16:43,698 THE KINDS OF INTERVENTIONS THAT WE HAVE COME TO FAVOR 308 00:16:43,741 --> 00:16:47,093 IN THIS COUNTRY ARE INHERENTLY COSTLY 309 00:16:47,136 --> 00:16:48,790 BECAUSE THEY'RE DEPENDENT 310 00:16:48,833 --> 00:16:51,488 ON EXPENSIVE TECHNOLOGY AND THAT INCLUDES PHARMACEUTICAL DRUGS. 311 00:16:51,532 --> 00:16:53,969 I THINK THERE'S SOME VERY GOOD DRUGS OUT THERE. 312 00:16:54,013 --> 00:16:55,840 I THING DRUG TREATMENT HAS ITS PLACE. 313 00:16:55,884 --> 00:16:59,018 I TAKE A PHARMACEUTICAL DRUG MYSELF, 314 00:16:59,061 --> 00:17:02,804 BUT IF THERE'S ONE THING THAT I WOULD LOVE TO SEE 315 00:17:02,847 --> 00:17:05,459 YOU BEGIN TO IMPLEMENT IN YOUR OWN PRACTICE 316 00:17:05,502 --> 00:17:10,420 AND TEACH OTHERS ABOUT, IT'S TO TRY TO CHANGE THIS MINDSET 317 00:17:10,464 --> 00:17:13,423 THAT HAS SO COMPLETELY TAKEN HOLD IN OUR CULTURE 318 00:17:13,467 --> 00:17:14,946 ON THE PART OF BOTH DOCTORS AND PATIENTS, 319 00:17:14,990 --> 00:17:18,646 THAT DRUGS ARE THE ONLY LEGITIMATE WAY TO TREAT DISEASE. 320 00:17:18,689 --> 00:17:21,562 I MEAN, WHERE DID THAT IDEA COME FROM? 321 00:17:24,043 --> 00:17:28,569 WE SPEND $300 BILLION A YEAR ON PHARMACEUTICALS. 322 00:17:28,612 --> 00:17:32,573 THAT'S ALMOST AS MUCH AS THE REST OF THE WORLD COMBINED. 323 00:17:32,616 --> 00:17:34,488 $300 BILLION ON DRUGS. 324 00:17:34,531 --> 00:17:39,667 IN THE 1950s, AMERICANS TOOK PHARMACEUTICAL MEDICATION 325 00:17:39,710 --> 00:17:42,626 AT ABOUT 10% OF THE RATE THAT THEY DO NOW. 326 00:17:42,670 --> 00:17:46,021 WE'RE TAUGHT WITH THE COMMERCIALS ON TELEVISION, 327 00:17:46,065 --> 00:17:50,112 WHY DO WE NEED TO WAIT? WE CAN JUST TAKE A PILL RIGHT NOW. 328 00:17:50,373 --> 00:17:52,114 WHEN I WATCH THE NETWORKS, 329 00:17:52,158 --> 00:17:54,986 HALF THE ADS ARE FOR PHARMACEUTICAL AGENTS. 330 00:17:55,030 --> 00:17:57,380 THAT ISN'T TRUE IN CANADA. 331 00:17:57,424 --> 00:17:58,903 IT'S NOT TRUE IN THE UNITED KINGDOM, 332 00:17:58,947 --> 00:18:00,601 IT'S NOT TRUE IN FRANCE AND GERMANY. 333 00:18:00,644 --> 00:18:03,038 THE ONLY OTHER COUNTRY, BY THE WAY, IS NEW ZEALAND. 334 00:18:03,082 --> 00:18:04,822 NEW ZEALAND AND THE UNITED STATES ARE THE ONLY 335 00:18:04,866 --> 00:18:08,609 2 COUNTRIES IN THE WORLD WHERE YOU CAN ADVERTISE PRESCRIPTION DRUGS. 336 00:18:08,652 --> 00:18:12,047 WHAT DOES THAT DO? WELL, IT DRIVES DEMAND. 337 00:18:12,091 --> 00:18:13,135 YOU KNOW, THE ADS ALWAYS END 338 00:18:13,179 --> 00:18:15,964 WITH THE SAME PHRASE-- ASK YOUR DOCTOR. 339 00:18:16,007 --> 00:18:17,226 AND PEOPLE DO. 340 00:18:17,270 --> 00:18:19,968 AND DOCTORS, WANTING TO PLEASE THEIR PATIENTS, 341 00:18:20,011 --> 00:18:22,013 WILL OFTEN PRESCRIBE IT. 342 00:18:33,199 --> 00:18:37,116 Woman: OVERMEDICATING IS A HUGE PROBLEM IN SOCIETY 343 00:18:37,159 --> 00:18:41,076 AND THE MILITARY IS NO EXCEPTION. 344 00:18:41,120 --> 00:18:42,904 THIS IS A NATIONAL PROBLEM FOR US. 345 00:18:42,947 --> 00:18:46,125 YOU KNOW, WE'RE SEEING THE MILITARY JUST BEING A MICROCOSM, 346 00:18:46,168 --> 00:18:47,822 I THINK, OF THE PROBLEM SOCIETY'S HAVING. 347 00:18:47,865 --> 00:18:52,609 Man: SOLDIERS' USE OF PRESCRIPTION DRUGS 348 00:18:52,653 --> 00:18:54,524 HAS TRIPLED IN THE PAST 5 YEARS. 349 00:18:54,568 --> 00:18:57,571 Woman: THE ARMY SAYS THIS IS ALL LINKED 350 00:18:57,614 --> 00:19:00,574 TO THE RISING NUMBER OF SOLDIER SUICIDES. 351 00:19:00,617 --> 00:19:02,880 IN FACT, MORE SOLDIERS DIED LAST YEAR 352 00:19:02,924 --> 00:19:06,754 FROM NON-COMBAT INJURIES THAN DURING WAR. 353 00:19:09,191 --> 00:19:14,109 I CAN SEE WHY THERE'S A LINK BETWEEN OPIATES, 354 00:19:14,153 --> 00:19:19,593 DEPENDENCY, MISUSE, AND SUICIDE. 355 00:19:19,636 --> 00:19:23,597 I WAS TAKING 64 PILLS A DAY 356 00:19:23,640 --> 00:19:28,863 OF COMBINATIONS OF ROXICET AND OXYCONTIN. 357 00:19:28,906 --> 00:19:31,082 THERE'S A CONTRADICTION TO WHAT WE DO. 358 00:19:31,126 --> 00:19:33,215 YOU AS CAREGIVERS ARE TOLD, 359 00:19:33,259 --> 00:19:34,999 YOU'VE GOT TO KEEP ME PAIN FREE. 360 00:19:35,043 --> 00:19:36,175 YOU'RE GONNA DO THAT. 361 00:19:36,218 --> 00:19:37,698 AND WE HAVE TO BE MINDFUL TO THOSE POINTS 362 00:19:37,741 --> 00:19:41,615 IN TIME WHERE YOU CAN INTERVENE AND SAY, ENOUGH'S ENOUGH. 363 00:19:41,658 --> 00:19:45,009 WE HAVE TO FIND THE RIGHT MIX OF TREATMENTS 364 00:19:45,053 --> 00:19:48,361 FOR THE GUYS AND THE ANSWERS ARE NOT IN A STACK OF PILLS. 365 00:19:48,404 --> 00:19:51,233 IF IT HAPPENED TO ME, IT HAPPENS TO A WHOLE LOT 366 00:19:51,277 --> 00:19:55,455 MORE PEOPLE THAT ARE ALMOST INVISIBLE TO THE SYSTEM. 367 00:20:06,030 --> 00:20:09,556 I'VE BEEN SHOT THIS DEPLOYMENT. 368 00:20:09,599 --> 00:20:12,385 8 I.E.D.'s JUST THIS DEPLOYMENT. 369 00:20:12,428 --> 00:20:16,476 I CARRY A LOT OF WEIGHT BECAUSE I'M INFANTRY. 370 00:20:16,519 --> 00:20:17,912 THE MOUNTAINS OF AFGHANISTAN 371 00:20:17,955 --> 00:20:23,439 ARE NOT EASY TO CLIMB, SO COMPRESSED MY BACK. 372 00:20:23,961 --> 00:20:28,052 I WAS TREATED FOR SCIATIC NERVE, BACK, 373 00:20:28,096 --> 00:20:29,532 L-2, L-3, L-4, L-5, 374 00:20:29,576 --> 00:20:32,753 SWELLING, LEFT SIDE OF MY BRAIN, 375 00:20:32,796 --> 00:20:36,235 AND EXTREME P.T.S.D. 376 00:20:37,453 --> 00:20:40,456 WITH 10 YEARS OF ONGOING WARS, 377 00:20:40,500 --> 00:20:43,067 THE AMOUNT OF SUFFERING THAT'S GOING ON 378 00:20:43,111 --> 00:20:46,201 IN THE MILITARY RIGHT NOW IS TREMENDOUS. 379 00:20:46,245 --> 00:20:49,726 WHEN YOU GO OVER INTO A WAR ZONE, 380 00:20:49,770 --> 00:20:51,467 WHERE YOU SEE YOUR BUDDIES DIE 381 00:20:51,511 --> 00:20:52,468 OR YOU GET INJURED, 382 00:20:52,512 --> 00:20:54,253 THAT'S GONNA TAX ANYBODY. 383 00:20:54,296 --> 00:20:56,777 AND WE SEE THAT SUFFERING. 384 00:21:11,487 --> 00:21:15,361 DURING THE AIR EVACS OF WOUNDED SOLDIERS, 385 00:21:15,404 --> 00:21:22,150 THE APPROACH TO PAIN THAT CURRENTLY EXISTS IS TO GET MEDICATIONS. 386 00:21:23,456 --> 00:21:26,372 DO YOU HAVE ANY PAIN RIGHT NOW? 387 00:21:26,415 --> 00:21:30,245 OK, I CAN SEE WHAT YOU CAN HAVE FOR PAIN, ALL RIGHT? 388 00:21:30,289 --> 00:21:32,247 Woman: HE ASKED FOR PAIN MEDICATION. 389 00:21:32,291 --> 00:21:33,944 THEY DON'T SAY HOW MUCH THEY GAVE HIM, 390 00:21:33,988 --> 00:21:35,076 BUT HE CAN HAVE ANYWHERE 391 00:21:35,119 --> 00:21:36,904 BETWEEN 5 AND 10 MILLIGRAMS OF MORPHINE. 392 00:21:36,947 --> 00:21:38,601 I JUST WANT TO SEE WHAT THEY'VE GIVEN HIM. 393 00:21:38,645 --> 00:21:41,343 BECAUSE HE'S REAL SLEEPY? YEAH. 394 00:21:41,387 --> 00:21:44,651 IT'S VERY HARD FOR US AS NURSES TO TREAT FOR PAIN 395 00:21:44,694 --> 00:21:47,349 BECAUSE THERE'S NO THERMOMETER THAT WE CAN STICK IN 396 00:21:47,393 --> 00:21:49,133 AND SAY, OH, IT'S 7 OUT OF 10 PAIN. 397 00:21:49,177 --> 00:21:52,441 WE HAVE TO BASICALLY TREAT THE PATIENT FOR WHATEVER THEY SAY. 398 00:21:52,485 --> 00:21:54,487 AND A LOT OF TIMES PATIENTS BECOME SO DROWSY 399 00:21:54,530 --> 00:21:56,967 THAT THEY'RE NOT AWARE OF HOW MUCH THEY'RE TAKING. 400 00:21:57,011 --> 00:22:00,275 ARE YOU OK?I'M SO UNCOMFORTABLE. 401 00:22:00,319 --> 00:22:02,059 AND I NEED TO PEE AGAIN. 402 00:22:02,103 --> 00:22:06,629 YOU NEED TO GET UP AND PEE? ALL RIGHT. 403 00:22:09,502 --> 00:22:11,373 OK, I NEED SOME HELP OVER HERE. 404 00:22:11,417 --> 00:22:13,375 THE PATIENT JUST FELL OFF THE LITTER. 405 00:22:13,419 --> 00:22:14,594 WAIT, WHAT? 406 00:22:14,637 --> 00:22:16,596 DID HE TRY TO GET UP WITHOUT ANYBODY KNOWING? 407 00:22:16,639 --> 00:22:20,382 NO, I TRIED GETTING HIM UP AND HE JUST ROLLED HIMSELF OUT. 408 00:22:20,426 --> 00:22:23,385 HE'S LIKE REALLY NOT LISTENING VERY WELL. 409 00:22:23,429 --> 00:22:26,083 YEAH, THAT'S WHY YOU DON'T WANT HIM TO FALL AGAIN. 410 00:22:26,127 --> 00:22:28,477 PROBABLY PUT HIM ON THE BOTTOM ON THE OTHER SIDE. 411 00:22:28,521 --> 00:22:30,349 I'M GONNA CHECK HIS CHART REAL QUICK 412 00:22:30,392 --> 00:22:34,527 AND FIND OUT WHAT HE GOT AT THE CASF. 413 00:22:34,570 --> 00:22:36,833 LET ME GET THAT JACKET AWAY FROM HIM. 414 00:22:36,877 --> 00:22:39,401 HE'S LIKE CLUTCHING HIS MEDS. 415 00:22:39,445 --> 00:22:42,317 HERE YOU GO. THIS IS WHAT HE'S GOT LEFT OF THE MORPHINE. 416 00:22:42,361 --> 00:22:44,450 HE WAS ISSUED A BOTTLE TODAY 417 00:22:44,493 --> 00:22:47,017 WITH 20 IN IT AND 10 ARE MISSING. 418 00:22:47,061 --> 00:22:48,323 HE'S TAKEN 10 TABLETS. 419 00:22:48,367 --> 00:22:50,194 THAT'S WHY.OH, MY GOD. 420 00:22:50,238 --> 00:22:51,326 THAT IS RIDICULOUS. 421 00:22:51,370 --> 00:22:54,851 THAT'S WHY HE'S A LITTLE HIGH RIGHT NOW. 422 00:22:54,895 --> 00:22:56,157 THAT'S THE POINT. 423 00:22:56,200 --> 00:22:57,593 HE COULD STOP BREATHING IF HE TOOK TOO MUCH 424 00:22:57,637 --> 00:23:00,030 NARCOTIC AND WE'RE GONNA BE DOING C.P.R. 425 00:23:00,074 --> 00:23:02,381 ON THE PATIENT, SO AT THIS POINT, 426 00:23:02,424 --> 00:23:04,383 WE WON'T ADMINISTER THE MEDICATION. 427 00:23:04,426 --> 00:23:05,993 WE MOVED YOU OVER HERE. 428 00:23:06,036 --> 00:23:07,386 TAKE THEM AWAY FROM HIM. 429 00:23:07,429 --> 00:23:09,039 DO YOU WANT TO DO A PILL COUNT WITH ME? 430 00:23:09,083 --> 00:23:10,693 WE'LL DO IT UP AT THE FRONT. 431 00:23:10,737 --> 00:23:12,260 OK. 432 00:23:12,303 --> 00:23:14,436 OK, SO, WE HAVE 10 DILAUDID. 433 00:23:14,480 --> 00:23:17,570 OK, THIS IS PRAZOSIN. 434 00:23:17,613 --> 00:23:19,180 HE'S GOT LUNESTA. 435 00:23:19,223 --> 00:23:21,225 AND HE ALSO HAS VALIUM. 436 00:23:21,269 --> 00:23:24,838 RIGHT HERE'S THE LORTAB, NAPROXEN. 437 00:23:24,881 --> 00:23:29,320 HE HAS PERCOCET AND HE HAS NORCO, WHICH IS PERCOCET. 438 00:23:29,364 --> 00:23:31,453 I'M NOT SURE WHAT IS WHAT. 439 00:23:31,497 --> 00:23:33,803 UM... 440 00:23:33,847 --> 00:23:34,717 THEY'RE NOT IN THERE? 441 00:23:34,761 --> 00:23:37,024 THESE ARE ALL NAME BRANDS.OH. 442 00:23:37,067 --> 00:23:39,156 THE ONLY THING WE CAN DO IS SEPARATE THEM OUT 443 00:23:39,200 --> 00:23:42,246 BECAUSE THERE'S NO WAY FOR US TO TELL WHICH ARE WHICH. 444 00:23:42,290 --> 00:23:43,683 THESE ARE ALL ONE PERSON'S? 445 00:23:43,726 --> 00:23:46,425 BUT THEY'RE COMBINED, SO WE DON'T KNOW WHAT THEY ARE. 446 00:24:12,668 --> 00:24:15,279 WHERE ARE YOU COMING FROM? 447 00:24:15,323 --> 00:24:16,324 AFGHANISTAN. 448 00:24:16,367 --> 00:24:18,500 AFGHANISTAN. HOW LONG WERE YOU THERE? 449 00:24:18,544 --> 00:24:19,632 9 MONTHS. 9 MONTHS? 450 00:24:19,675 --> 00:24:23,418 WE'RE GLAD TO HAVE YOU HOME. 451 00:24:27,466 --> 00:24:31,948 YOU WANNA TELL ME ABOUT SOME OF THOSE THAT YOU LOST? 452 00:24:33,167 --> 00:24:36,344 A PLATOON OF 23. 453 00:24:38,477 --> 00:24:42,524 CAME OFF THE MOUNTAIN WITH 8. 454 00:24:42,568 --> 00:24:46,354 OFF THE MOUNTAIN WITH ONLY 8? 455 00:24:47,616 --> 00:24:50,532 YOU'VE SEEN A LOT. 456 00:25:01,369 --> 00:25:04,503 LIFT, LIFT! LIFT! 457 00:25:05,982 --> 00:25:08,115 [INDISTINCT] GO! 458 00:25:32,182 --> 00:25:36,447 DARK MATTER IS A DISCOVERY BY ASTRONOMERS 459 00:25:36,491 --> 00:25:40,887 THAT THERE IS A HUGE AMOUNT OF THE UNIVERSE THAT WE CAN'T SEE. 460 00:25:40,930 --> 00:25:43,585 IT'S NOT VISIBLE, BUT IT'S THERE. 461 00:25:43,629 --> 00:25:44,543 WE KNOW IT'S THERE. 462 00:25:44,586 --> 00:25:46,936 AND IN SOME WAYS I THINK OF A LOT 463 00:25:46,980 --> 00:25:50,244 OF WHAT'S HAPPENING IN HEALTHCARE IS KIND OF DARK MATTER. 464 00:25:50,287 --> 00:25:52,463 IT'S UNSEEN, BUT IT'S THERE, 465 00:25:52,507 --> 00:25:53,900 AND IT'S VERY, VERY POWERFUL. 466 00:25:53,943 --> 00:25:57,643 WE TEND TO SEE JUST THE LIGHT OF HEALTHCARE. 467 00:25:57,686 --> 00:25:58,905 WE SEE THE GOODNESS OF HEALTHCARE, 468 00:25:58,948 --> 00:26:00,602 THE POTENTIAL FOR HELPING. 469 00:26:00,646 --> 00:26:03,910 WHEN I WAS AT "U.S. NEWS AND WORLD REPORT," 470 00:26:03,953 --> 00:26:05,912 I WROTE COVER STORIES ABOUT HOW GREAT 471 00:26:05,955 --> 00:26:07,957 THE NEWEST AND GREATEST TREATMENT 472 00:26:08,001 --> 00:26:09,872 AND PILL AND PROCEDURE WAS. 473 00:26:09,916 --> 00:26:12,266 BUT, IN FACT, THE MORE I LOOKED, 474 00:26:12,309 --> 00:26:14,398 THE MORE I FOUND THAT THERE'S ALL THIS STUFF 475 00:26:14,442 --> 00:26:20,230 IN MEDICINE THAT WE DON'T THINK ABOUT THAT IS ACTUALLY HARMFUL. 476 00:26:22,929 --> 00:26:25,018 WHEN A TEAM FROM DARTMOUTH MEDICAL SCHOOL 477 00:26:25,061 --> 00:26:26,933 MAPPED MEDICARE PAYMENTS, IT FOUND SOME 478 00:26:26,976 --> 00:26:29,370 DISCONCERTING DIFFERENCES FROM ONE PART 479 00:26:29,413 --> 00:26:31,938 OF THE COUNTRY TO ANOTHER. 480 00:26:31,981 --> 00:26:34,767 FOR EXAMPLE, IN 2007, 481 00:26:34,810 --> 00:26:36,638 THE AVERAGE MEDICARE RECIPIENT IN MIAMI 482 00:26:36,682 --> 00:26:40,773 TALLIED MORE THAN $15,000 IN HEALTHCARE BILLS, 483 00:26:40,816 --> 00:26:43,993 WHEREAS A RECIPIENT IN MINNEAPOLIS ONLY COST 484 00:26:44,037 --> 00:26:46,779 THE GOVERNMENT ABOUT HALF THAT AMOUNT. 485 00:26:46,822 --> 00:26:48,084 AND IT WASN'T BECAUSE PROCEDURES 486 00:26:48,128 --> 00:26:50,826 WERE MORE EXPENSIVE IN MIAMI THAN IN MINNEAPOLIS. 487 00:26:50,870 --> 00:26:53,524 THE DARTMOUTH STUDY SHOWED THAT PATIENTS 488 00:26:53,568 --> 00:26:57,877 IN PLACES LIKE MIAMI WERE RECEIVING MORE CARE, 489 00:26:57,920 --> 00:27:00,706 MORE TESTS, MORE DRUGS, 490 00:27:00,749 --> 00:27:02,403 MORE TIME IN THE HOSPITAL, 491 00:27:02,446 --> 00:27:03,926 MORE INVASIVE OPERATIONS, 492 00:27:03,970 --> 00:27:06,102 THAN PATIENTS IN OTHER PARTS OF THE COUNTRY, 493 00:27:06,146 --> 00:27:08,801 EVEN THOUGH THE PATIENTS IN MIAMI 494 00:27:08,844 --> 00:27:12,239 WEREN'T ANY SICKER THAN THEIR NEIGHBORS. 495 00:27:12,282 --> 00:27:14,197 BUT SO WHAT, RIGHT? 496 00:27:14,241 --> 00:27:15,590 WE WANT MORE SPECIALISTS. 497 00:27:15,634 --> 00:27:16,852 WE WANT MORE PROCEDURES. 498 00:27:16,896 --> 00:27:20,639 WE WANT MORE TESTS OR AT LEAST WE THINK WE DO. 499 00:27:20,682 --> 00:27:21,988 AND THAT'S THE PROBLEM 500 00:27:22,031 --> 00:27:26,253 BECAUSE WHAT WE THINK IS BEST FOR US OFTEN ISN'T. 501 00:27:26,296 --> 00:27:28,037 WHAT THE DARTMOUTH GROUP DISCOVERED 502 00:27:28,081 --> 00:27:30,823 IS THAT THE PATIENTS IN THE MOST COSTLY REGIONS, 503 00:27:30,866 --> 00:27:33,695 WHERE MEDICARE SPENT MORE MONEY ON PATIENTS, 504 00:27:33,739 --> 00:27:37,220 THOSE PATIENTS DID NOT HAVE BETTER HEALTH OUTCOMES. 505 00:27:37,264 --> 00:27:42,225 AND, IN FACT, THEY WERE MORE LIKELY TO DIE. 506 00:27:43,574 --> 00:27:45,881 IF YOU LOOK AT HEALTHCARE IN AMERICA, 507 00:27:45,925 --> 00:27:48,710 YOU'RE TWICE AS LIKELY TO GET YOUR KNEE REPLACED 508 00:27:48,754 --> 00:27:50,407 AS YOU ARE IN WESTERN COUNTRIES 509 00:27:50,451 --> 00:27:52,409 WITH THE SAME STANDARD OF LIVING. 510 00:27:52,453 --> 00:27:54,673 YOU'RE 2 OR 3 TIMES AS LIKELY TO GET 511 00:27:54,716 --> 00:27:55,935 A HEART CATHETERIZATION 512 00:27:55,978 --> 00:27:59,503 OR HAVE A STENT IN YOUR CORONARIES. 513 00:27:59,547 --> 00:28:03,246 WE'VE SET UP A SYSTEM THAT OFTEN PUSHES 514 00:28:03,290 --> 00:28:04,639 PHYSICIANS AND HOSPITALS 515 00:28:04,683 --> 00:28:08,338 AND THE ENTIRE HEALTHCARE SYSTEM INTO DOING MORE. 516 00:28:08,382 --> 00:28:11,733 DRIVEN BY THESE PERVERSE ECONOMIC INCENTIVES, 517 00:28:11,777 --> 00:28:16,738 WE ARE DOING A LOT OF PROCEDURES TO PEOPLE THAT THEY DON'T NEED. 518 00:28:16,782 --> 00:28:18,914 TO A MAN WITH A HAMMER, 519 00:28:18,958 --> 00:28:21,787 EVERYTHING LOOKS LIKE A NAIL. 520 00:28:28,663 --> 00:28:29,620 Woman: OK, READY? 521 00:28:29,664 --> 00:28:31,622 NOW, I'M GOING TO GET THE SCISSORS. 522 00:28:31,666 --> 00:28:33,233 Girl: YEAH. 523 00:28:33,929 --> 00:28:36,802 I STARTED GETTING SICK IN MY 30s. 524 00:28:36,845 --> 00:28:40,762 I STARTED HAVING REALLY, REALLY BAD CHEST PAIN. 525 00:28:40,806 --> 00:28:43,199 THERE WE GO, A FLOWER FOR YA. 526 00:28:43,243 --> 00:28:45,767 OH, IT'S SO BEAUTIFUL. 527 00:28:45,811 --> 00:28:50,119 I JUST HAD BEEN IGNORING IT BECAUSE I THOUGHT, 528 00:28:50,163 --> 00:28:52,034 YOU KNOW, I'M ONLY 34 YEARS OLD, 529 00:28:52,078 --> 00:28:55,472 I CAN'T BE HAVING HEART PROBLEMS. 530 00:28:55,516 --> 00:28:58,737 BUT ONE EVENING I SAT STRAIGHT UP IN BED 531 00:28:58,780 --> 00:29:00,782 WITH THE WORST CHEST PAIN. 532 00:29:00,826 --> 00:29:03,306 SO, I WENT INTO THE HOSPITAL 533 00:29:03,350 --> 00:29:06,832 AND THEY TOLD ME I'D HAD A HEART ATTACK. 534 00:29:06,875 --> 00:29:08,790 I WAS 35 AT THE TIME 535 00:29:08,834 --> 00:29:11,358 AND WAS SCHEDULED FOR OPEN HEART SURGERY. 536 00:29:11,401 --> 00:29:13,926 AND I THOUGHT, ONCE I GET THIS, 537 00:29:13,969 --> 00:29:15,841 I WON'T HAVE THE BLOCKAGES ANYMORE, 538 00:29:15,884 --> 00:29:17,320 YOU KNOW, THEY'LL ACTUALLY FIX IT. 539 00:29:17,364 --> 00:29:19,801 LITTLE DID I KNOW THAT IT WAS FOLLOWED BY YEARS 540 00:29:19,845 --> 00:29:22,238 OF THE SAME THING OVER AND OVER AND OVER AGAIN. 541 00:29:22,282 --> 00:29:23,587 A HEART CATH, GET ANOTHER STENT. 542 00:29:23,631 --> 00:29:25,502 HEART CATH, GET ANOTHER STENT. 543 00:29:25,546 --> 00:29:27,026 UNTIL MY DOCTOR SAID TO ME, 544 00:29:27,069 --> 00:29:28,810 I DON'T KNOW WHAT ELSE TO DO FOR YOU. 545 00:29:28,854 --> 00:29:32,205 THERE'S NOTHING ELSE I CAN DO. 546 00:29:32,466 --> 00:29:35,512 CONTRARY TO WHAT MOST PEOPLE BELIEVE, 547 00:29:35,556 --> 00:29:37,166 GETTING A STENT IN YOUR CORONARY, 548 00:29:37,210 --> 00:29:39,386 IF YOU HAVE STABLE CHEST PAIN, 549 00:29:39,429 --> 00:29:40,735 WILL LIKELY RELIEVE YOUR PAIN, 550 00:29:40,779 --> 00:29:43,477 BUT IT WILL NOT HELP YOU LIVE LONGER 551 00:29:43,520 --> 00:29:47,481 AND IT WILL NOT PROTECT YOU FROM HAVING A HEART ATTACK. 552 00:29:47,524 --> 00:29:49,875 IT ONLY REDUCES SYMPTOMS. 553 00:29:49,918 --> 00:29:56,446 AND THE PROBLEM IS, IS THAT SOME OF THOSE PROCEDURES WILL LEAD TO BAD OUTCOMES. 554 00:29:58,361 --> 00:30:03,323 I HAD STARTED DOING RESEARCH ABOUT WHERE IN THE UNITED STATES 555 00:30:03,366 --> 00:30:05,020 DO I HAVE TO GO TO GET THE BEST HEART CARE 556 00:30:05,064 --> 00:30:10,417 AND, IRONICALLY, IT WAS ONLY 2 HOURS AWAY AT THE CLEVELAND CLINIC. 557 00:30:11,853 --> 00:30:13,376 HOW ARE YOU? 558 00:30:13,420 --> 00:30:14,421 I AM GREAT. 559 00:30:14,464 --> 00:30:15,422 LOOK AT THE THINNESS. 560 00:30:15,465 --> 00:30:16,771 I KNOW. YOU LOOK REALLY GOOD. 561 00:30:16,815 --> 00:30:18,817 I HAVE LOST--SINCE LAST YEAR I HAVE LOST 21 POUNDS. 562 00:30:18,860 --> 00:30:20,427 OH, MY GOD. 563 00:30:20,470 --> 00:30:21,907 YVONNE CAME TO SEE ME WHEN SHE WAS SORT OF AT HER WIT'S END. 564 00:30:21,950 --> 00:30:24,997 SHE HAD HAD A BYPASS SURGERY AT AN EARLY AGE, 565 00:30:25,040 --> 00:30:30,829 27 CARDIAC CATHETERIZATIONS, AND WELL OVER 7 STENTS. 566 00:30:30,872 --> 00:30:32,482 DEEP BREATH. 567 00:30:32,526 --> 00:30:38,010 THIS IS JUST AN UNBELIEVABLE AMOUNT OF STENTS AND CARDIAC CATHS. 568 00:30:38,053 --> 00:30:40,577 I'M SORRY, IT'S GONNA GET PRETTY TIGHT. 569 00:30:40,621 --> 00:30:41,970 OH, IT'S ALL RIGHT. 570 00:30:42,014 --> 00:30:44,886 I CAN'T TELL YOU HOW SHOCKED WE WERE WHEN WE SAW HER 571 00:30:44,930 --> 00:30:47,889 THE FIRST TIME BECAUSE HERE WAS A YOUNG WOMAN, 572 00:30:47,933 --> 00:30:50,457 WHOSE DIABETES WAS NOT WELL CONTROLLED. 573 00:30:50,500 --> 00:30:52,024 HER CHOLESTEROL WAS NEVER WELL CONTROLLED 574 00:30:52,067 --> 00:30:54,635 AND HER HIGH BLOOD PRESSURE WAS NEVER WELL CONTROLLED. 575 00:30:54,678 --> 00:30:56,028 BREATHE NORMALLY FOR ME. 576 00:30:56,071 --> 00:30:57,986 IF SOMEONE HAD TALKED TO HER, I THINK SOMEONE 577 00:30:58,030 --> 00:30:59,945 HAD REALLY TEASED OUT HER CHEST PAIN 578 00:30:59,988 --> 00:31:01,163 AND HER SHORTNESS OF BREATH, 579 00:31:01,207 --> 00:31:03,513 I THINK MANY OF HER CARDIAC CATHETERIZATIONS 580 00:31:03,557 --> 00:31:05,385 AND STENTS WOULD NOT HAVE BEEN NECESSARY. 581 00:31:05,428 --> 00:31:06,777 YOU KNOW, YOU HAVE ALL THESE STENTS 582 00:31:06,821 --> 00:31:08,692 AND, YOU KNOW, THESE STENTS, ONCE THEY GO IN, 583 00:31:08,736 --> 00:31:10,346 THEY NEVER COME OUT, AND THEY'RE PART OF YOU. 584 00:31:10,390 --> 00:31:13,915 NOW, WE'RE KIND OF DEALING WITH THE CONSEQUENCES. 585 00:31:16,962 --> 00:31:20,748 WHEN YOU REWARD PHYSICIANS FOR DOING PROCEDURES, 586 00:31:20,791 --> 00:31:21,967 INSTEAD OF TALKING TO PATIENTS, 587 00:31:22,010 --> 00:31:25,187 THAT'S WHAT THEY'RE GONNA DO IS DO PROCEDURES. 588 00:31:25,231 --> 00:31:29,148 THE VAST MAJORITY OF DOCTORS IN THIS COUNTRY 589 00:31:29,191 --> 00:31:31,933 ARE PAID BY A FEE FOR SERVICE SYSTEM. 590 00:31:31,977 --> 00:31:34,893 AND THAT SIMPLY MEANS THAT THEY GET PAID FOR EACH OFFICE VISIT. 591 00:31:34,936 --> 00:31:40,420 IF THEY'RE SURGEONS, THEY GET PAID FOR EACH PROCEDURE. 592 00:31:41,029 --> 00:31:42,944 IF IT'S A RADIOLOGIST, 593 00:31:42,988 --> 00:31:47,427 THEY GET PAID FOR EACH C.T. SCAN THAT THEY DELIVER. 594 00:31:47,731 --> 00:31:49,559 IF I SPENT 5 MINUTES WITH YOU 595 00:31:49,603 --> 00:31:51,648 AND THEN PUT IN ONE OF THESE STENTS, 596 00:31:51,692 --> 00:31:54,782 PROBABLY GET PAID $1,500. 597 00:31:55,043 --> 00:31:58,525 FOR ME TO SPEND 45 MINUTES ON AN ESTABLISHED VISIT 598 00:31:58,568 --> 00:32:01,920 WITH A PATIENT TO MAKE SURE THEY'RE DOING THEIR EXERCISE, 599 00:32:01,963 --> 00:32:03,747 MAKE SURE THEIR DIABETES IS GOING OK, 600 00:32:03,791 --> 00:32:07,447 AND TO TRY TO FIGURE OUT WHAT THEIR TRUE PROBLEM IS, 601 00:32:07,490 --> 00:32:10,189 PROBABLY GET PAID $15. 602 00:32:11,930 --> 00:32:15,542 IT'S A COMPLETELY IRRATIONAL SYSTEM. 603 00:32:15,585 --> 00:32:21,069 FEE FOR SERVICE REWARDS PHYSICIANS FOR DOING MORE. 604 00:32:21,113 --> 00:32:23,158 IT DOESN'T REWARD THEM FOR DOING A BETTER JOB. 605 00:32:23,202 --> 00:32:26,727 IT DOESN'T REWARD THEM FOR KEEPING THEIR PATIENTS HEALTHY. 606 00:32:26,770 --> 00:32:30,905 IT REWARDS THEM FOR DELIVERING MORE CARE. 607 00:32:32,907 --> 00:32:35,910 I WAS TRYING TO FIGURE OUT HOW MUCH YVONNE'S CARE 608 00:32:35,954 --> 00:32:37,172 WOULD HAVE BEEN OVER THE YEARS 609 00:32:37,216 --> 00:32:41,263 AND I THINK IT'S WELL OVER $1.5 MILLION... 610 00:32:41,916 --> 00:32:43,483 BUT IT'S MORE THAN COST. 611 00:32:43,526 --> 00:32:45,528 IT'S JUST SO MUCH MORE THAN MONEY. 612 00:32:45,572 --> 00:32:51,839 THE PSYCHOLOGICAL TRAUMA OF EVERY ONE OF THOSE MULTIPLE CARDIO CATHETERIZATIONS, 613 00:32:51,882 --> 00:32:54,842 EVERY TIME SHE HAD A CHEST PAIN, COMING INTO THE E.R., 614 00:32:54,885 --> 00:33:01,675 AND, UNFORTUNATELY, THERE ARE LOTS OF YVONNES OUT THERE. 615 00:33:12,425 --> 00:33:14,731 ALTHOUGH WE'VE MADE PROGRESS TECHNOLOGICALLY, YOU KNOW, 616 00:33:14,775 --> 00:33:17,256 WE KNOW HOW TO DO THINGS FOR DISEASES WE COULDN'T HAVE DONE BEFORE, 617 00:33:17,299 --> 00:33:20,911 WE HAVEN'T REALLY EXPERIENCED THE SYSTEMIC IMPROVEMENT 618 00:33:20,955 --> 00:33:24,828 THAT WE WANT THE NEW HEALTHCARE SYSTEM, THAT WE'RE REALLY AFTER. 619 00:33:26,439 --> 00:33:27,831 WE PAY FOR FRAGMENTS OF CARE. 620 00:33:27,875 --> 00:33:29,572 A DOCTOR VISIT, A HOSPITAL STAY, 621 00:33:29,616 --> 00:33:32,097 A LAB TEST, AN AMBULANCE TRIP, 622 00:33:32,140 --> 00:33:33,837 SO BECAUSE WE PAY FOR PIECES, 623 00:33:33,881 --> 00:33:37,102 WE HAVE PIECES AND SO PEOPLE WHO REALLY NEED A COORDINATED SYSTEM, 624 00:33:37,145 --> 00:33:38,190 THEY DON'T GET THAT. 625 00:33:38,233 --> 00:33:40,888 MEDICINE IS VERY [INDISTINCT] NOW. 626 00:33:40,931 --> 00:33:43,369 MEDICINE IS VERY SPECIALIZED. 627 00:33:43,412 --> 00:33:45,023 AND THIS IS REALLY A BIG PROBLEM 628 00:33:45,066 --> 00:33:47,764 WHEN YOU GO TO THE HOSPITAL BECAUSE 629 00:33:47,808 --> 00:33:49,636 THERE ARE SO MANY DIFFERENT PEOPLE 630 00:33:49,679 --> 00:33:52,073 WHO LAY THEIR HANDS ON YOU AND IF THEY'RE NOT 631 00:33:52,117 --> 00:33:56,773 TALKING TO EACH OTHER, YOU CAN'T NECESSARILY GET THE RIGHT DIAGNOSIS. 632 00:33:56,817 --> 00:33:58,514 YOU CAN GET REPEATED TESTS. 633 00:33:58,558 --> 00:34:00,516 YOU CAN GET THINGS HAPPENING TO YOU 634 00:34:00,560 --> 00:34:04,781 THAT PUT YOU IN HARMS WAY BECAUSE NOBODY'S REALLY KEEPING TRACK 635 00:34:04,825 --> 00:34:08,307 OF YOU AS AN INDIVIDUAL PATIENT. 636 00:34:08,785 --> 00:34:13,181 A RECENT STUDY FOUND THAT 187,000 PATIENTS DIE 637 00:34:13,225 --> 00:34:15,270 EACH YEAR FROM HARMFUL CARE IN THE HOSPITAL, 638 00:34:15,314 --> 00:34:19,535 WHICH INCLUDES MEDICAL ERRORS AND DEADLY INFECTIONS. 639 00:34:19,579 --> 00:34:21,537 BASED ON THESE NUMBERS, 640 00:34:21,581 --> 00:34:24,540 THIS WOULD BE THE THIRD LEADING CAUSE OF DEATH 641 00:34:24,584 --> 00:34:25,585 IN THE UNITED STATES, 642 00:34:25,628 --> 00:34:28,979 JUST AFTER HEART DISEASE AND CANCER. 643 00:34:49,826 --> 00:34:51,828 HELLO. DR. ROSS. 644 00:34:51,872 --> 00:34:54,353 I AM BACK IN THE CHEST PAIN CENTER 645 00:34:54,396 --> 00:34:56,137 WITH A PRETTY SICK PATIENT 646 00:34:56,181 --> 00:34:58,705 AND I'M GONNA NEED YOU TO CALL ATTENDING PHONE, TOO. 647 00:34:58,748 --> 00:35:04,972 THE EMERGENCY DEPARTMENT IS THE SAFETY NET OF HEALTHCARE. 648 00:35:05,015 --> 00:35:09,585 WE SEE A LOT OF THE CHRONIC CONDITIONS THAT EFFECT 649 00:35:09,629 --> 00:35:12,545 MANY AMERICANS THAT HAVE GONE UNTREATED 650 00:35:12,588 --> 00:35:16,549 FOR SOMETIMES MONTHS, BUT SOMETIMES YEARS. 651 00:35:16,592 --> 00:35:19,247 AND, OF COURSE, THE NATURAL END POINT 652 00:35:19,291 --> 00:35:22,381 IS GOING TO BE IN THE EMERGENCY DEPARTMENT. 653 00:35:22,424 --> 00:35:25,514 LET ME JUST TAKE A LISTEN TO YOU. 654 00:35:25,558 --> 00:35:29,736 IT WOULD BE SO WONDERFUL IF THEIR CHRONIC HEALTH CONDITIONS 655 00:35:29,779 --> 00:35:35,698 COULD BE PREVENTED THROUGH EFFECTIVE PRIMARY CARE. 656 00:35:36,395 --> 00:35:38,005 THERE'S A SAYING IN HEALTHCARE POLICY 657 00:35:38,048 --> 00:35:42,531 THAT 20% OF THE PATIENTS ACCOUNT FOR 80% OF THE COSTS 658 00:35:42,575 --> 00:35:43,706 AND THE MAJORITY OF THOSE COSTS 659 00:35:43,750 --> 00:35:45,926 ARE WHEN THEY ARE REPEATEDLY HOSPITALIZED. 660 00:35:45,969 --> 00:35:48,058 THEY'RE PATIENTS WITH HEART FAILURE, 661 00:35:48,102 --> 00:35:50,104 THEY'RE MORBIDLY OBESE PATIENTS. 662 00:35:50,148 --> 00:35:54,239 THEY ARE OFTEN POOR PATIENTS, BUT NOT ALWAYS. 663 00:35:54,282 --> 00:35:56,632 ONE OF THE WAYS TO THINK ABOUT SAVING MONEY 664 00:35:56,676 --> 00:36:00,593 IN HEALTHCARE IS TO FOCUS OUR ENERGIES ON THAT 20% 665 00:36:00,636 --> 00:36:01,855 OF PATIENTS AND THINK ABOUT TREATING 666 00:36:01,898 --> 00:36:06,076 THOSE PEOPLE IN A MORE EFFECTIVE WAY. 667 00:36:06,120 --> 00:36:08,601 I JUST WANT TO REVIEW THIS PAIN. 668 00:36:08,644 --> 00:36:11,081 IT'S HERE RIGHT IN THE CENTER OF YOUR CHEST. 669 00:36:11,125 --> 00:36:13,519 OK. AND IS IT STILL TRAVELING INTO YOUR NECK? 670 00:36:13,562 --> 00:36:16,391 IT'S TRAVELING DOWN MY ARM AND MY NECK, 671 00:36:16,435 --> 00:36:18,698 AND MY HEAD AND EARS ARE BUZZING AND RINGING. 672 00:36:18,741 --> 00:36:20,439 OK. WHAT WAS IT, MR. LITTON, 673 00:36:20,482 --> 00:36:23,877 THAT FINALLY MADE YOU SAY, OK, THAT'S IT? 674 00:36:23,920 --> 00:36:25,487 I'M GOING TO THE EMERGENCY DEPARTMENT. 675 00:36:25,531 --> 00:36:27,141 YOU SEE, I'VE BEEN TO THE EMERGENCY DEPARTMENT 676 00:36:27,185 --> 00:36:31,493 A FEW TIMES BEFORE AND THE LAST TIME I WAS HAVING CHEST PAINS, 677 00:36:31,537 --> 00:36:34,061 NOT LIKE THIS, THIS IS A LOT WORSE, 678 00:36:34,104 --> 00:36:35,367 THEY SENT ME HOME WITH THEM. 679 00:36:35,410 --> 00:36:36,411 HOW LONG AGO WAS THAT? 680 00:36:36,455 --> 00:36:39,240 THAT WAS A MONTH AND A HALF AGO. 681 00:36:39,284 --> 00:36:41,068 WHEN I HAD MY FIRST HEART ATTACK, 682 00:36:41,111 --> 00:36:43,026 DID THE CARDIAC CATHETERIZATION, YOU KNOW, 683 00:36:43,070 --> 00:36:44,941 PUT THE THING UP THERE AND THEN PUT A STENT IN MY HEART 684 00:36:44,985 --> 00:36:47,988 BECAUSE I HAD A CLOGGED ARTERY, 685 00:36:48,031 --> 00:36:50,295 AND THAT WORKED FOR A WHILE. 686 00:36:50,338 --> 00:36:53,036 I MEAN, FOR A COUPLE OF WEEKS I FELT LIKE I WAS OK, 687 00:36:53,080 --> 00:36:55,561 AND THEN ALL OF A SUDDEN I STARTED GETTING CHEST PAINS. 688 00:36:55,604 --> 00:36:57,476 SO, HERE I HAM GOING IN AND OUT OF THE HOSPITAL 689 00:36:57,519 --> 00:36:59,086 TO FIND OUT WHAT'S GOING ON. 690 00:36:59,129 --> 00:37:00,783 DO YOU HAVE ANY EATING HABITS 691 00:37:00,827 --> 00:37:01,871 THAT YOU THINK MIGHT BE-- 692 00:37:01,915 --> 00:37:03,046 NO, I EAT THE REGULAR FOOD AND STUFF. 693 00:37:03,090 --> 00:37:04,570 WHAT'S THE REGULAR FOOD? 694 00:37:04,613 --> 00:37:06,572 EGGS, SAUSAGE, GRITS, BACON. 695 00:37:06,615 --> 00:37:09,314 WELL, WHAT DO YOU THINK ABOUT YOUR DIET? 696 00:37:09,357 --> 00:37:10,271 A HEALTHY DIET?YEAH. 697 00:37:10,315 --> 00:37:12,055 WHAT DO YOU THINK ABOUT THAT? 698 00:37:12,099 --> 00:37:13,492 I'D DO IT IF I HAD TO. 699 00:37:13,535 --> 00:37:14,710 IF YOU HAD TO. 700 00:37:14,754 --> 00:37:17,409 WELL, YOU HAVE A STENT IN YOUR HEART, RIGHT? 701 00:37:17,452 --> 00:37:19,149 YEAH. ALL RIGHT. 702 00:37:19,193 --> 00:37:23,502 AND YOU'VE HAD HEART ATTACKS AND YOU'RE HERE TODAY WITH CHEST PAIN, 703 00:37:23,545 --> 00:37:27,506 WHEN DO YOU THINK IT WOULD BE GOOD TO TRY IT? 704 00:37:27,549 --> 00:37:31,292 ONCE I FOUND OUT WHAT'S REALLY WRONG WITH ME. 705 00:37:31,336 --> 00:37:34,556 WE'VE BECOME A CULTURE WHERE YOU DRIVE UP, 706 00:37:34,600 --> 00:37:36,471 YOU GET WHAT YOU WANT, YOU GET IT FAST, 707 00:37:36,515 --> 00:37:38,473 YOU GET IT RIGHT AWAY, AND YOU DRIVE OFF. 708 00:37:38,517 --> 00:37:44,000 AND THAT BEING A CLIENT TO HEALTHCARE JUST DOESN'T WORK. 709 00:37:44,044 --> 00:37:47,439 MOST DISEASES DON'T HAPPEN OVER NIGHT. 710 00:37:47,482 --> 00:37:50,006 SOMETIMES THEY'RE RELATED TO LIFESTYLE HABITS. 711 00:37:50,050 --> 00:37:56,752 SOMETIMES IT'S RELATED TO WHAT THE INDIVIDUALS ACTUALLY HAVE ACCESS TO. 712 00:38:04,760 --> 00:38:08,329 I HAVE NO HEALTH INSURANCE. 713 00:38:08,373 --> 00:38:10,331 SOME DAYS I GO TO THE HOSPITAL 714 00:38:10,375 --> 00:38:13,334 AND THAT'S THE ONLY HEALTHCARE I EVER GOT. 715 00:38:13,378 --> 00:38:17,077 I NEVER HAD A PERSONAL DOCTOR, FAMILY DOCTOR, 716 00:38:17,120 --> 00:38:19,340 NOTHING, ALL MY LIFE. 717 00:38:21,473 --> 00:38:23,823 I STOPPED TAKING MY MEDICINE MONTHS AGO 718 00:38:23,866 --> 00:38:27,305 BECAUSE IT WAS TOO MUCH, CAN'T AFFORD IT. 719 00:38:27,653 --> 00:38:30,395 IF YOU GO OUT AND BUY HEART HEALTHY DIET FOOD, 720 00:38:30,438 --> 00:38:34,312 IT'S GONNA COST YOU MORE MONEY THAN ANYTHING. 721 00:38:40,361 --> 00:38:43,451 HIPPOCRATES SAID, LET FOOD BE YOUR MEDICINE 722 00:38:43,495 --> 00:38:44,583 AND MEDICINE BE YOUR FOOD, 723 00:38:44,626 --> 00:38:47,194 AND I THINK THAT'S A GOOD PLACE TO START. 724 00:38:47,237 --> 00:38:50,632 AS A SOCIETY WE HAVE TO MAKE IT EASIER AND MORE AFFORDABLE 725 00:38:50,676 --> 00:38:55,289 FOR PEOPLE TO MAKE BETTER LIFESTYLE CHOICES THAN WORSE ONES. 726 00:38:57,422 --> 00:38:59,293 [DOOR DINGS] 727 00:39:00,381 --> 00:39:03,558 THERE'S THE BRIGHT BLUE SLUSH. 728 00:39:04,167 --> 00:39:07,127 THIS IS RESPONSIBLE FOR INSULIN RESISTANCE 729 00:39:07,170 --> 00:39:08,998 AND METABOLIC SYNDROME AND OBESITY 730 00:39:09,042 --> 00:39:10,739 AND THE ARTIFICIAL COLORS ARE NOT GOOD FOR YOU. 731 00:39:10,783 --> 00:39:15,657 THIS IS A MAJOR REASON WHY WE SEE KIDS GETTING FAT IN THIS COUNTRY. 732 00:39:15,701 --> 00:39:18,138 LET'S SEE WHAT WE GOT HERE. 733 00:39:18,181 --> 00:39:22,142 ONE OF THE GREAT CONTRIBUTIONS IN AMERICA TO WORLD CUISINE, 734 00:39:22,185 --> 00:39:24,231 YOU KNOW, FAKE BREAD. 735 00:39:24,274 --> 00:39:27,365 WE TAKE GRAINS AND WE'VE TURNED THEM INTO PRODUCTS 736 00:39:27,408 --> 00:39:30,324 LIKE THIS WHICH RAPIDLY RAISE BLOOD SUGAR, 737 00:39:30,368 --> 00:39:31,630 PROVOKE INSULIN RESPONSES, 738 00:39:31,673 --> 00:39:34,023 CAUSE INSULIN RESISTANCE AND PROMOTE WEIGHT GAIN 739 00:39:34,067 --> 00:39:36,330 IN GENETICALLY-SUSCEPTIBLE PEOPLE, WHICH IS MOST OF US. 740 00:39:36,374 --> 00:39:40,247 SOME PEOPLE, THIS IS ALL THEY EAT IS FOOD OF THIS SORT. 741 00:39:40,290 --> 00:39:42,728 IT'S NOT WHOLE FOOD AS NATURE PRODUCES IT, 742 00:39:42,771 --> 00:39:47,385 IT'S COMPLETELY CHANGED FOOD AND, YOU KNOW, 743 00:39:47,428 --> 00:39:50,257 AND OUR GRANDPARENTS DID NOT EAT STUFF LIKE THIS. 744 00:39:50,300 --> 00:39:53,216 WE HAVE MADE ALL OF THIS UNHEALTHY FOOD 745 00:39:53,260 --> 00:39:55,001 THE CHEAPEST AND MOST AVAILABLE FOOD. 746 00:39:55,044 --> 00:39:58,439 PEOPLE EAT WHAT'S CHEAP AND WHAT'S AVAILABLE. 747 00:39:58,961 --> 00:40:00,920 McDONALD'S PUT SALADS ON THE MENU, 748 00:40:00,963 --> 00:40:03,488 BUT AS IT TURNS OUT, THE SALAD IS $6.00, 749 00:40:03,531 --> 00:40:04,445 THE BURGER IS 99 CENTS, 750 00:40:04,489 --> 00:40:05,794 AND IF YOU'RE ON A FIXED INCOME, 751 00:40:05,838 --> 00:40:08,101 WHAT ARE YOU GONNA DO FOR YOUR FAMILY? 752 00:40:08,144 --> 00:40:10,277 THESE CALORIES ARE CHEAP ONLY WHEN YOU BUY THEM, 753 00:40:10,320 --> 00:40:13,280 BUT IF YOU LOOK AT THE OVERALL COST TO SOCIETY 754 00:40:13,323 --> 00:40:15,064 OF THESE CHEAP CALORIES THAT ARE SO JUNKY, 755 00:40:15,108 --> 00:40:17,284 THEY'RE REALLY THE MOST EXPENSIVE. 756 00:40:17,327 --> 00:40:21,723 IT'S SCARY HOW FAST OBESITY IS SPREADING IN OUR COUNTRY. 757 00:40:21,767 --> 00:40:27,599 OBESITY LEADS TO HEART DISEASE AND STROKES AND DIABETES. 758 00:40:27,642 --> 00:40:30,689 IF TRENDS CONTINUE THROUGH 2020, 759 00:40:30,732 --> 00:40:33,343 UP TO 1/5 OF HEALTHCARE SPENDING, 760 00:40:33,387 --> 00:40:35,998 OR ALMOST A TRILLION DOLLARS ANNUALLY, 761 00:40:36,042 --> 00:40:37,260 WILL BE DEVOTED TO TREATING 762 00:40:37,304 --> 00:40:41,003 THE CONSEQUENCES OF OBESITY. 763 00:40:45,486 --> 00:40:47,445 IF YOU WANT TO UNDERSTAND HOW AMERICANS 764 00:40:47,488 --> 00:40:49,490 ARE GETTING MORE AND MORE OVERWEIGHT, 765 00:40:49,534 --> 00:40:52,275 IT'S BECAUSE WE HAVEN'T REALLY RETHOUGHT THINGS 766 00:40:52,319 --> 00:40:54,539 THAT WERE PUT INTO PLACE A LONG TIME AGO 767 00:40:54,582 --> 00:40:55,714 WHEN NOBODY REALLY THOUGHT 768 00:40:55,757 --> 00:40:58,630 WHAT THE UNINTENDED CONSEQUENCES MIGHT BE. 769 00:40:58,673 --> 00:41:03,461 THE DEPARTMENT OF AGRICULTURE SUBSIDIZES ALL THE WRONG FOODS. 770 00:41:03,504 --> 00:41:06,855 WE SUBSIDIZE CORN, WE SUBSIDIZE SUGAR, WE SUBSIDIZE WHEAT. 771 00:41:06,899 --> 00:41:08,378 WE DON'T SUBSIDIZE CARROTS. 772 00:41:08,422 --> 00:41:11,294 WE DON'T SUBSIDIZE CELERY AND WE DON'T SUBSIDIZE APPLES. 773 00:41:11,338 --> 00:41:13,471 YOU CAN LAY IT AT THE FEET OF A GUY NAMED RUSTY BUTZ. 774 00:41:13,514 --> 00:41:19,128 HE WAS THE SECRETARY OF AGRICULTURE DURING THE NIXON ADMINISTRATION. 775 00:41:19,172 --> 00:41:21,566 HE WAS THE ONE WHO THOUGHT THAT WE SHOULD SUBSIDIZE 776 00:41:21,609 --> 00:41:24,394 COMMODITIES BECAUSE IT WOULD ALLOW US TO SELL 777 00:41:24,438 --> 00:41:26,527 THESE COMMODITIES ON INTERNATIONAL MARKETS 778 00:41:26,571 --> 00:41:31,489 AND WE'VE MADE ONE HECK OF A LOT OF MONEY. 779 00:41:31,532 --> 00:41:33,534 THE OTHER REASON WE SUBSIDIZE CERTAIN THINGS 780 00:41:33,578 --> 00:41:36,232 IS BECAUSE THEY HAVE POWERFUL LOBBIES. 781 00:41:36,276 --> 00:41:39,497 THE MONEY THAT'S INVOLVED ENDS UP BEING 782 00:41:39,540 --> 00:41:44,502 FUNNELED TOWARDS CONGRESS AND CONGRESS DOESN'T WANT TO FIX IT. 783 00:41:59,342 --> 00:42:00,561 THE AMERICAN HEALTHCARE SYSTEM, 784 00:42:00,605 --> 00:42:03,521 IT'S GENERATING RIVERS OF MONEY THAT ARE FLOWING 785 00:42:03,564 --> 00:42:05,261 INTO VERY FEW POCKETS, 786 00:42:05,305 --> 00:42:07,829 AND THOSE ARE THE POCKETS OF THE MANUFACTURERS OF MEDICAL DEVICES, 787 00:42:07,873 --> 00:42:10,440 THE BIG INSURERS, THE PHARMACEUTICAL COMPANIES, 788 00:42:10,484 --> 00:42:11,920 AND THE OWNERS OF THOSE POCKETS 789 00:42:11,964 --> 00:42:16,055 DO NOT WANT ANYTHING TO FUNDAMENTALLY CHANGE. 790 00:42:26,544 --> 00:42:30,417 I DON'T RECALL ANYTIME TELLING A LIE, 791 00:42:30,460 --> 00:42:32,375 BUT I KNOW THAT THERE WERE MANY TIMES 792 00:42:32,419 --> 00:42:36,379 THAT I DIDN'T DISCLOSE FULL INFORMATION. 793 00:42:36,423 --> 00:42:38,904 I WAS THE COMPANY'S CHIEF SPOKESMAN. 794 00:42:38,947 --> 00:42:40,645 I WAS HEAD OF CORPORATE COMMUNICATIONS, 795 00:42:40,688 --> 00:42:44,692 WHICH MEANS I WAS THE TOP PUBLIC RELATIONS OFFICER FOR THE COMPANY. 796 00:42:44,736 --> 00:42:47,390 WHEN YOU'RE IN THE INNER CIRCLE OF A HEALTH INSURANCE COMPANY, 797 00:42:47,434 --> 00:42:50,480 WHAT'S MOST IMPORTANT IS MEETING WALL STREET'S EXPECTATIONS. 798 00:42:50,524 --> 00:42:54,441 AND THEY HAVE TO, THESE FOR-PROFIT COMPANIES, BY LAW, 799 00:42:54,484 --> 00:42:57,052 HAVE TO SERVE THE SHAREHOLDERS. 800 00:42:57,096 --> 00:42:59,185 PEOPLE GO IN AND OUT OF HEALTH PLANS. 801 00:42:59,228 --> 00:43:04,625 THEY MAY BE A MEMBER OF A HEALTH PLAN FOR A YEAR AND MAYBE NO LONGER. 802 00:43:04,669 --> 00:43:07,367 YOU DON'T NECESSARILY MAKE A LOT OF INVESTMENTS 803 00:43:07,410 --> 00:43:11,240 IN PREVENTIVE CARE FOR SOMEONE WHO'S NOT GOING TO BE A PART 804 00:43:11,284 --> 00:43:14,156 OF YOUR HEALTH PLAN FOR A LONG PERIOD OF TIME. 805 00:43:14,200 --> 00:43:16,071 IT JUST DOESN'T WORK OUT FINANCIALLY. 806 00:43:16,115 --> 00:43:20,685 THE ONLY WAY THAT YOU CAN CONTINUE TO MAKE THE PROFITS 807 00:43:20,728 --> 00:43:21,860 THAT YOU ARE EXPECTED TO MAKE 808 00:43:21,903 --> 00:43:25,341 IS TO CHARGE MORE FOR THE POLICIES. 809 00:43:25,385 --> 00:43:28,127 INSURANCE COMPANIES HAVE ALWAYS BEEN ABLE 810 00:43:28,170 --> 00:43:29,650 TO REGULATE THE RATES THEY CHARGE. 811 00:43:29,694 --> 00:43:31,086 THEY CAN PRETTY MUCH GET AWAY 812 00:43:31,130 --> 00:43:35,351 WITH INCREASING THE RATES AS MUCH AS THEY WANT TO. 813 00:43:52,238 --> 00:43:56,851 YOU ALMOST FORGET THAT WHAT YOU'RE DOING IS PROVIDING HEALTH INSURANCE. 814 00:43:56,895 --> 00:43:59,245 IT'S ALL ABOUT THE NUMBERS AND HOW MANY MILLIONS OF DOLLARS, 815 00:43:59,288 --> 00:44:04,511 IF NOT BILLIONS OF DOLLARS, YOU'RE EARNING IN PROFITS. 816 00:44:07,253 --> 00:44:11,257 IN THE SUMMER OF 2007, I READ ABOUT A HEALTHCARE EXPEDITION 817 00:44:11,300 --> 00:44:13,999 THAT WAS BEING HELD BY REMOTE AREA MEDICAL 818 00:44:14,042 --> 00:44:16,828 A FEW MILES FROM WHERE I GREW UP. 819 00:44:18,830 --> 00:44:23,225 I DECIDED OUT OF CURIOSITY TO GO CHECK THIS OUT. 820 00:44:23,269 --> 00:44:26,925 ALL THESE FOLKS HAVE DRIVEN FROM 4 AND 500 MILES AWAY 821 00:44:26,968 --> 00:44:31,712 WAITING TO GET CARE THAT'S BEING PROVIDED TO THEM FREE. 822 00:44:31,756 --> 00:44:34,323 THE FOLKS WHO WERE THERE WERE NOT TRYING 823 00:44:34,367 --> 00:44:36,369 TO SHIRK THEIR RESPONSIBILITIES. 824 00:44:36,412 --> 00:44:37,718 THEY COULDN'T GET INSURANCE. 825 00:44:37,762 --> 00:44:39,764 THEY EITHER COULDN'T AFFORD IT OR MANY OF THEM WORK 826 00:44:39,807 --> 00:44:44,594 FOR SMALL EMPLOYERS THAT HAD BEEN PURGED BY BIG INSURANCE COMPANIES. 827 00:44:44,638 --> 00:44:48,990 IT WAS EITHER COME AND GET CARE THERE OR NOT GET CARE AT ALL 828 00:44:49,034 --> 00:44:51,689 AND EVERY YEAR THEY HAVE TO TURN PEOPLE AWAY. 829 00:44:54,039 --> 00:44:57,172 IT WAS LIKE SOMETHING THAT I COULD NEVER HAVE IMAGINED 830 00:44:57,216 --> 00:44:58,826 THAT I'D EVER SEE IN THIS COUNTRY. 831 00:44:58,870 --> 00:45:01,611 AND I KNEW WHAT I WAS DOING FOR A LIVING 832 00:45:01,655 --> 00:45:03,135 WAS MAKING IT NECESSARY FOR THOSE FOLKS 833 00:45:03,178 --> 00:45:08,009 TO STAND IN LINE TO WAIT FOR CARE IN OLD STALLS AND BARNS. 834 00:45:09,924 --> 00:45:13,101 I, ULTIMATELY, HAD A CRISIS OF CONSCIENCE 835 00:45:13,145 --> 00:45:16,757 BECAUSE I WAS NOT AT ALL PROUD OF WHAT I WAS DOING. 836 00:45:16,801 --> 00:45:18,498 I HAD DIFFICULTY SLEEPING AT NIGHT. 837 00:45:18,541 --> 00:45:20,152 THERE WERE EVEN TIMES, HONESTLY, 838 00:45:20,195 --> 00:45:23,808 THAT I LOOKED IN THE MIRROR AND I SAID, HOW DID YOU GET HERE? 839 00:45:23,851 --> 00:45:28,856 I JUST COULD NOT CONTINUE DOING WHAT I WAS DOING. 840 00:45:37,865 --> 00:45:39,258 GOOD MORNING. 841 00:45:39,301 --> 00:45:40,738 GOOD MORNING. 842 00:45:40,781 --> 00:45:43,566 OUR FOREFATHERS IN MEDICINE WERE REALLY ABOUT PATIENTS. 843 00:45:43,610 --> 00:45:45,699 IT WAS ABOUT A PASSION FOR HEALING. 844 00:45:45,743 --> 00:45:47,092 WHEN MEDICINE BECAME A BUSINESS, 845 00:45:47,135 --> 00:45:51,792 WE LOST OUR MORAL COMPASS AND I THINK WE'VE GOTTEN 846 00:45:51,836 --> 00:45:53,881 INTO A GREAT DEAL OF TROUBLE BECAUSE OF THAT. 847 00:45:53,925 --> 00:45:58,016 SINCE I HAVE TYPE 2 DIABETES, I TRY TO DO WHAT MY DOCTOR SAYS. 848 00:45:58,059 --> 00:46:00,975 Announcer: MANAGING TYPE 2 DIABETES CAN BE HARD. 849 00:46:01,019 --> 00:46:03,238 ADDING AVANDIA CAN HELP. 850 00:46:03,282 --> 00:46:05,937 THERE WAS A DRUG ON THE MARKET, AVANDIA. 851 00:46:05,980 --> 00:46:08,417 IT GOT FAST TRACKED BY THE FDA. 852 00:46:08,461 --> 00:46:10,028 IT GOT APPROVED VERY QUICKLY. 853 00:46:10,071 --> 00:46:12,465 IT WAS MASSIVELY MARKETED. 854 00:46:12,508 --> 00:46:18,210 AND BY 2006, THIS DRUG BECAME THE LARGEST SELLING 855 00:46:18,253 --> 00:46:19,733 DIABETES DRUG IN THE WORLD. 856 00:46:19,777 --> 00:46:23,737 WE'RE TALKING ABOUT A $3 OR 4 BILLION A YEAR DRUG. 857 00:46:23,781 --> 00:46:26,305 I GOT MY BLOOD SUGAR UNDER CONTROL. 858 00:46:26,348 --> 00:46:28,176 HE REALLY DID. 859 00:46:28,220 --> 00:46:31,353 CAN ADDING AVANDIA HELP YOU? 860 00:46:31,397 --> 00:46:37,142 I WAS DOING A GOOGLE SEARCH AND WHAT I FOUND WAS A WEBSITE 861 00:46:37,185 --> 00:46:42,538 IN THE UNITED KINGDOM WHERE THE CLINICAL TRIALS DONE 862 00:46:42,582 --> 00:46:46,760 WITH AVANDIA WERE ACTUALLY PARTIALLY DISCLOSED. 863 00:46:46,804 --> 00:46:52,113 AND WHAT I SAW, IT ACTUALLY MADE ME PHYSICALLY ILL. 864 00:46:52,157 --> 00:46:55,508 AS I LOOKED AT TRIAL AFTER TRIAL, 865 00:46:55,551 --> 00:46:58,685 THERE WERE MORE HEART ATTACKS IN THE AVANDIA GROUP. 866 00:46:58,728 --> 00:47:00,121 IT WAS SO CONSISTENT. 867 00:47:00,165 --> 00:47:03,472 YOU DIDN'T HAVE TO BE STATISTICIAN OR IN THE WORDS 868 00:47:03,516 --> 00:47:05,300 OF MY OLD FRIEND BOB DYLAN, 869 00:47:05,344 --> 00:47:08,347 "YOU DON'T HAVE TO BE A WEATHER MAN TO KNOW WHICH WAY THE WIND BLOWS." 870 00:47:08,390 --> 00:47:10,436 THERE WAS OBVIOUSLY A PROBLEM, 871 00:47:10,479 --> 00:47:13,656 ABOUT A 30% INCREASE IN THE RISK 872 00:47:13,700 --> 00:47:16,877 OF HEART ATTACK AND RELATED COMPLICATIONS. 873 00:47:16,921 --> 00:47:20,881 AND THE COMPANY DID NOTHING. 874 00:47:20,925 --> 00:47:23,188 THEY TOLD NO ONE. 875 00:47:23,231 --> 00:47:25,233 THEY DID NOT TELL PHYSICIANS. 876 00:47:25,277 --> 00:47:28,715 THEY DID NOT TELL THE FDA AND THEY DID NOT TELL PATIENTS. 877 00:47:28,758 --> 00:47:32,240 Man: CLEVELAND CLINIC CARDIOLOGIST DR. STEVEN NISSEN 878 00:47:32,284 --> 00:47:33,851 DECIDED TO DO HIS OWN REVIEW. 879 00:47:33,894 --> 00:47:38,681 NOW, THE LEADING CAUSE OF DEATH IN DIABETES IS HEART DISEASE. 880 00:47:38,725 --> 00:47:44,122 70% OF ALL THE DEATHS IN DIABETES ARE DUE TO HEART DISEASE. 881 00:47:44,165 --> 00:47:47,560 HAVING A DIABETES DRUG THAT INCREASES 882 00:47:47,603 --> 00:47:51,346 THE RISK OF HEART ATTACK BY NEARLY 1/3 883 00:47:51,390 --> 00:47:54,393 IS A PUBLIC HEALTH CATASTROPHE. 884 00:47:54,436 --> 00:47:57,875 AND THE COMPANY DIDN'T TELL ANYBODY. 885 00:47:57,918 --> 00:48:00,442 Woman: A SENATE INVESTIGATION ACCUSES THE FOOD 886 00:48:00,486 --> 00:48:03,315 AND DRUG ADMINISTRATION OF IGNORING RESEARCH. 887 00:48:03,358 --> 00:48:07,449 FINALLY, THE FDA PUT SEVERE RESTRICTIONS ON THE DRUG. 888 00:48:07,493 --> 00:48:10,322 Woman: YOU DO HAVE, YOU KNOW, A LOT OF MONEY AT STAKE HERE. 889 00:48:10,365 --> 00:48:13,368 Second Woman: GLAXOSMITHKLINE WORKED VERY HARD TO KEEP 890 00:48:13,412 --> 00:48:15,153 THESE NUMBERS FROM THE PUBLIC. 891 00:48:15,196 --> 00:48:18,765 Brian Williams: AN FDA ADVISORY COMMITTEE STARTING HEARING EVIDENCE 892 00:48:18,808 --> 00:48:20,593 ON WHETHER AVANDIA IS SO UNSAFE 893 00:48:20,636 --> 00:48:23,291 IT SHOULD BE PULLED OFF THE MARKET ALTOGETHER. 894 00:48:23,335 --> 00:48:25,467 THERE'S LITIGATION INVOLVED AND THE COMPANY 895 00:48:25,511 --> 00:48:28,949 SET ASIDE $6 BILLION TO SETTLE LAWSUITS. 896 00:48:28,993 --> 00:48:32,083 THE DOCUMENTS ARE COMING OUT IN THESE COURT SUITS. 897 00:48:32,126 --> 00:48:34,389 IT LOOKS WORSE AND WORSE. 898 00:48:34,433 --> 00:48:36,783 THE INDEPENDENT SAFETY OFFICIALS AT THE FDA 899 00:48:36,826 --> 00:48:40,787 ESTIMATES SOMEWHERE BETWEEN 50 AND 200,000 DEATHS 900 00:48:40,830 --> 00:48:42,832 OR HEART ATTACKS DUE TO THE DRUG. 901 00:48:42,876 --> 00:48:44,965 WE'RE NOT TALKING ABOUT A HANDFUL OF PEOPLE HERE. 902 00:48:45,009 --> 00:48:49,665 THIS DRUG WAS THE NUMBER ONE SELLING DIABETES DRUG IN THE WORLD IN 2006. 903 00:48:49,709 --> 00:48:53,321 IT'S JUST A TERRIBLE TRAGEDY FOR PATIENTS. 904 00:49:10,860 --> 00:49:16,562 IT IS VERY HARD TO GET LEGISLATIVE ACTION TO IMPROVE THE FDA 905 00:49:16,605 --> 00:49:20,609 AND TO BETTER REGULATE THE--PARTICULARLY, THE PHARMACEUTICAL INDUSTRY. 906 00:49:24,744 --> 00:49:27,442 IT IS THE ASSUMPTION THAT PEOPLE WHO RUN 907 00:49:27,486 --> 00:49:29,053 GOVERNMENT ARE ELECTED OFFICIALS, 908 00:49:29,096 --> 00:49:33,666 ARE MEMBERS OF CONGRESS, BUT IT'S NOT TRUE IN MANY CASES. 909 00:49:33,709 --> 00:49:35,363 THE POWER LIES WITH CORPORATIONS 910 00:49:35,407 --> 00:49:38,018 AND CORPORATE INTERESTS AND THE LOBBYISTS THAT THEY BUY. 911 00:49:38,062 --> 00:49:40,325 GOOD MORNING, FOLKS, HOW ARE YA? 912 00:49:40,368 --> 00:49:42,022 [BELL DINGS] 913 00:49:42,066 --> 00:49:46,331 I WAS ALMOST SURPRISED AS ANYBODY TO SEE THE REPORTS 914 00:49:46,374 --> 00:49:48,028 THAT I WAS THE MOST FREQUENT VISITOR 915 00:49:48,072 --> 00:49:50,378 TO THE WHITE HOUSE DURING THE HEALTH REFORM DEBATE. 916 00:49:50,422 --> 00:49:56,428 IT WAS IMPORTANT TO KEEP EXPRESSING THE HOSPITALS' POSITION. 917 00:50:05,698 --> 00:50:08,570 IT'S AN EXPENSIVE WORLD TO LIVE IN, 918 00:50:08,614 --> 00:50:11,443 IN TERMS OF GETTING YOUR VOICE HEARD IN D.C., 919 00:50:11,486 --> 00:50:13,749 BUT THAT'S THE WHOLE FUNCTION OF ADVOCACY. 920 00:50:13,793 --> 00:50:17,492 HOW POWERFUL ARE LOBBYISTS IN THE HEALTHCARE SYSTEM? 921 00:50:17,536 --> 00:50:19,494 [LAUGHING] 922 00:50:19,538 --> 00:50:20,800 INFINITELY. 923 00:50:20,843 --> 00:50:23,977 WHAT GIVES LOBBYISTS POWER IS THE AMOUNT OF MONEY 924 00:50:24,021 --> 00:50:26,806 THEY HAVE FOR CAMPAIGN CONTRIBUTIONS. 925 00:50:27,502 --> 00:50:29,678 WE HAVE BEEN TRYING TO REFORM 926 00:50:29,722 --> 00:50:31,158 THE HEALTHCARE SYSTEM FOR 100 YEARS. 927 00:50:31,202 --> 00:50:32,638 IT GOES BACK TO TEDDY ROOSEVELT. 928 00:50:32,681 --> 00:50:34,770 BUT THESE COMPANIES WILL DO WHATEVER IT TAKES 929 00:50:34,814 --> 00:50:37,643 TO MAKE SURE THERE ARE NO NEW LAWS OR REGULATIONS 930 00:50:37,686 --> 00:50:40,124 THAT WILL HINDER THEIR PROFITS. 931 00:50:40,515 --> 00:50:42,952 I WAS A PART OF EFFORTS GOING BACK 932 00:50:42,996 --> 00:50:45,433 TO THE CLINTON ADMINISTRATION TO MAKE SURE 933 00:50:45,477 --> 00:50:47,522 THERE WAS NO PATIENT'S BILL OF RIGHTS PASSED 934 00:50:47,566 --> 00:50:50,308 BECAUSE IT WOULD HAVE EXPANDED PATIENT'S ABILITY 935 00:50:50,351 --> 00:50:51,874 TO SUE THEIR INSURANCE COMPANY 936 00:50:51,918 --> 00:50:54,442 OR THEIR EMPLOYER IF THEY HAD BEEN DENIED NEEDED COVERAGE. 937 00:50:54,486 --> 00:50:59,752 SO, WE CREATED A FRONT GROUP CALLED THE HEALTH BENEFITS COALITION. 938 00:50:59,795 --> 00:51:03,147 I'D LIKE TO WELCOME YOU TO THE FIRST PRESS CONFERENCE 939 00:51:03,190 --> 00:51:05,105 OF THE HEALTH BENEFITS COALITION. 940 00:51:05,149 --> 00:51:09,153 CORPORATIONS ARE VERY CAREFUL TO CHOOSE NAMES 941 00:51:09,196 --> 00:51:11,111 FOR THESE ORGANIZATIONS TO MAKE PEOPLE THINK 942 00:51:11,155 --> 00:51:13,331 THAT THEY REALLY ARE GRASSROOTS ORGANIZATIONS 943 00:51:13,374 --> 00:51:15,159 AND THEY'RE REALLY NOTHING OF THE KIND. 944 00:51:15,202 --> 00:51:18,640 PART OF THE WHOLE EFFORT IS TO GET PEOPLE ULTIMATELY TO VOTE 945 00:51:18,684 --> 00:51:20,381 AGAINST THEIR OWN SELF-INTEREST. 946 00:51:20,425 --> 00:51:23,645 THE SPIN WAS TO SCARE PEOPLE INTO THINKING THAT PREMIUMS 947 00:51:23,689 --> 00:51:26,605 WOULD GO UP BECAUSE MORE PEOPLE WOULD BE FILING 948 00:51:26,648 --> 00:51:29,129 FRIVOLOUS LAWSUITS, BUT, OF COURSE, THESE PEOPLE 949 00:51:29,173 --> 00:51:32,654 HAD NO IDEA THAT THEY WERE BEING MADE TO BELIEVE 950 00:51:32,698 --> 00:51:34,091 THIS BY THE INSURANCE INDUSTRY. 951 00:51:34,134 --> 00:51:37,659 THE PATIENT'S BILL OF RIGHTS HAD BIPARTISAN SUPPORT, 952 00:51:37,703 --> 00:51:40,619 SENATOR JOHN McCAIN AND SENATOR TED KENNEDY WERE CO-SPONSORS, 953 00:51:40,662 --> 00:51:45,232 BUT IT WAS SO OPPOSED BY THE POWERFUL INSURANCE INDUSTRY, 954 00:51:45,276 --> 00:51:47,887 NO BILL WAS EVER PASSED. 955 00:51:55,460 --> 00:51:58,637 [APPLAUSE] 956 00:51:59,507 --> 00:52:02,641 THE HEALTHCARE REFORM BILL THAT WAS ENACTED 957 00:52:02,684 --> 00:52:06,949 ACHIEVED 2 OF THE INSURANCE INDUSTRY'S MAJOR OBJECTIVES. 958 00:52:06,993 --> 00:52:10,344 IT INCLUDES THE MANDATE, THE REQUIREMENT, 959 00:52:10,388 --> 00:52:12,607 THAT WE ALL HAVE TO BUY THEIR COVERAGE. 960 00:52:12,651 --> 00:52:14,435 THAT WAS JOB NUMBER ONE FOR THEM. 961 00:52:14,479 --> 00:52:17,612 JOB NUMBER 2 WAS TO MAKE SURE THAT THERE WAS NOT A PUBLIC OPTION. 962 00:52:17,656 --> 00:52:19,614 THEY DIDN'T WANT TO HAVE A NEW COMPETITOR. 963 00:52:19,658 --> 00:52:24,445 THEY HAD TO LIVE WITH SOME OF THE NEW CONSUMER PROTECTIONS IN THE BILL. 964 00:52:24,489 --> 00:52:27,492 IT DOES MAKE IT ILLEGAL FOR COMPANIES 965 00:52:27,535 --> 00:52:29,450 TO JUST CANCEL SOMEONE'S POLICY 966 00:52:29,494 --> 00:52:32,323 BECAUSE OF A PRE-EXISTING CONDITION. 967 00:52:32,366 --> 00:52:35,543 WHAT THE INSURANCE INDUSTRY'S OBJECTIVE IS, 968 00:52:35,587 --> 00:52:39,286 IS TO TRY TO WEAKEN THOSE CONSUMER PROTECTIONS OVER TIME 969 00:52:39,330 --> 00:52:43,072 AND TO TRY TO INFLUENCE HOW THE LAW IS BEING IMPLEMENTED. 970 00:52:43,116 --> 00:52:45,858 BECAUSE OF THE MONEY THAT'S INVOLVED, 971 00:52:45,901 --> 00:52:47,338 GETTING PEOPLE TO DO THE RIGHT THING 972 00:52:47,381 --> 00:52:52,604 FOR THE AMERICAN PEOPLE HAS BECOME EXTREMELY DIFFICULT. 973 00:53:00,264 --> 00:53:03,049 [CROWD CHEERING] 974 00:53:04,268 --> 00:53:07,009 PEOPLE NOW, THEY HIT THE PITCH WE THROW. 975 00:53:07,053 --> 00:53:12,145 IF WE CHANGE THE PITCH, THEY'LL HIT THAT ONE, TOO. 976 00:53:12,189 --> 00:53:13,407 BETWEEN THE HEALTHCARE WE HAVE 977 00:53:13,451 --> 00:53:15,322 AND THE HEALTHCARE WE COULD HAVE 978 00:53:15,366 --> 00:53:18,238 LIES NOT JUST A GAP BUT A CHASM. 979 00:53:18,282 --> 00:53:19,631 THAT'S HOW BIG THE DIFFERENCE IS 980 00:53:19,674 --> 00:53:21,241 BETWEEN WHAT WE COULD BE DOING AND WHAT WE ARE DOING. 981 00:53:21,285 --> 00:53:23,374 I THINK WE HAVE TO RECOGNIZE AS A COUNTRY, 982 00:53:23,417 --> 00:53:27,421 WE COULD HAVE A CARE SYSTEM THAT WE CAN SUSTAIN FOR THE LONG HAUL 983 00:53:27,465 --> 00:53:28,944 AND IT WILL BE FAR MORE BETTER PERFORMING 984 00:53:28,988 --> 00:53:31,251 THAN WHAT WE HAVE NOW IF WE GET TOGETHER AND WORK ON IT. 985 00:53:31,295 --> 00:53:34,950 I DON'T BLAME ANYBODY, THEY'RE JUST DOING WHAT MAKES SENSE, 986 00:53:34,994 --> 00:53:37,953 AND WE HAVE TO CHANGE WHAT MAKES SENSE. 987 00:53:42,523 --> 00:53:45,961 IF OUR CIVILIAN HEALTHCARE SYSTEM IS SMOLDERING 988 00:53:46,005 --> 00:53:49,051 AND WE SEE IT'S GONNA CATCH ON FIRE AND BURN PRETTY SOON 989 00:53:49,095 --> 00:53:50,705 AND IS GONNA BE UNSUSTAINABLE 990 00:53:50,749 --> 00:53:54,187 BECAUSE OF THE COSTS, THE MILITARY SYSTEM IS ALREADY ON FIRE. 991 00:53:54,231 --> 00:53:57,103 IT IS A BURNING PLATFORM AND THEY SEE THIS. 992 00:53:57,146 --> 00:54:00,237 THE COSTS ARE GOING THROUGH THE ROOF AND THE ABILITY 993 00:54:00,280 --> 00:54:02,891 TO HELP THESE SERVICE MEMBERS AND THEIR FAMILIES 994 00:54:02,935 --> 00:54:06,068 RECOVER AND REPAIR AND COME BACK TO A FUNCTIONAL LIFE 995 00:54:06,112 --> 00:54:08,593 IS GETTING LESS AND LESS. 996 00:54:14,033 --> 00:54:17,863 I WAS IN THE WORST PLACE IN AFGHANISTAN. 997 00:54:17,906 --> 00:54:19,604 THE KORENGAL, THE WATERPUR, 998 00:54:19,647 --> 00:54:25,914 IT'S THE MOST INTENSE BATTLEGROUND THAT YOU CAN EVER BE IN. 999 00:54:26,567 --> 00:54:28,482 I LOST A LOT OF GOOD MEN. 1000 00:54:28,526 --> 00:54:32,486 IT STILL BOTHERS ME TO THIS DAY. 1001 00:54:33,313 --> 00:54:37,709 I'M 2 1/2 MONTHS OUT OF COMBAT. 1002 00:54:38,057 --> 00:54:46,021 MY VERY BEST FRIEND FROM WAR, HE WAS ON NARCOTICS. 1003 00:54:46,065 --> 00:54:49,982 HE OVERDOSED, RESPIRATORY SHUT DOWN. 1004 00:54:50,025 --> 00:54:51,984 I LOST HIM... 1005 00:54:52,027 --> 00:54:54,334 AND FROM THAT POINT ON, 1006 00:54:54,378 --> 00:54:58,338 I REALIZED THAT I DON'T WANT TO BE ON THIS SIDE. 1007 00:54:58,382 --> 00:55:01,907 I DON'T WANT TO GO DOWN THE SAME PATH. 1008 00:55:09,784 --> 00:55:13,048 I CAME TO WALTER REED. 1009 00:55:15,573 --> 00:55:20,621 I WAS ON VALIUM JUST FOR THE ANXIETY. 1010 00:55:21,056 --> 00:55:24,277 I WAS ON ANTIDEPRESSANTS. 1011 00:55:24,321 --> 00:55:28,716 I WAS ON TRAZODONE, CLONIDINE. 1012 00:55:28,760 --> 00:55:33,808 I WAS SO DEPENDENT ON MY PAIN MEDICATION. 1013 00:55:33,852 --> 00:55:35,636 THIS... 1014 00:55:41,947 --> 00:55:45,646 IS THE MEDICATIONS I WAS ON. 1015 00:55:46,430 --> 00:55:47,648 DO YOU UNDERSTAND? 1016 00:55:47,692 --> 00:55:52,697 THAT IS HOW MANY MEDICATIONS I WAS ON. 1017 00:55:55,743 --> 00:56:02,663 WHEN YOU'RE INJURED, THEY FEED YOU, FEED YOU, FEED YOU ALL THIS STUFF. 1018 00:56:02,707 --> 00:56:07,146 IT'S ADDICTIVE. IT IS SO ADDICTIVE. 1019 00:56:07,189 --> 00:56:08,843 I'D RATHER BE SHOT AGAIN 1020 00:56:08,887 --> 00:56:13,631 THAN GO THROUGH WITHDRAWALS OF COMING OFF THAT MEDICINE. 1021 00:56:13,674 --> 00:56:17,461 NO SOLDIER SHOULD HAVE TO GO THROUGH THIS. 1022 00:56:30,430 --> 00:56:33,564 AS WE'VE PUSHED MEDICAL INNOVATION AND CAPABILITY 1023 00:56:33,607 --> 00:56:35,130 TO THE LEADING EDGE OF THE BATTLEFIELD, 1024 00:56:35,174 --> 00:56:37,132 WHERE WE CAN SAVE THEIR LIFE, WE'VE GOT SOME GUYS THAT HAVE 1025 00:56:37,176 --> 00:56:42,181 SOME HORRIFIC INJURIES AND THEY'RE GETTING NARCOTICS FOR LONGER PERIOD OF TIME. 1026 00:56:42,224 --> 00:56:44,313 THEY CERTAINLY ARE AT RISK TO DEVELOP DEPENDENCY. 1027 00:56:44,357 --> 00:56:46,272 AND THAT'S WHAT WE'RE TRYING TO AVOID. 1028 00:56:46,315 --> 00:56:50,276 THE ARMY SURGEON GENERAL DIRECTED THAT WE ESTABLISH 1029 00:56:50,319 --> 00:56:51,495 THE PAIN MANAGEMENT TASK FORCE 1030 00:56:51,538 --> 00:56:55,150 TO TAKE A LOOK AT ALTERNATIVES TO NARCOTICS. 1031 00:56:57,065 --> 00:56:59,111 Dr. Jonas: THERE'S VERY LARGE, RANDOMIZED TRIALS 1032 00:56:59,154 --> 00:57:01,548 DONE AT MULTIPLE CENTERS 1033 00:57:01,592 --> 00:57:04,464 THAT HAVE DEMONSTRATED THAT ACUPUNCTURE WORKS, 1034 00:57:04,508 --> 00:57:06,031 SO WE PUT TOGETHER A STUDY TO SEE 1035 00:57:06,074 --> 00:57:08,729 IF WE CAN ACTUALLY INSERT THIS SIMPLE ACUPUNCTURE TECHNIQUE 1036 00:57:08,773 --> 00:57:13,952 DURING THE AIR EVACS OF WOUNDED SOLDIERS INTO WALTER REED 1037 00:57:13,995 --> 00:57:17,912 AND OTHER MEDICAL CENTERS IN THE UNITED STATES. 1038 00:57:22,177 --> 00:57:24,789 THE QUESTION WAS, CAN WE RELIEVE THEIR PAIN 1039 00:57:24,832 --> 00:57:27,487 AND REDUCE THE AMOUNT OF MEDICATIONS THAT THEY'RE ON, 1040 00:57:27,531 --> 00:57:28,793 SO BY THE TIME THEY GET BACK, 1041 00:57:28,836 --> 00:57:31,273 THEY'RE NOT SNOWED UNDER ON MULTIPLE MEDICATIONS. 1042 00:57:31,317 --> 00:57:33,928 GUTEN MORGEN. WELCOME TO GERMANY. 1043 00:57:33,972 --> 00:57:35,234 AND WELCOME HOME. 1044 00:57:35,277 --> 00:57:36,496 I KNOW YOU ARE HEADING HOME AND YOU ARE EXCITED. 1045 00:57:36,540 --> 00:57:38,890 WHAT IT FIRST SEEMS LIKE STRANGE BED FELLOWS-- 1046 00:57:38,933 --> 00:57:41,458 HEALING-ORIENTED MIND/BODY PRACTICES 1047 00:57:41,501 --> 00:57:43,634 AND SORT OF THE HARD-CORE MILITARY... 1048 00:57:43,677 --> 00:57:46,332 ACTUALLY IS AN OPPORTUNITY 1049 00:57:46,375 --> 00:57:48,769 THAT THEY JUMPED AT BECAUSE OF THE PRAGMATIC NEED 1050 00:57:48,813 --> 00:57:52,120 IN NATURE THAT THE WARS HAVE DRIVEN THEM TO RESPOND TO. 1051 00:57:52,164 --> 00:57:54,166 THERE'S A VERY, VERY SMALL CHANCE 1052 00:57:54,209 --> 00:57:58,518 OF YOU HAVING INFECTION OR ANY OF THOSE KIND OF PROBLEMS. 1053 00:57:58,562 --> 00:57:59,954 I AM VERY SKEPTICAL ABOUT IT, 1054 00:57:59,998 --> 00:58:01,869 THIS IDEA THAT PUTTING SOME LITTLE STICK PINS 1055 00:58:01,913 --> 00:58:05,960 IN YOUR EAR IS GONNA CURE PAIN ON A 9-HOUR FLIGHT. 1056 00:58:06,787 --> 00:58:09,486 IT WEARS ON YOUR LOWER BACK WEARING, YOU KNOW, 1057 00:58:09,529 --> 00:58:13,402 A 40-POUND VEST AND IT'S GOT TO THE POINT WHERE THE PAIN 1058 00:58:13,446 --> 00:58:14,621 IS RADIATING FROM MY BACK 1059 00:58:14,665 --> 00:58:19,583 DOWN TO MY HIPS AND THEN DOWN INTO MY THIGHS. 1060 00:58:21,889 --> 00:58:23,151 THAT'S IT. 1061 00:58:23,195 --> 00:58:25,632 THAT'S MY DAILY ROUTINE. 1062 00:58:28,592 --> 00:58:31,508 THE FIRST ONE'S GOING IN. 1063 00:58:34,511 --> 00:58:36,382 HOW'S YOUR PAIN, SIR? 1064 00:58:36,425 --> 00:58:39,907 I FEEL LIKE I'M WARMING UP A LITTLE BIT. 1065 00:58:40,604 --> 00:58:42,519 IT'S PRETTY IMPRESSIVE, 1066 00:58:42,562 --> 00:58:44,695 ESPECIALLY FOR IT TO REACT THAT QUICKLY. 1067 00:58:44,738 --> 00:58:50,091 WHEN YOU PUT THE ACUPUNCTURE NEEDLES IN THE EAR, 1068 00:58:50,135 --> 00:58:52,659 YOU SEE THE ACTIVITY DROPS DOWN. 1069 00:58:52,703 --> 00:58:58,404 SO, WHAT HAS HAPPENED IS YOU HAVE REDUCED THE SIGNALS, 1070 00:58:58,447 --> 00:59:00,580 OR THE PROCESSING, OF THE PAIN. 1071 00:59:00,624 --> 00:59:02,930 WHEN YOU PROVIDE A SMALL STIMULUS LIKE THAT, 1072 00:59:02,974 --> 00:59:08,196 THE BODY RESPONDS BY TRYING TO HEAL ITSELF, TRYING TO REPAIR ITSELF. 1073 00:59:08,240 --> 00:59:12,244 IT'LL GO RIGHT THERE. 1074 00:59:12,287 --> 00:59:13,462 OK. 1075 00:59:13,506 --> 00:59:15,813 GO AHEAD AND BEND DOWN. 1076 00:59:18,467 --> 00:59:20,339 THAT'S PRETTY GOOD. 1077 00:59:20,382 --> 00:59:21,253 ANY PAIN? 1078 00:59:21,296 --> 00:59:22,907 NOT WHEN I'M DOING THAT. 1079 00:59:22,950 --> 00:59:24,256 NORMALLY YOU WOULD? 1080 00:59:24,299 --> 00:59:25,300 OH, YES. 1081 00:59:25,344 --> 00:59:26,780 I HAVEN'T TOUCHED MY TOES IN MONTHS. 1082 00:59:26,824 --> 00:59:28,608 THAT MEANS WE'RE GETTING THE NEEDLES IN THE RIGHT PLACE. 1083 00:59:28,652 --> 00:59:30,479 OK. I HAVEN'T EVEN GOTTEN NEAR MY TOES 1084 00:59:30,523 --> 00:59:34,571 IN MONTHS, UNLESS I DO THIS, YOU KNOW? 1085 00:59:53,241 --> 00:59:54,025 HOW ARE YOU DOING? 1086 00:59:54,068 --> 00:59:55,548 I'M DOING GOOD. 1087 00:59:55,592 --> 00:59:58,899 YEAH, ACTUALLY, I WANT YOU THERE WHEN I GO INTO SURGERY. 1088 01:00:02,860 --> 01:00:04,775 HI. HOW ARE YOU FEELING? 1089 01:00:04,818 --> 01:00:10,607 I HAVE PAIN, BUT IT'S MORE OF AN ANNOYANCE THAN IT IS PAIN. 1090 01:00:10,650 --> 01:00:11,782 JUST SORE. 1091 01:00:11,825 --> 01:00:13,392 IF YOU DIDN'T HAVE THE ACUPUNCTURE NEEDLES, 1092 01:00:13,435 --> 01:00:16,134 HOW DO YOU THINK YOU WOULD BE FEELING NOW? 1093 01:00:16,177 --> 01:00:19,441 I'D BE CHOMPING NARCOTICS. 1094 01:00:19,485 --> 01:00:20,965 OH, YOU WOULD? OH, YEAH. 1095 01:00:21,008 --> 01:00:23,402 OH, SO, YOU HAVEN'T TAKEN ANYTHING? 1096 01:00:23,445 --> 01:00:24,664 NO. BECAUSE OF THAT? 1097 01:00:24,708 --> 01:00:26,448 YEP. THAT'S GOOD. 1098 01:00:26,492 --> 01:00:29,800 15 YEARS AGO WE DID A CONSENSUS CONFERENCE 1099 01:00:29,843 --> 01:00:31,715 AT THE NATIONAL INSTITUTES OF HEALTH 1100 01:00:31,758 --> 01:00:34,456 AND WE ASKED THE QUESTION, DO WE HAVE 1101 01:00:34,500 --> 01:00:36,154 GOOD EVIDENCE TO SHOW THAT ACUPUNCTURE 1102 01:00:36,197 --> 01:00:39,026 IS SAFE AND EFFECTIVE FOR ANY CONDITION? 1103 01:00:39,070 --> 01:00:40,637 THEY SAID, ABSOLUTELY. 1104 01:00:40,680 --> 01:00:43,248 IT'S BEEN DEMONSTRATED THAT ACUPUNCTURE IS SAFE AND EFFECTIVE, 1105 01:00:43,291 --> 01:00:46,120 ESPECIALLY WITH POST- OPERATIVE AND INJURY PAIN. 1106 01:00:46,164 --> 01:00:46,991 APPRECIATE IT. 1107 01:00:47,034 --> 01:00:48,645 THANK YOU VERY MUCH. 1108 01:00:48,688 --> 01:00:52,997 15 YEARS LATER, YOU CAN'T WALK INTO YOUR AVERAGE HOSPITAL TODAY 1109 01:00:53,040 --> 01:00:55,477 AND GET ACUPUNCTURE AFTER AN OPERATION. 1110 01:00:55,521 --> 01:00:58,655 THE PROBLEM IS NOT THAT IT DOESN'T WORK. 1111 01:00:58,698 --> 01:01:00,918 THE PROBLEM IS THAT WE HAVEN'T FIGURED OUT 1112 01:01:00,961 --> 01:01:03,921 HOW TO GET IT INTO THE SYSTEM SO THAT WE CAN MAKE 1113 01:01:03,964 --> 01:01:07,272 IT WIDELY AVAILABLE TO THE POPULATION. 1114 01:01:15,497 --> 01:01:19,937 Woman: IN THE LAST FEW YEARS A PROFOUND CHANGE HAS BEGUN IN AMERICAN MEDICINE. 1115 01:01:19,980 --> 01:01:22,504 Man: DR. DEAN ORNISH HAS STUDIED AND WRITTEN 1116 01:01:22,548 --> 01:01:24,724 ABOUT DIET AND HEART DISEASE FOR DECADES. 1117 01:01:24,768 --> 01:01:28,728 IN MEDICAL SCHOOL I WAS LEARNING HOW TO DO BYPASS SURGERY 1118 01:01:28,772 --> 01:01:30,208 WITH MICHAEL DEBAKEY, THE HEART SURGEON. 1119 01:01:30,251 --> 01:01:32,819 WE CUT PEOPLE OPEN, WE BYPASSED THEIR BLOCKED ARTERIES, 1120 01:01:32,863 --> 01:01:35,474 AND HE WOULD TELL THEM THEY WERE CURED AND THEY'D GO HOME 1121 01:01:35,517 --> 01:01:37,737 AND MORE OFTEN THAN NOT, EAT THE SAME JUNK FOOD, 1122 01:01:37,781 --> 01:01:39,260 SMOKE AND NOT MANAGE STRESS, 1123 01:01:39,304 --> 01:01:42,873 NOT EXERCISE, AND THEN OFTEN THEIR BYPASSES WOULD CLOG UP. 1124 01:01:42,916 --> 01:01:44,265 SO, WE'D CUT THEM OPEN, 1125 01:01:44,309 --> 01:01:46,790 WE'D BYPASS THEIR BYPASS, SOMETIMES MULTIPLE TIMES. 1126 01:01:46,833 --> 01:01:49,314 I SAID THERE'S GOT TO BE A BETTER WAY. 1127 01:01:49,357 --> 01:01:54,101 WE SPEND SO MUCH TIME IN MEDICINE MOPPING UP THE FLOOR 1128 01:01:54,145 --> 01:01:55,450 AROUND THE SINK THAT'S OVERFLOWING 1129 01:01:55,494 --> 01:01:56,930 WITHOUT ALSO TURNING OFF THE FAUCET. 1130 01:01:56,974 --> 01:02:00,107 IF WE JUST LITERALLY OR FIGURATIVELY BYPASS THE PROBLEM 1131 01:02:00,151 --> 01:02:03,894 WITH ANGIOPLASTIES AND STENTS OR LIFETIMES OF DRUGS 1132 01:02:03,937 --> 01:02:05,460 OR OTHER KINDS OF INTERVENTIONS, 1133 01:02:05,504 --> 01:02:07,854 THEN MORE OFTEN THAN NOT, THE SAME PROBLEM COMES BACK AGAIN. 1134 01:02:07,898 --> 01:02:11,031 BUT WHAT WE'RE FINDING IS THAT IF YOU TURN OFF THE FAUCET, 1135 01:02:11,075 --> 01:02:12,729 IF WE TREAT THE UNDERLYING CAUSES, 1136 01:02:12,772 --> 01:02:14,948 WHICH TO A LARGE DEGREE ARE NOT SO MUCH OUR GENES 1137 01:02:14,992 --> 01:02:19,083 BUT OUR LIFESTYLE, THAT OUR BODIES HAVE A REMARKABLE CAPACITY 1138 01:02:19,126 --> 01:02:22,521 TO BEGIN HEALING THEMSELVES AND THESE CHRONIC DISEASES 1139 01:02:22,564 --> 01:02:24,175 CAN NOT ONLY BE PREVENTED, 1140 01:02:24,218 --> 01:02:27,395 BUT EVEN REVERSED MUCH MORE QUICKLY THAN WE HAD ONCE REALIZED. 1141 01:02:27,874 --> 01:02:29,049 WHEN I WENT TO MEDICAL SCHOOL, 1142 01:02:29,093 --> 01:02:30,790 I STARTED READING ALL THE MEDICAL LITERATURE 1143 01:02:30,834 --> 01:02:33,314 AND REALIZED THAT IN DOGS AND CATS 1144 01:02:33,358 --> 01:02:34,794 AND PIGS AND RABBITS AND MONKEYS, 1145 01:02:34,838 --> 01:02:36,404 YOU COULD CAUSE THEM TO GET HEART DISEASE 1146 01:02:36,448 --> 01:02:40,800 IF YOU PUT THEM ON A BAD DIET AND "X" DIDN'T LET THEM EXERCISE 1147 01:02:40,844 --> 01:02:42,323 AND PUT THEM UNDER EMOTIONAL STRESS, 1148 01:02:42,367 --> 01:02:44,543 BUT YOU COULD REVERSE IT IF YOU CHANGED THOSE SAME THINGS. 1149 01:02:44,586 --> 01:02:46,850 SO, I THOUGHT, WHY SHOULD PEOPLE BE ANY DIFFERENT? 1150 01:02:46,893 --> 01:02:49,548 AND EVERYBODY SAID, THAT'S A CRAZY IDEA. 1151 01:02:49,591 --> 01:02:50,767 THERE'S NO WAY THAT'S GONNA WORK, 1152 01:02:50,810 --> 01:02:52,377 YOU KNOW, WHAT'S THE MATTER WITH YOU? 1153 01:02:52,420 --> 01:02:55,510 I SPENT MORE THAN 30 YEARS OF DOING THESE STUDIES, 1154 01:02:55,554 --> 01:02:56,990 SHOWING THAT HEART DISEASE COULD BE REVERSED 1155 01:02:57,034 --> 01:02:59,427 BY CHANGING WHAT WE EAT, HOW WE RESPOND TO STRESS, 1156 01:02:59,471 --> 01:03:04,737 HOW MUCH WE EXERCISE AND HOW MUCH LOVE AND SUPPORT WE HAVE IN OUR LIVES. 1157 01:03:04,781 --> 01:03:08,088 IN OUR MODEL THE PHYSICIAN ACTS AS A QUARTERBACK 1158 01:03:08,132 --> 01:03:11,962 AND HE OR SHE ASSEMBLES A TEAM OF 5 OTHER PEOPLE TO WORK WITH-- 1159 01:03:12,005 --> 01:03:13,833 A NURSE, A YOGA TEACHER, 1160 01:03:13,877 --> 01:03:15,226 AN EXERCISE PHYSIOLOGIST, 1161 01:03:15,269 --> 01:03:18,795 A REGISTERED DIETITIAN, AND A CLINICAL PSYCHOLOGIST. 1162 01:03:18,838 --> 01:03:20,884 AND WHEN WE WORK AT THAT LEVEL, 1163 01:03:20,927 --> 01:03:22,842 WE FIND THAT PEOPLE ARE MUCH MORE LIKELY TO MAKE 1164 01:03:22,886 --> 01:03:25,584 THESE SUSTAINABLE CHANGES AND THE PATIENT LEARNS 1165 01:03:25,627 --> 01:03:30,502 HOW TO EMPOWER THEMSELVES AND TO TRANSFORM THEIR LIVES. 1166 01:03:33,244 --> 01:03:37,552 25 YEARS AGO I HAD 5 RESTAURANTS IN SAN FRANCISCO. 1167 01:03:37,596 --> 01:03:39,598 IT WAS A GREAT LIFE. 1168 01:03:39,641 --> 01:03:44,733 I SMOKED 6 CIGARS A DAY, 10 CUPS OF COFFEE, 1169 01:03:44,777 --> 01:03:47,649 AND A LOT OF WINE. 1170 01:03:47,693 --> 01:03:50,478 IT WAS WONDERFUL. 1171 01:03:50,522 --> 01:03:55,092 AND I HAD A MASSIVE HEART ATTACK. 1172 01:03:58,051 --> 01:04:01,576 I WAS IN THE HOSPITAL FOR 2 WEEKS. 1173 01:04:01,620 --> 01:04:03,709 I COULD HARDLY, UH... 1174 01:04:03,752 --> 01:04:07,887 JUST ABOUT WALK 3 STEPS AND I'D HAVE TO STOP AND REST. 1175 01:04:07,931 --> 01:04:13,414 I WAS POPPING 20 OR 30 NITRATES A DAY. 1176 01:04:13,458 --> 01:04:16,722 BUT THEN DEAN ORNISH WAS STARTING HIS PROGRAM 1177 01:04:16,765 --> 01:04:18,898 TO SEE IF YOU CAN REVERSE HEART DISEASE 1178 01:04:18,942 --> 01:04:20,421 THROUGH A LIFESTYLE CHANGE 1179 01:04:20,465 --> 01:04:24,077 AND HE WENT TO MY DOCTOR AND ASKED IF HE COULD APPROACH ME. 1180 01:04:24,121 --> 01:04:26,775 HE TOLD DEAN, HOW LONG IS THE PROGRAM? 1181 01:04:26,819 --> 01:04:28,212 HE SAID IT WAS A YEAR. 1182 01:04:28,255 --> 01:04:31,998 AND MY DOCTOR TOLD HIM HE WOULDN'T RECOMMEND TAKING ME 1183 01:04:32,042 --> 01:04:33,826 BECAUSE HE DIDN'T THINK I WOULD LIVE THE YEAR. 1184 01:04:33,870 --> 01:04:40,659 SO, HE FIGURED I WAS GONNA DIE 'CAUSE I WAS IN SUCH BAD SHAPE. 1185 01:04:41,573 --> 01:04:46,621 AND NOW 25 YEARS LATER, AND I'M IN PRETTY GOOD SHAPE. 1186 01:04:46,665 --> 01:04:49,886 HA HA HA HA. 1187 01:04:52,410 --> 01:04:53,846 WE FOUND THAT AFTER A YEAR, 1188 01:04:53,890 --> 01:04:56,718 THE MEN WHO MADE THESE INTENSIVE LIFESTYLE CHANGES, 1189 01:04:56,762 --> 01:04:59,983 THEIR PHYSICAL HEART DISEASE IMPROVED. 1190 01:05:01,462 --> 01:05:02,724 IT CAUSED THEIR BLOCKAGES 1191 01:05:02,768 --> 01:05:04,596 TO BECOME LESS BLOCKED IN THEIR ARTERIES. 1192 01:05:04,639 --> 01:05:10,341 AND THAT WAS THE FIRST STUDY SHOWN THAT HEART DISEASE WAS REVERSIBLE, 1193 01:05:10,384 --> 01:05:11,603 BUT WHEN YOU'RE DOING SOMETHING 1194 01:05:11,646 --> 01:05:13,474 THAT HAS NEVER BEEN DONE BEFORE, 1195 01:05:13,518 --> 01:05:15,346 IT'S NOT UNIVERSALLY ACCEPTED, TO SAY THE LEAST. 1196 01:05:15,389 --> 01:05:18,610 IT WAS, YOU KNOW, THERE WAS A HUGE AMOUNT OF SKEPTICISM AND RESISTANCE. 1197 01:05:18,653 --> 01:05:21,352 PEOPLE WOULD SAY, OH, BUT YOU'RE DOING THIS RADICAL INTERVENTION, YOU KNOW. 1198 01:05:21,395 --> 01:05:24,181 I SAY, RADICAL? YEAH, LIKE COMPARED TO HAVING YOUR CHEST CUT OPEN? 1199 01:05:24,224 --> 01:05:25,573 I MEAN, GIVE ME A BREAK. 1200 01:05:25,617 --> 01:05:29,664 WE NEED TO EMPOWER PEOPLE TO CHANGE THEIR LIFESTYLE. 1201 01:05:29,708 --> 01:05:30,970 AND IF WE CAN MAKE IT REIMBURSABLE, 1202 01:05:31,014 --> 01:05:33,625 THAT REALLY BRINGS IT INTO THE MAINSTREAM. 1203 01:05:34,669 --> 01:05:36,628 NOW, AS YOU KNOW, HEART AND BLOOD VESSEL DISEASES 1204 01:05:36,671 --> 01:05:40,066 KILL MORE AMERICANS THAN VIRTUALLY EVERYTHING ELSE COMBINED 1205 01:05:40,110 --> 01:05:42,460 AND IT'S TREATED WITH THINGS LIKE ANGIOPLASTIES AND STENTS 1206 01:05:42,503 --> 01:05:45,115 AND BYPASS SURGERY AND YET, WHAT DOES THE EVIDENCE REALLY SHOW? 1207 01:05:45,158 --> 01:05:46,725 UNLESS YOU'RE IN THE MIDDLE OF HAVING A HEART ATTACK, 1208 01:05:46,768 --> 01:05:49,771 WHICH 95% OF PEOPLE WHO GET THEM ARE NOT, 1209 01:05:49,815 --> 01:05:50,859 THEY DON'T PROLONG YOUR LIFE, 1210 01:05:50,903 --> 01:05:52,513 THEY DON'T EVEN PREVENT HEART ATTACKS. 1211 01:05:52,557 --> 01:05:54,341 WE HAVE A MODEL THAT WORKS 1212 01:05:54,385 --> 01:05:57,649 SIMPLY BY MAKING CHANGES IN DIET AND LIFESTYLES. 1213 01:05:57,692 --> 01:05:59,694 AND IN OUR STUDIES FOR THE LAST 33 YEARS, 1214 01:05:59,738 --> 01:06:02,045 WE'VE USED VERY HIGH TECH, EXPENSIVE, 1215 01:06:02,088 --> 01:06:04,438 STATE-OF-THE-ART MEASURES TO PROVE HOW POWERFUL 1216 01:06:04,482 --> 01:06:09,574 THESE VERY SIMPLE AND LOW TECH AND LOW COST INTERVENTIONS CAN BE. 1217 01:06:11,097 --> 01:06:14,492 NOW, TO A NEW STUDY THAT SHOWS DIET 1218 01:06:14,535 --> 01:06:16,798 MAY BE A KEY TOOL IN THE FIGHT AGAINST CANCER. 1219 01:06:16,842 --> 01:06:19,279 THE STUDY WAS CONDUCTED BY DR. DEAN ORNISH, 1220 01:06:19,323 --> 01:06:23,936 WHO LOOKED AT PATIENTS WITH EARLY STAGE PROSTATE CANCER. 1221 01:06:25,111 --> 01:06:29,159 MORE THAN HALF OF MEN OVER THE AGE OF 50, GET A P.S.A. 1222 01:06:29,202 --> 01:06:32,814 TEST EVERY YEAR TO TRY TO DETECT PROSTATE CANCER EARLY. 1223 01:06:32,858 --> 01:06:37,515 IT TURNS OUT LOTS AND LOTS OF MEN WHO HAD A CANCER 1224 01:06:37,558 --> 01:06:41,562 THAT DIDN'T NEED TO BE TREATED, BUT THEY GOT TREATED ANYWAY 1225 01:06:41,606 --> 01:06:43,869 AND IT WAS CAUSING A LOT OF HARM. 1226 01:06:44,565 --> 01:06:46,437 THERE'S VERY LITTLE EVIDENCE 1227 01:06:46,480 --> 01:06:49,092 THAT THESE CONVENTIONAL TREATMENTS MAKE YOU LIVE LONGER, 1228 01:06:49,135 --> 01:06:52,443 BUT THEY CAUSE MANY MEN TO BE IMPOTENT OR INCONTINENT OR BOTH, 1229 01:06:52,486 --> 01:06:55,837 AND SO THERE'S A SUBSET OF MEN WHO HAVE DIAGNOSED, 1230 01:06:55,881 --> 01:06:57,274 BIOPSY-PROVEN PROSTATE CANCER, 1231 01:06:57,317 --> 01:07:00,799 WHO ELECT NOT TO GET TREATED CONVENTIONALLY. 1232 01:07:03,410 --> 01:07:07,632 MY PATH CROSSED WITH DEAN'S BECAUSE WE BOTH WANTED HIM 1233 01:07:07,675 --> 01:07:10,026 TO TRY AND BRING RIGOROUS CLINICAL TRIAL TESTING 1234 01:07:10,069 --> 01:07:12,289 TO THIS HYPOTHESIS THAT LIFESTYLE INTERVENTION 1235 01:07:12,332 --> 01:07:17,511 COULD HAVE AN IMPORTANT IMPACT IN MEN WITH EARLY STAGE PROSTATE CANCER. 1236 01:07:18,251 --> 01:07:19,035 HOW ARE YOU? 1237 01:07:19,078 --> 01:07:20,340 STEVEN. NICE TO SEE YOU. 1238 01:07:20,384 --> 01:07:22,473 I'M ONE OF THE BUSIEST SURGEONS IN THE COUNTRY. 1239 01:07:22,516 --> 01:07:23,778 HOWEVER, I DON'T BELIEVE EVERY MAN 1240 01:07:23,822 --> 01:07:25,432 WITH PROSTATE CANCER NEEDS IMMEDIATE TREATMENTS. 1241 01:07:25,476 --> 01:07:27,913 SO, I SIMPLY FOLLOW THEM VERY CAREFULLY 1242 01:07:27,956 --> 01:07:30,176 AND YOU TREAT THEM AT THE FIRST SIGN OF PROGRESSION. 1243 01:07:30,220 --> 01:07:34,180 IF YOU CAN DELAY TREATMENT, THEN THAT MAN IS NOT AT RISK 1244 01:07:34,224 --> 01:07:37,270 FOR SIDE EFFECTS DURING THAT PERIOD OF TIME. 1245 01:07:39,316 --> 01:07:40,447 HEY, LIZ. 1246 01:07:40,491 --> 01:07:42,188 COME ON IN. 1247 01:07:42,232 --> 01:07:45,409 DR. PETER CARROLL AND I COLLABORATED WITH DR. ELIZABETH BLACKBURN, 1248 01:07:45,452 --> 01:07:46,932 WHO WON THE NOBEL PRIZE IN MEDICINE 1249 01:07:46,975 --> 01:07:48,542 AND SHE HAD DONE A STUDY SHOWING 1250 01:07:48,586 --> 01:07:50,283 THAT STRESS CREATES SHORTER TELOMERES. 1251 01:07:50,327 --> 01:07:52,981 SO, AS YOUR TELOMERES GET SHORTER, YOUR LIFE GETS SHORTER. 1252 01:07:53,025 --> 01:07:55,897 TELOMERES ARE THE ENDS OF CHROMOSOMES 1253 01:07:55,941 --> 01:07:59,162 AND CHROMOSOMES HAVE ALL OUR GENETIC INFORMATION ON THEM. 1254 01:07:59,205 --> 01:08:02,469 WHEN TELOMERES WEAR DOWN AND GET FRAYED, 1255 01:08:02,513 --> 01:08:04,819 THE GENETIC MATERIAL WOULD GET MESSED UP. 1256 01:08:04,863 --> 01:08:08,171 THAT PREVENTS TISSUES FROM RENEWING THEMSELVES 1257 01:08:08,214 --> 01:08:11,348 IN THE BODY AND DISEASES TAKE HOLD. 1258 01:08:11,391 --> 01:08:14,351 I THOUGHT MOST THINGS IN BIOLOGY GO BOTH WAYS, 1259 01:08:14,394 --> 01:08:16,831 SO IF BAD THINGS MAKE YOUR TELOMERES SHORTER, 1260 01:08:16,875 --> 01:08:18,094 MAYBE GOOD THINGS WILL MAKE THEM LONGER. 1261 01:08:18,137 --> 01:08:20,444 SO, WE TOOK THE MEN WITH PROSTATE CANCER TO SEE 1262 01:08:20,487 --> 01:08:26,189 IF LIFESTYLE CHANGES CAN AFFECT GENE EXPRESSION AND EVEN TELOMERES. 1263 01:08:28,060 --> 01:08:30,149 Robin Roberts: THE RESEARCH FOUND THAT EMBRACING 1264 01:08:30,193 --> 01:08:32,499 A LOW-FAT VEGETARIAN DIET, 1265 01:08:32,543 --> 01:08:34,501 EXERCISING HALF AN HOUR A DAY, 1266 01:08:34,545 --> 01:08:37,722 AND TAKING PART IN DAILY STRESS REDUCING ACTIVITIES 1267 01:08:37,765 --> 01:08:40,768 CAN ACTUALLY CHANGE THE REGULATION OF GENES 1268 01:08:40,812 --> 01:08:42,379 THAT ARE KEY PLAYERS IN CANCER DEVELOPMENT 1269 01:08:42,422 --> 01:08:45,512 AND CONTRIBUTE TO BETTER OVERALL SURVIVAL. 1270 01:08:45,556 --> 01:08:47,471 WE FOUND THAT THE MEN WHO UNDERWENT 1271 01:08:47,514 --> 01:08:49,429 LIFESTYLE INTERVENTION, THEIR P.S.A. RATES 1272 01:08:49,473 --> 01:08:53,041 GENERALLY WENT DOWN AND THEY WERE LESS LIKELY TO REQUIRE TREATMENT. 1273 01:08:53,085 --> 01:08:55,957 THE PROGRAM INCREASED THE TELOMERE LENGTH. 1274 01:08:56,001 --> 01:08:58,395 WE EVEN FOUND THAT WHEN YOU CHANGE YOUR LIFESTYLE, 1275 01:08:58,438 --> 01:09:00,266 OVER 500 GENES WERE CHANGED, AND IN FACT, 1276 01:09:00,310 --> 01:09:02,399 TURNING ON THE GENES THAT PREVENT DISEASE, 1277 01:09:02,442 --> 01:09:05,489 TURNING OFF THE GENES THAT PROMOTE BREAST CANCER, 1278 01:09:05,532 --> 01:09:07,012 PROSTATE CANCER, AND COLON CANCER. 1279 01:09:07,055 --> 01:09:10,537 AND EVEN DRUGS, EVEN PHARMA, HASN'T BEEN SHOWN TO DO THAT. 1280 01:09:10,581 --> 01:09:12,322 THIS PUTS A LANGUAGE OF NUMBERS 1281 01:09:12,365 --> 01:09:16,108 AND MOLECULAR REDOX, THROUGH DEAN ORNISH AND THOSE INTERVENTIONS, 1282 01:09:16,152 --> 01:09:21,287 THAT MANY IN THE MEDICAL FIELD, I THINK, FEEL MORE COMFORTABLE WITH. 1283 01:09:21,331 --> 01:09:24,377 THESE LIFESTYLE CHANGES CAN NOT ONLY WORK AS WELL AS DRUGS AND SURGERY, 1284 01:09:24,421 --> 01:09:27,772 BUT OFTEN EVEN BETTER AT A FRACTION OF THE COST 1285 01:09:27,815 --> 01:09:31,167 AND THE ONLY SIDE EFFECTS ARE GOOD ONES. 1286 01:09:42,090 --> 01:09:44,441 ALMOST ONE YEAR INTO THE FELLOWSHIP, 1287 01:09:44,484 --> 01:09:46,138 I JOINED THIS NEW PRACTICE. 1288 01:09:46,182 --> 01:09:48,227 HELLO. HOW ARE YOU? 1289 01:09:48,271 --> 01:09:51,404 THEY PROMISED ME THAT I COULD MAKE THE PRACTICE 1290 01:09:51,448 --> 01:09:52,623 WHATEVER I WANTED IT TO BE 1291 01:09:52,666 --> 01:09:55,365 AND IF I DON'T WANNA SEE 6 PATIENTS AN HOUR, 1292 01:09:55,408 --> 01:09:58,281 I DON'T HAVE TO SEE 6 PATIENTS AN HOUR. 1293 01:09:58,890 --> 01:10:02,241 WE'RE THE ONLY CLINIC IN SKAMANIA COUNTY, 1294 01:10:02,285 --> 01:10:04,461 SO IT'S ABOUT 20,000 PEOPLE, OVERALL, 1295 01:10:04,504 --> 01:10:05,853 THAT WE'RE THE ONLY PROVIDERS FOR. 1296 01:10:05,897 --> 01:10:08,726 [SPEAKING IN SPANISH] 1297 01:10:10,293 --> 01:10:11,381 WE'RE PART OF THE COMMUNITY. 1298 01:10:11,424 --> 01:10:14,427 ALL OF US LIVE HERE AND WORK HERE. 1299 01:10:14,471 --> 01:10:16,255 HOW ARE YOU TODAY? 1300 01:10:16,299 --> 01:10:17,648 PRETTY GOOD, HOW ARE YOU?GOOD. 1301 01:10:17,691 --> 01:10:20,433 THERE'S BEEN A LOT OF CHANGE IN ME 1302 01:10:20,477 --> 01:10:23,306 IN THAT TRANSITION BETWEEN LA CLINICA AND HERE. 1303 01:10:23,349 --> 01:10:26,004 I CAN ACT MORE AS A GUIDE FOR PATIENTS, 1304 01:10:26,047 --> 01:10:28,789 TAKING THE TIME TO EDUCATE THEM AND HAVING THEM UNDERSTAND 1305 01:10:28,833 --> 01:10:33,359 THAT THERE ARE CHOICES THAT THEY HAVE THE POWER TO MAKE FOR THEMSELVES. 1306 01:10:33,403 --> 01:10:38,538 IF YOU HAVE THAT DESIRE TO QUIT SMOKING, WE'LL GET THERE EVENTUALLY. 1307 01:10:38,582 --> 01:10:39,713 YEAH. OK? 1308 01:10:39,757 --> 01:10:41,280 WE JUST HAVE TO KEEP WORKING TOWARDS THAT. 1309 01:10:41,324 --> 01:10:45,415 AND INTERESTINGLY, PATIENTS REALLY RESPOND TO THAT. 1310 01:10:45,458 --> 01:10:48,287 DID YOU GO TO THE DIABETES EDUCATION? 1311 01:10:48,331 --> 01:10:49,506 YES. 1312 01:10:49,549 --> 01:10:51,029 HOW DID THAT--WHAT DID YOU THINK ABOUT THAT? 1313 01:10:51,072 --> 01:10:52,422 IT WAS OK. IT KIND OF GAVE ME A MORE IDEA OF WHAT TO EAT. 1314 01:10:52,465 --> 01:10:54,772 OK. OK. YOU LOST 5 POUNDS. 1315 01:10:54,815 --> 01:10:57,557 MM-HMM. I QUIT DRINKING, TOO, SO... 1316 01:10:57,601 --> 01:10:59,472 HOW MUCH WERE YOU DRINKING BEFORE? 1317 01:10:59,516 --> 01:11:01,866 6 AND OVER. A DAY? 1318 01:11:01,909 --> 01:11:04,216 A DAY, FOR 25 YEARS, SO... 1319 01:11:04,260 --> 01:11:06,000 WOW. WHAT MADE YOU DECIDE TO DO THAT? 1320 01:11:06,044 --> 01:11:09,134 WELL, THAT HAD TO BE SOMETHING TO DO WITH MY DIABETES. 1321 01:11:09,177 --> 01:11:13,181 MM-HMM. I'M REALLY, REALLY PLEASED. 1322 01:11:13,225 --> 01:11:14,226 YOU JUST LOOK DIFFERENT. 1323 01:11:14,270 --> 01:11:16,794 SO, THAT'S REWARDING FOR ME. 1324 01:11:16,837 --> 01:11:18,012 I FEEL DIFFERENT. 1325 01:11:18,056 --> 01:11:18,926 [CHUCKLES] 1326 01:11:18,970 --> 01:11:20,972 I HAD TO DO SOMETHING.MM-HMM. 1327 01:11:22,800 --> 01:11:25,890 I GUESS I NEED TO COME BACK IN A MONTH OR SO. 1328 01:11:25,933 --> 01:11:27,631 COME BACK IN ONE MONTH. 1329 01:11:28,196 --> 01:11:31,199 ALMOST EVERY STUDY SAYS THAT THE DOCTOR 1330 01:11:31,243 --> 01:11:33,463 THAT HAS THE GREATEST IMPACT ON YOUR HEALTH, 1331 01:11:33,506 --> 01:11:35,595 IN GENERAL, THE GREATEST IMPACT 1332 01:11:35,639 --> 01:11:37,075 ON THE HEALTH OF A POPULATION 1333 01:11:37,118 --> 01:11:40,731 IS PRIMARY CARE DOCTORS. WE NEED PRIMARY CARE DOCTORS. 1334 01:11:40,774 --> 01:11:43,255 YEAH, YOUR THYROID IS A LITTLE BIT BIG. AH. 1335 01:11:43,299 --> 01:11:45,562 WHAT'S HAPPENED TODAY IS WE FOUND OURSELVES IN A POSITION 1336 01:11:45,605 --> 01:11:49,043 WHERE WE DON'T HAVE ENOUGH PRIMARY CARE CLINICIANS 1337 01:11:49,087 --> 01:11:54,135 TO PROVIDE THAT IMPORTANT FUNDAMENTAL LEVEL OF CARE. 1338 01:11:54,179 --> 01:11:56,921 WHEN WAS YOUR LAST MAMMOGRAM AND PAP SMEAR? 1339 01:11:56,964 --> 01:11:58,270 HAVE YOU... 1340 01:11:58,314 --> 01:11:59,663 UH, 2008. 1341 01:11:59,706 --> 01:12:04,145 WHY? WE HAVE UNDERPAID ON A CHRONIC BASIS, 1342 01:12:04,189 --> 01:12:05,712 UNDER REWARDED PRIMARY CARE. 1343 01:12:05,756 --> 01:12:11,327 SOME WOULD SAY OVER REWARDED SPECIALTY AND SUB-SPECIALTIES. 1344 01:12:17,855 --> 01:12:20,945 OK, SO, FIRST TOPIC-- MEDICAID REIMBURSEMENT. 1345 01:12:20,988 --> 01:12:24,209 ABOUT 3 WEEKS AGO BECAUSE OF THE STATE BUDGET CRISIS, 1346 01:12:24,252 --> 01:12:26,733 WE GOT TOLD WITH VERY LITTLE NOTICE 1347 01:12:26,777 --> 01:12:29,301 THAT MEDICARE AND MEDICAID REIMBURSEMENT 1348 01:12:29,345 --> 01:12:31,564 WAS GONNA BE CUT BY ABOUT 25%. 1349 01:12:31,608 --> 01:12:33,392 SO, TO MAKE UP THAT DIFFERENCE 1350 01:12:33,436 --> 01:12:35,351 IN THE REIMBURSEMENT RATES DECREASING, 1351 01:12:35,394 --> 01:12:37,178 WE'RE CHANGING TO SHORTER APPOINTMENTS NEXT WEEK, 1352 01:12:37,222 --> 01:12:39,137 WE'RE ON TRACK FOR THAT ON TUESDAY. 1353 01:12:39,180 --> 01:12:41,269 SO, RIGHT NOW THE ONLY WAY WE HAVE TO MAKE UP 1354 01:12:41,313 --> 01:12:44,969 THE DIFFERENCE IS BASICALLY TO SEE MORE PEOPLE? 1355 01:12:45,012 --> 01:12:45,926 RIGHT. 1356 01:12:45,970 --> 01:12:47,101 [SIGHS] 1357 01:12:47,145 --> 01:12:48,581 THAT'S A LITTLE--IT MIGHT BE A LITTLE BIT 1358 01:12:48,625 --> 01:12:50,931 OF A CULTURE SHIFT, TOO, FOR THE PATIENTS. 1359 01:12:50,975 --> 01:12:53,151 AND IF THEY HAVE A RELATIONSHIP WITH YOU, 1360 01:12:53,194 --> 01:12:54,631 FEELING TRUNCATED, THAT'S GOING TO BE A LITTLE BIT 1361 01:12:54,674 --> 01:12:56,589 OF A CHANGE AND A LITTLE UNFORTUNATE. 1362 01:12:56,633 --> 01:12:58,069 IT'S A FINANCIAL NECESSITY. 1363 01:12:58,112 --> 01:13:01,855 THAT'S THE ONLY REASON WE'RE MAKING THE CHANGE, RIGHT? 1364 01:13:01,899 --> 01:13:03,291 I MEAN... 1365 01:13:03,335 --> 01:13:04,641 BUT YOU HAVE TO HAVE THE TIME TO EDUCATE YOUR PATIENTS 1366 01:13:04,684 --> 01:13:07,121 AND THEY DON'T REIMBURSE FOR NUTRITIONAL COUNSELING 1367 01:13:07,165 --> 01:13:08,514 OR ANYTHING LIKE THAT, 1368 01:13:08,558 --> 01:13:11,169 BUT WE'RE GONNA TALK TO THEM ABOUT STILL, YOU KNOW. 1369 01:13:11,212 --> 01:13:12,823 WE ALL KNOW THERE'S THINGS WE CAN DO 1370 01:13:12,866 --> 01:13:14,607 AND THOSE THINGS MAKE US ALL FEEL GOOD 1371 01:13:14,651 --> 01:13:15,782 AND WE LIKE TO DO THEM, 1372 01:13:15,826 --> 01:13:17,305 BUT WE'RE GONNA FEEL REALLY BAD 1373 01:13:17,349 --> 01:13:20,918 IF OUR DOORS CLOSE AND THEN WE'RE NOT GONNA HAVE ANYBODY. 1374 01:13:23,486 --> 01:13:27,446 CONVENTIONAL WISDOM IS OVER THE NEXT 2 YEARS 1375 01:13:27,490 --> 01:13:29,056 WE WILL LIKELY GO OUT OF BUSINESS. 1376 01:13:29,100 --> 01:13:32,146 WE'RE FIGHTING EVERYTHING FOR THAT NOT TO HAPPEN, 1377 01:13:32,190 --> 01:13:34,627 BUT IT'S BECAUSE THERE ISN'T THE FUNDING GOING 1378 01:13:34,671 --> 01:13:37,456 IN TO PRIMARY CARE, IT GOES INTO THE OTHER AREAS 1379 01:13:37,500 --> 01:13:42,113 AND IT'S JUST NOT SUSTAINABLE. 1380 01:13:42,548 --> 01:13:46,378 DR. MARTIN HAS A LOT MORE TIME WITH PATIENTS RIGHT NOW 1381 01:13:46,422 --> 01:13:48,119 BECAUSE SHE'S REALLY RAMPING UP HER SCHEDULE, 1382 01:13:48,162 --> 01:13:49,773 BUT SHE'S NOT COVERING HER COSTS, 1383 01:13:49,816 --> 01:13:55,300 SO THE REST OF THE PHYSICIANS ARE COVERING HER COSTS RIGHT NOW. 1384 01:13:56,083 --> 01:13:59,173 BECAUSE WE'RE A PHYSICIAN-OWNED AND A PHYSICIAN RUN PRACTICE, 1385 01:13:59,217 --> 01:14:00,784 SHE'S IN CHARGE OF HER OWN SCHEDULE, 1386 01:14:00,827 --> 01:14:03,656 BUT IF THAT REIMBURSEMENT LEVEL IS SMALLER 1387 01:14:03,700 --> 01:14:05,919 AND SMALLER, SHE'S GONNA HAVE A LOT LESS TIME 1388 01:14:05,963 --> 01:14:07,660 TO SPEND WITH PATIENTS, SO THAT WE CAN AT LEAST 1389 01:14:07,704 --> 01:14:11,316 COVER OUR COSTS AND STAY IN BUSINESS. 1390 01:14:15,625 --> 01:14:17,191 BECAUSE OF THE BOTTOM LINE, 1391 01:14:17,235 --> 01:14:19,498 BECAUSE OF THE CUTS THAT ARE COMING THROUGH THE GOVERNMENT, 1392 01:14:19,542 --> 01:14:22,327 IF IT CAME TO THE POINT WHERE THEY COULDN'T PAY ME 1393 01:14:22,370 --> 01:14:25,243 ANYMORE, THAT WOULD SUCK, BUT I'M NOT AFRAID 1394 01:14:25,286 --> 01:14:28,507 BECAUSE I'VE GOTTEN A LOT OF INSPIRATION FROM THE FELLOWSHIP, 1395 01:14:28,551 --> 01:14:31,815 A DIFFERENT PERSPECTIVE THAT THERE'S A DIFFERENT WAY 1396 01:14:31,858 --> 01:14:33,469 OF DOING THINGS THAT IS POSSIBLE. 1397 01:14:33,512 --> 01:14:36,297 DID YOU HAVE A GOOD DAY TODAY? 1398 01:14:36,341 --> 01:14:38,430 UH...YES. 1399 01:14:38,474 --> 01:14:39,692 YEAH? 1400 01:14:39,736 --> 01:14:41,389 I WOULD PROBABLY LEAVE HEALTHCARE BEFORE I WENT 1401 01:14:41,433 --> 01:14:46,394 BACK TO PRACTICING THE WAY I PRACTICED LAST YEAR. 1402 01:15:04,587 --> 01:15:07,111 I CHOSE TO GET OFF ALL NARCOTICS, 1403 01:15:07,154 --> 01:15:10,506 ALL MEDICINE, EVERYTHING. 1404 01:15:10,549 --> 01:15:13,857 SO, JUST TAKE A COUPLE OF MINUTES TO KIND OF ARRIVE. 1405 01:15:13,900 --> 01:15:16,990 ALL RIGHT, SO TAKE A BREATH. 1406 01:15:17,034 --> 01:15:18,296 [INHALING] 1407 01:15:18,339 --> 01:15:21,386 I'M A REDNECK, SOUTH LOUISIANA BOY, 1408 01:15:21,429 --> 01:15:22,996 JUST AN OLD HILLBILLY, YOU KNOW. 1409 01:15:23,040 --> 01:15:26,347 I DON'T BELIEVE IN THAT STUFF, YOU KNOW, IN EASTERN MEDICINE. 1410 01:15:26,391 --> 01:15:30,482 ANYBODY ELSE WOULD LAUGH, YOU KNOW, BE LIKE WHAT IS THAT FOR? 1411 01:15:30,526 --> 01:15:32,963 HOLD MY BEER WHILE I SHOOT THIS GATOR, 1412 01:15:33,006 --> 01:15:36,357 YOU KNOW? BUT I DECIDED TO GIVE IT A SHOT. 1413 01:15:36,401 --> 01:15:38,969 SO, WE GOING TO OPEN UP SOME CHI? 1414 01:15:39,012 --> 01:15:39,970 WE GONNA OPEN UP SOME CHI. 1415 01:15:40,013 --> 01:15:41,449 THAT'S A GOOD WAY TO THINK OF IT. 1416 01:15:41,493 --> 01:15:44,931 OH, WOW. [CHUCKLES] THAT'S THE WAY I LIKE TO LOOK AT IT. 1417 01:15:45,236 --> 01:15:50,502 BECAUSE OF THIS PROGRAM THAT'S HERE, THERE'S YOGA... 1418 01:15:50,546 --> 01:15:52,373 I'M JUST GOING TO GO AHEAD AND PUT THE LAST ONE IN... 1419 01:15:52,417 --> 01:15:58,118 I MEDITATE AND IT HAS OPENED UP A WHOLE NEW WORLD FOR ME. 1420 01:15:58,162 --> 01:16:02,079 I'M GOING TO LEAVE THESE IN FOR ABOUT 5, 7 MINUTES, 1421 01:16:02,122 --> 01:16:03,907 SOMETHING LIKE THAT, OK? 1422 01:16:03,950 --> 01:16:05,430 ROGER THAT. 1423 01:16:05,473 --> 01:16:08,346 IT'S WONDERFUL. 1424 01:16:09,434 --> 01:16:11,828 [GUNFIRE] 1425 01:16:11,871 --> 01:16:14,526 Man: A NEW STUDY FINDS A GROWING NUMBER OF COMBAT VETERANS 1426 01:16:14,570 --> 01:16:18,269 ARE BATTLING MENTAL ILLNESS, BUT MANY ARE FINDING IT 1427 01:16:18,312 --> 01:16:21,577 DIFFICULT TO GET THE HELP THEY NEED. 1428 01:16:23,579 --> 01:16:26,059 POST TRAUMATIC STRESS DISORDER, OR P.T.S.D., 1429 01:16:26,103 --> 01:16:30,934 IT'S AN INDIVIDUAL'S REACTION TO THE EXPOSURES AND EXPERIENCES OF WAR. 1430 01:16:30,977 --> 01:16:33,806 WAR IS HELL. IT'S ALWAYS HELL. 1431 01:16:34,415 --> 01:16:36,069 SO, YOU PICK YOUR SPOT. 1432 01:16:36,113 --> 01:16:39,333 SOLDIERS KNOW IF THEY GO TO WAR AND IF THEY GET A LEG BLOWN OFF, 1433 01:16:39,377 --> 01:16:41,205 THAT YOUR MEDICS GOING TO TAKE CARE OF YOU 1434 01:16:41,248 --> 01:16:44,382 AND THE SAME THING NEEDS TO APPLY THAT IF YOU HAVE POST TRAUMATIC STRESS, 1435 01:16:44,425 --> 01:16:47,603 INVISIBLE AS IT IS, IT'S JUST AS SIGNIFICANT 1436 01:16:47,646 --> 01:16:50,257 AS A BULLET WOUND TO THE HEAD OR CHEST. 1437 01:16:50,301 --> 01:16:54,000 THE FIRST THING I'D LIKE TO DO IS TEACH YOU 1438 01:16:54,044 --> 01:16:57,134 A BREATHING EXERCISE WITH A TARGETED EFFECT 1439 01:16:57,177 --> 01:16:58,918 ON POST TRAUMATIC STRESS. 1440 01:16:58,962 --> 01:17:01,399 ALL RIGHT, SO, INHALE. [INHALING] 1441 01:17:01,442 --> 01:17:03,793 EXHALE. [EXHALING] 1442 01:17:03,836 --> 01:17:07,274 CATCHING IT VERY, VERY EARLY AFTER THEIR EXPOSURE 1443 01:17:07,318 --> 01:17:08,841 AND ALLOWING THEM TO PROCESS THAT 1444 01:17:08,885 --> 01:17:11,235 IS SO CRITICAL IN THE LONG-TERM RECOVERY. 1445 01:17:11,278 --> 01:17:17,371 RELEASE THE BREATH IN A SMOOTH, EVEN STREAM OUT. 1446 01:17:17,415 --> 01:17:20,679 OK, SO, LET'S GO INTO OUR MEDITATION PRACTICE. 1447 01:17:20,723 --> 01:17:23,334 MEDITATION IS SCARY SOMETIMES. 1448 01:17:23,377 --> 01:17:24,335 SOMETIMES WHEN YOU GO, 1449 01:17:24,378 --> 01:17:26,206 YOU GO TO BAD PLACES IN YOUR HEAD. 1450 01:17:26,250 --> 01:17:29,819 I WILL BE AT YOUR SIDE, SHOULD ANYTHING CHALLENGING COME UP FOR YOU. 1451 01:17:29,862 --> 01:17:34,345 THAT'S A HEALING PROCESS BECAUSE YOU'RE NOT BOTTLING UP. 1452 01:17:34,388 --> 01:17:35,694 IT'S GOING TO A DIFFERENT SECTION 1453 01:17:35,738 --> 01:17:39,002 IN YOUR MIND TO WHERE YOU CAN START PROCESSING IT. 1454 01:17:39,045 --> 01:17:44,311 SO, FEEL YOURSELF THERE IN YOUR SAFE PLACE. 1455 01:17:45,835 --> 01:17:50,622 AND REMEMBER THAT YOU CAN RETURN TO THIS PLACE 1456 01:17:50,666 --> 01:17:54,191 AT ANYTIME DURING THE MEDITATION. 1457 01:17:54,234 --> 01:17:55,758 LET GO OF THINKING. 1458 01:17:55,801 --> 01:18:00,676 DROP BACK IN AWARENESS AND NOTICE HOW A THOUGHT MAY SHOW UP, 1459 01:18:00,719 --> 01:18:02,242 SEEMINGLY OUT OF NOWHERE, 1460 01:18:02,286 --> 01:18:06,420 OR AN IMAGE MAY SHOW UP AND THEN DISAPPEAR. 1461 01:18:06,464 --> 01:18:11,121 AND FEEL YOURSELF OBSERVING ALL THESE CONSTANTLY 1462 01:18:11,164 --> 01:18:16,082 CHANGING SENSATIONS AND THOUGHTS AND FEELINGS. 1463 01:18:16,126 --> 01:18:20,347 RECOGNIZE THAT YOU ARE THIS SPACIOUS, 1464 01:18:20,391 --> 01:18:25,178 WELCOMING, OPEN AWARENESS. 1465 01:18:25,222 --> 01:18:30,140 NO MATTER WHAT THOUGHT, NO MATTER WHAT FEELING, 1466 01:18:30,183 --> 01:18:36,973 NO MATTER WHAT SENSATION OR CIRCUMSTANCE HAPPENS TO ARISE. 1467 01:18:37,016 --> 01:18:37,930 [SHUDDERING] 1468 01:18:37,974 --> 01:18:40,803 YOUR ARMS HEAVY, YOUR LEGS HEAVY. 1469 01:18:40,846 --> 01:18:41,934 YOU'RE GOOD. YOU'RE GOOD. 1470 01:18:41,978 --> 01:18:44,328 I KNOW, I KNOW. 1471 01:18:46,983 --> 01:18:48,724 THAT'S SOME SWEAT. 1472 01:18:48,767 --> 01:18:51,857 YOU DONE SOME SWEATING. 1473 01:18:52,597 --> 01:18:57,384 I WAS ON PRAZOSIN JUST FOR NIGHTMARES. 1474 01:18:57,428 --> 01:19:00,692 MEDITATION, IT TAKES THE PLACE OF THAT. 1475 01:19:00,736 --> 01:19:04,957 NOTICE WHERE YOU ARE IN THE ROOM, THE PEOPLE AROUND. 1476 01:19:05,001 --> 01:19:09,832 THE PAIN...IT'S HARD, YOU KNOW, IT'S REALLY HARD. 1477 01:19:09,875 --> 01:19:11,311 YOU GOT TO PUSH THROUGH IT. 1478 01:19:11,355 --> 01:19:19,929 BUT THIS PROGRAM HAS JUST INSPIRED ME TO PRESS FORWARD. 1479 01:19:23,976 --> 01:19:26,849 THE MEDICATION DEPRESSES YOU. 1480 01:19:26,892 --> 01:19:30,591 IT MAKES YOU THINK THAT... 1481 01:19:30,635 --> 01:19:33,986 IS ALL YOU'RE EVER GONNA BE IN. 1482 01:19:35,988 --> 01:19:41,951 WE'LL END THE PRACTICE TODAY WITH THE COMPLETING STATEMENTS. 1483 01:19:41,994 --> 01:19:45,737 MAY EVERYONE BE WELL... 1484 01:19:45,781 --> 01:19:49,697 MAY EVERYONE BE HEALTHY... 1485 01:19:51,308 --> 01:19:54,311 MAY EVERYONE BE HAPPY. 1486 01:19:54,354 --> 01:19:57,053 MAY EVERYONE BE HAPPY. 1487 01:20:00,491 --> 01:20:04,495 IF THE MILITARY IS ABLE TO SUCCESSFULLY INTEGRATE ACUPUNCTURE, 1488 01:20:04,538 --> 01:20:06,627 MEDITATION AND MIND BODY, YOGA, 1489 01:20:06,671 --> 01:20:09,761 THEN WE'LL FIND THAT THE CULTURE AT LARGE WILL LEARN 1490 01:20:09,805 --> 01:20:11,110 HOW TO ADOPT IT AND IT WILL HAVE 1491 01:20:11,154 --> 01:20:14,853 A TRANSFORMATIVE EFFECT ON OUR HEALTHCARE SYSTEM. 1492 01:20:14,897 --> 01:20:15,854 READY? 1493 01:20:15,898 --> 01:20:17,421 YES, MA'AM. 1494 01:20:24,994 --> 01:20:28,084 THE LIMITATIONS OF HIGH TECH MEDICINE HAVE NEVER BEEN CLEARER, 1495 01:20:28,127 --> 01:20:31,957 AT THE SAME TIME THAT THE POWER OF THESE SIMPLE LOW TECH, 1496 01:20:32,001 --> 01:20:35,047 LOW COST INTERVENTIONS IS ALSO BECOMING CLEARER. 1497 01:20:35,091 --> 01:20:38,834 WE COULD DO A THOUSAND STUDIES WITH A MILLION PATIENTS. 1498 01:20:38,877 --> 01:20:40,313 IT WOULD ALWAYS REMAIN ON THE FRINGES. 1499 01:20:40,357 --> 01:20:42,663 IT'S ALL ABOUT THE BENJAMIN'S, AS THE RAPPERS WOULD SAY. 1500 01:20:42,707 --> 01:20:44,056 IT'S ALL ABOUT THE REIMBURSEMENT. 1501 01:20:44,100 --> 01:20:46,450 IF WE CAN CHANGE REIMBURSEMENT, IT'S A GAME CHANGER. 1502 01:20:46,493 --> 01:20:47,843 WE CHANGE MEDICAL PRACTICE 1503 01:20:47,886 --> 01:20:49,757 AND WE CHANG MEDICAL EDUCATION. 1504 01:20:49,801 --> 01:20:53,805 TRYING TO GET MEDICARE TO COVER THE HEART DISEASE PROGRAM 1505 01:20:53,849 --> 01:20:58,897 HAS BEEN BY FAR THE HARDEST THING I'VE EVER DONE IN MY ENTIRE LIFE. 1506 01:20:58,941 --> 01:21:01,552 MOST INSURANCE COMPANIES WILL FOLLOW MEDICARE'S LEAD, 1507 01:21:01,595 --> 01:21:04,207 SO I REALIZE THAT MEDICARE'S THE ROSETTA STONE. 1508 01:21:04,250 --> 01:21:05,773 IF WE GET MEDICARE TO COVER IT, 1509 01:21:05,817 --> 01:21:07,732 THEN EVERYONE ELSE WILL COVER IT AND IF EVERYONE COVERS IT, 1510 01:21:07,775 --> 01:21:11,388 THEN IT BECOMES THE STANDARD OF CARE. 1511 01:21:18,917 --> 01:21:21,050 I WANTED TO BRING YOU UP TO DATE ON OUR PROGRESS. 1512 01:21:21,093 --> 01:21:22,878 WE'VE BEEN MAKING A LOT. 1513 01:21:22,921 --> 01:21:25,358 MEDICARE FINALLY IS GOING TO COVER OUR REVERSING HEART DISEASE PROGRAM. 1514 01:21:25,402 --> 01:21:27,360 THAT WAS 16 YEARS IN THE MAKING, AS YOU KNOW. 1515 01:21:27,404 --> 01:21:29,797 IT'S NOT LIKE THERE'S ONE LIFESTYLE PROGRAM 1516 01:21:29,841 --> 01:21:31,756 FOR HEART DISEASE AND ANOTHER ONE FOR DIABETES 1517 01:21:31,799 --> 01:21:33,497 AND ANOTHER ONE FOR CHANGING YOUR GENE EXPRESSION, 1518 01:21:33,540 --> 01:21:36,108 ANOTHER ONE FOR PROSTATE CANCER, IT'S ESSENTIALLY THE SAME PROGRAM. 1519 01:21:36,152 --> 01:21:38,328 IT'S JUST A QUESTION OF THE DEGREE THAT PEOPLE 1520 01:21:38,371 --> 01:21:39,807 ARE WILLING TO MAKE THESE CHANGES. 1521 01:21:39,851 --> 01:21:42,506 THAT'S THE KEY POINT, DEAN. 1522 01:21:42,549 --> 01:21:46,814 PEOPLE, SO TO SPEAK, HAVE A CONSTITUTIONAL RIGHT TO BE FOOLISH. 1523 01:21:46,858 --> 01:21:48,816 HA HA HA.WE HAVE TO RESPECT THAT. 1524 01:21:48,860 --> 01:21:51,210 BUT IF WE'RE REALLY TALKING ABOUT TRUE FREEDOM OF CHOICE, 1525 01:21:51,254 --> 01:21:53,517 THEY ALREADY PAY FOR THE DRUGS AND SURGERY, 1526 01:21:53,560 --> 01:21:55,084 WHAT WE ALSO WANT THEM TO PAY FOR ARE 1527 01:21:55,127 --> 01:21:57,042 FOR THOSE PEOPLE WHO ARE MOTIVATED AND WHO WANT TO CHANGE, 1528 01:21:57,086 --> 01:21:59,784 TO GIVE THEM THE SUPPORT THAT THEY NEED IN ORDER TO BE ABLE TO DO THAT. 1529 01:21:59,827 --> 01:22:02,178 THAT'S PROBABLY TOO LOGICAL FOR THE FEDERAL GOVERNMENT 1530 01:22:02,221 --> 01:22:06,965 TO PICK UP ON IMMEDIATELY, BUT WE DIDN'T GET INTO THIS 1531 01:22:07,009 --> 01:22:09,881 SITUATION WITH SO MANY AMERICANS OBESE, 1532 01:22:09,925 --> 01:22:13,406 WITH THIS LEVEL OF JUVENILE DIABETES, BY ACCIDENT. 1533 01:22:13,450 --> 01:22:18,411 WE GOT INTO BECAUSE THERE WERE A WHOLE HOST OF POLICIES 1534 01:22:18,455 --> 01:22:21,762 THAT LED US DOWN THIS PATH TO SICK CARE, 1535 01:22:21,806 --> 01:22:24,809 RATHER THAN THE FOCUS ON PREVENTION AND WELLNESS. 1536 01:22:26,985 --> 01:22:30,641 NOW, THAT MEDICARE'S GONNA COVER THE HEART DISEASE PROGRAM, 1537 01:22:30,684 --> 01:22:32,904 THE NEXT STEP WILL BE TYPE 2 DIABETES. 1538 01:22:32,948 --> 01:22:34,514 HALF OF AMERICANS WILL BE DIABETIC 1539 01:22:34,558 --> 01:22:37,126 OR PRE-DIABETIC IN THE NEXT 10 YEARS. HALF. 1540 01:22:37,169 --> 01:22:40,172 IF WE CAN PREVENT THAT AND EVEN REVERSE IT, 1541 01:22:40,216 --> 01:22:42,914 THAT'S HOW WE'RE GONNA MAKE TRUE HEALTHCARE, 1542 01:22:42,958 --> 01:22:44,307 NOT JUST SICK CARE AVAILABLE, 1543 01:22:44,350 --> 01:22:47,963 AT A TIME WHEN THE MEDICAL SYSTEM IS SO BADLY BROKEN. 1544 01:22:54,708 --> 01:22:57,015 Woman: ONE COMPANY HAS FIGURED OUT 1545 01:22:57,059 --> 01:23:00,062 HOW TO LOWER HEALTHCARE COSTS BY MORE THAN 40%. 1546 01:23:00,105 --> 01:23:03,282 IT'S AN IDEA THAT'S RECEIVED NATIONAL ATTENTION. 1547 01:23:03,326 --> 01:23:05,197 FOLLOWING THE EXAMPLE OF PLACES LIKE SAFEWAY. 1548 01:23:05,241 --> 01:23:07,678 Charlie Gibson: THE SAFEWAY SUPERMARKET CHAIN LOOKED 1549 01:23:07,721 --> 01:23:09,941 FOR A WAY TO REIGN IN SPIRALING PREMIUMS 1550 01:23:09,985 --> 01:23:14,250 AND HIT ON WHAT SEEMS TO BE A WIN-WIN SOLUTION. 1551 01:23:16,817 --> 01:23:22,127 IN 2005, WE HAD A BILLION DOLLAR HEALTHCARE BILL, 1552 01:23:22,171 --> 01:23:24,390 RISING AT THE RATE OF $100 MILLION A YEAR. 1553 01:23:24,434 --> 01:23:27,480 THESE ARE THE COSTS OF ALL OF OUR DRUGS IN ORDER, 1554 01:23:27,524 --> 01:23:31,136 SO DIABETICS ARE ONE THE NUMBER ONE COST OF PRESCRIPTIONS. 1555 01:23:31,180 --> 01:23:33,182 YOU CAN SEE HOW MANY SCRIPTS AND THE AVERAGE SCRIPT. 1556 01:23:33,225 --> 01:23:39,188 WHAT WE DISCOVERED WAS THAT 70% OF HEALTHCARE COSTS 1557 01:23:39,231 --> 01:23:40,972 ARE DRIVEN BY PEOPLE'S BEHAVIORS. 1558 01:23:41,016 --> 01:23:45,150 AT MY HEAVIEST, I WAS OVER 200 POUNDS. 1559 01:23:45,194 --> 01:23:47,674 I'D HAVE MY PIZZA, I'D HAVE MY COMICS, 1560 01:23:47,718 --> 01:23:49,589 I'D HAVE MY D.V.D.s AND THAT WAS THE WEEKEND. 1561 01:23:49,633 --> 01:23:54,116 YOU REALIZE ONE DAY, WOW, YOU KNOW, I HAVEN'T WORKED OUT, 1562 01:23:54,159 --> 01:23:56,161 I HAVEN'T EXERCISED AND, YOU KNOW, YOU KIND OF GET BUSY 1563 01:23:56,205 --> 01:24:01,079 AND IT'S JUST THE LAST THING THAT YOU'RE REALLY CONCERNED ABOUT. 1564 01:24:01,123 --> 01:24:04,169 I WAS CHRONICALLY COMING DOWN WITH COLDS 1565 01:24:04,213 --> 01:24:07,172 AND I KNEW THAT THERE WAS A HISTORY OF CANCER 1566 01:24:07,216 --> 01:24:10,088 IN MY FAMILY AND DIABETES, HEART DISEASE. 1567 01:24:10,132 --> 01:24:11,785 I WAS A WALKING DEAD MAN. 1568 01:24:11,829 --> 01:24:16,747 NOW, AS A BUSINESS GUY, I THOUGHT IF WE COULD INFLUENCE BEHAVIOR 1569 01:24:16,790 --> 01:24:18,923 OF OUR 200,000 PERSON WORKFORCE, 1570 01:24:18,966 --> 01:24:21,186 WE COULD HAVE A MATERIAL EFFECT ON HEALTHCARE COSTS. 1571 01:24:21,230 --> 01:24:27,975 THE EASIEST STARTING POINT WAS IN THE 30,000 NON-UNION WORKFORCE 1572 01:24:28,019 --> 01:24:30,108 AND I BELIEVE THAT WITHIN 4 YEARS 1573 01:24:30,152 --> 01:24:35,331 ALL OF OUR EMPLOYEES WILL GET THIS KIND OF HEALTHCARE PLAN. 1574 01:24:37,768 --> 01:24:41,076 ALL AMERICANS HAVE ACCEPTED FOR 50 OR MORE YEARS 1575 01:24:41,119 --> 01:24:47,082 IN THE AUTOMOBILE INSURANCE INDUSTRY THAT DRIVING RECORD DICTATE PREMIUM. 1576 01:24:47,343 --> 01:24:49,910 AND ALL INSURANCE COMPANIES ARE SAYING 1577 01:24:49,954 --> 01:24:53,000 IS YOUR BEHAVIOR SHOULD DRIVE THE PREMIUM. 1578 01:24:53,044 --> 01:24:56,003 AND HEALTHCARE DOESN'T NEED TO BE IMMUNE TO THAT. 1579 01:24:56,047 --> 01:25:02,140 SO, WE PROVIDE INCENTIVES FOR PEOPLE TO ENGAGE IN HEALTHIER BEHAVIOR. 1580 01:25:02,184 --> 01:25:05,752 OUR HEALTHCARE PREMIUMS STARTS HERE 1581 01:25:05,796 --> 01:25:09,104 AND IF YOU HAVE A BODY MASS INDEX LESS THAN 30, 1582 01:25:09,147 --> 01:25:10,192 YOU GET A DISCOUNT. 1583 01:25:10,235 --> 01:25:11,976 IF THEY ARE A CONFIRMED A NON-SMOKER, 1584 01:25:12,019 --> 01:25:13,064 WE GIVE THEM A DISCOUNT. 1585 01:25:13,108 --> 01:25:15,675 IF YOU HAVE CHOLESTEROL UNDER CONTROL, 1586 01:25:15,719 --> 01:25:18,809 A DISCOUNT. BLOOD PRESSURE UNDER CONTROL, A DISCOUNT. 1587 01:25:18,852 --> 01:25:21,638 AND SO BEHAVIOR BECOMES A FORM OF CURRENCY 1588 01:25:21,681 --> 01:25:25,511 FOR PEOPLE TO ACCOMPLISH THEIR LIFESTYLE CHANGES. 1589 01:25:25,555 --> 01:25:27,122 WITHOUT THE FINANCIAL INCENTIVES, 1590 01:25:27,165 --> 01:25:30,734 THERE'S NO WAY I COULD HAVE GOTTEN TO THE POINT THAT I AM NOW. 1591 01:25:30,777 --> 01:25:33,171 IT'S SAVING LITERALLY THOUSANDS OF DOLLARS 1592 01:25:33,215 --> 01:25:36,957 OVER THE PAST FEW YEARS BY BEING HEALTHIER. 1593 01:25:37,001 --> 01:25:39,134 [INDISTINCT CHATTER] 1594 01:25:41,919 --> 01:25:43,094 ARE WE READY TO ROLL? 1595 01:25:43,138 --> 01:25:43,921 YES, WE ARE. 1596 01:25:43,964 --> 01:25:46,880 ALL RIGHT! LET'S GO! WHOO! 1597 01:25:46,924 --> 01:25:47,925 ALL RIGHT. 1598 01:25:47,968 --> 01:25:49,883 WHOO! 1599 01:25:49,927 --> 01:25:51,885 I NEVER WAS A RUNNER 1600 01:25:51,929 --> 01:25:53,496 BEFORE I STARTED THE SAFEWAY RUNNING GROUP. 1601 01:25:53,539 --> 01:25:56,107 LITTLE BY LITTLE AS WE WERE HERE IN THE GYM, 1602 01:25:56,151 --> 01:25:57,195 THEY JUST KIND OF DRAFTED US IN 1603 01:25:57,239 --> 01:25:59,502 AND WE'VE BEEN RUNNING EVER SINCE. 1604 01:25:59,545 --> 01:26:03,897 ALL WE DID WAS FACILITATE SMART CHOICES FOR PEOPLE 1605 01:26:03,941 --> 01:26:07,553 AND DEVELOPED THIS CULTURE OF HEALTH AND FITNESS. 1606 01:26:07,597 --> 01:26:09,990 DID YOU BIKE TO WORK TODAY? 1607 01:26:10,034 --> 01:26:11,514 I DID YESTERDAY. 1608 01:26:11,557 --> 01:26:12,558 ALL RIGHT. 1609 01:26:12,602 --> 01:26:14,212 I'M GOING TO DO IT AGAIN ON FRIDAY. 1610 01:26:14,256 --> 01:26:15,909 ALL RIGHT. 1611 01:26:16,997 --> 01:26:20,349 IF YOU TALK TO THE EMPLOYEES AROUND HERE 1612 01:26:20,392 --> 01:26:24,875 THAT HAVE LOST 35, 50, 60, 100 POUNDS, 1613 01:26:24,918 --> 01:26:26,572 THEY WILL TELL YOU WITHOUT A DOUBT 1614 01:26:26,616 --> 01:26:29,140 THEY HAVE A BETTER QUALITY OF LIFE. 1615 01:26:29,184 --> 01:26:32,056 FOR A LONG PERIOD OF TIME, I WAS HIDING. 1616 01:26:32,099 --> 01:26:33,231 I HAD A FULL BEARD. 1617 01:26:33,275 --> 01:26:35,668 I HAD DREADS DOWN TO MY WAIST. 1618 01:26:35,712 --> 01:26:38,323 I WAS SHUTTING DOWN EMOTIONALLY. 1619 01:26:38,367 --> 01:26:41,239 I NOT ONLY HAVE A SECOND CHANCE, 1620 01:26:41,283 --> 01:26:43,502 I HAVE THE GREATEST CHANCE BECAUSE I HAVE 1621 01:26:43,546 --> 01:26:46,070 A CHANCE TO MAKE MY NEXT 50 YEARS 1622 01:26:46,113 --> 01:26:47,854 BETTER THAN MY LAST 50 YEARS. 1623 01:26:47,898 --> 01:26:50,466 IT'S STILL A STRUGGLE. 1624 01:26:50,509 --> 01:26:52,032 WHEN I'M RUNNING AND IT'S A HOT DAY 1625 01:26:52,076 --> 01:26:54,252 AND I FEEL LIKE GIVING UP, IT NEVER FAILS, 1626 01:26:54,296 --> 01:26:56,123 I'LL LOOK UP AND I'LL SEE A PERSON 1627 01:26:56,167 --> 01:26:58,256 WHO'S OVERWEIGHT ACROSS THE STREET. 1628 01:26:58,300 --> 01:27:00,040 MY FIRST THOUGHT IS THAT'S WHY I'M RUNNING 1629 01:27:00,084 --> 01:27:03,435 BECAUSE I KNOW WHAT THAT PERSON'S LIKE, IT USED TO BE ME. 1630 01:27:03,479 --> 01:27:06,133 LET ME HAVE A SALMON STEAMER BASKET. 1631 01:27:06,177 --> 01:27:07,396 COMING RIGHT UP. 1632 01:27:07,439 --> 01:27:09,093 YOU CAN'T SAY YOU'RE INTERESTED IN THE CULTURE 1633 01:27:09,136 --> 01:27:11,791 OF HEALTH AND FITNESS WITHOUT PROVIDING A FIRST CLASS GYM. 1634 01:27:11,835 --> 01:27:16,318 YOU CAN'T HAVE A CAFETERIA THAT DOESN'T HAVE CALORIE COUNTS ON IT. 1635 01:27:16,361 --> 01:27:19,495 OUR APPROACH HERE IS COMPLETELY HOLISTIC. 1636 01:27:19,538 --> 01:27:22,715 Woman: SAFEWAY'S HEALTHCARE COSTS HAVE REMAINED FLAT 1637 01:27:22,759 --> 01:27:26,284 COMPARED TO A 40% JUMP FOR MOST OTHER COMPANIES. 1638 01:27:26,328 --> 01:27:27,807 30% OF OUR SMOKERS HAVE QUIT. 1639 01:27:27,851 --> 01:27:32,334 21% OF OUR OBESE POPULATION ARE NO LONGER OBESE. 1640 01:27:32,377 --> 01:27:36,512 AND SAFEWAY EMPLOYEES WILL BE LESS OF A BURDEN ON THE MEDICARE 1641 01:27:36,555 --> 01:27:39,341 OF THE FUTURE BECAUSE THEY HAVE ADAPTED 1642 01:27:39,384 --> 01:27:41,343 TO THIS CULTURE OF HEALTH AND FITNESS. 1643 01:27:41,386 --> 01:27:45,782 YOU ALLOW AND ENCOURAGE YOUR EMPLOYEES TO BECOME HEALTHIER. 1644 01:27:45,825 --> 01:27:48,785 THEY BECOME MORE PRODUCTIVE. 1645 01:27:48,828 --> 01:27:50,700 YOUR COMPANY BECOMES MORE COMPETITIVE. 1646 01:27:50,743 --> 01:27:54,660 I MEAN, I CAN'T THINK OF A SINGLE NEGATIVE IN DOING THIS. 1647 01:27:54,704 --> 01:27:56,880 IF I'M FRUSTRATED BY ANYTHING, 1648 01:27:56,923 --> 01:28:00,318 IT'S THAT MORE OF THE NATION HASN'T ADOPTED THIS. 1649 01:28:00,362 --> 01:28:05,105 SAFEWAY CORPORATION, THEY'VE ACTUALLY BEEN ABLE TO BEND THE COST CURVE, 1650 01:28:05,149 --> 01:28:08,021 THOSE ARE THE KIND OF THINGS THAT ACTUALLY HAVE AN IMPACT. 1651 01:28:08,065 --> 01:28:12,635 MAKING MONEY AND DOING GOOD IN THE WORLD ARE NOT MUTUALLY EXCLUSIVE. 1652 01:28:12,678 --> 01:28:17,335 I LOST ABOUT 120 POUNDS OVER THE COURSE OF 3 YEARS. 1653 01:28:18,031 --> 01:28:19,685 EVEN IF I LOSE 30 MORE POUNDS, 1654 01:28:19,729 --> 01:28:21,731 WHICH PROBABLY IS MY ULTIMATE TARGET, 1655 01:28:21,774 --> 01:28:24,603 I'M NOT GONNA STOP DOING THIS. 1656 01:28:24,647 --> 01:28:25,648 MY ENERGY LEVEL IS UP. 1657 01:28:25,691 --> 01:28:27,345 ALL MY HEALTH ISSUES HAVE GONE AWAY. 1658 01:28:27,389 --> 01:28:30,435 IT'S NICE TO KNOW THAT I'VE GOT A LONG TIME TO SPEND 1659 01:28:30,479 --> 01:28:34,744 WITH MY FAMILY AND I'M GOING TO GET SEE MY SON GROW OLDER 1660 01:28:34,787 --> 01:28:38,574 AND GO TO COLLEGE AND ALL THAT FUN STUFF. 1661 01:28:44,623 --> 01:28:47,278 IF WE REALLY CAN, PUBLIC AND PRIVATE SIDE, 1662 01:28:47,322 --> 01:28:50,890 BEGIN TO MIGRATE PAYMENT FROM PAYING FOR VOLUME, 1663 01:28:50,934 --> 01:28:52,805 PAYING FOR HOW MUCH YOU DO, 1664 01:28:52,849 --> 01:28:54,285 TO PAYING FOR OUTCOMES, 1665 01:28:54,329 --> 01:28:57,201 PAYING FOR HOW WELL YOU DO, HOW WELL THE PATIENT DOES... 1666 01:28:57,244 --> 01:28:58,724 THAT WILL CHANGE THE GAME. 1667 01:28:58,768 --> 01:29:01,640 PEOPLE WILL START TO SAY, WELL, NOW THE MONEY IS IN HEALTH 1668 01:29:01,684 --> 01:29:06,123 AND WELL BEING AND SAFETY AND VITALITY, 1669 01:29:06,166 --> 01:29:08,778 NOT IN MORE, MORE, MORE, MORE. 1670 01:29:12,738 --> 01:29:13,870 THERE ARE ANSWERS. 1671 01:29:13,913 --> 01:29:15,393 WE KNOW WHAT SAFE CARE LOOKS LIKE. 1672 01:29:15,437 --> 01:29:17,526 IT'S NOT JUST WE KNOW IT, WE ACTUALLY CAN GO AND VISIT IT. 1673 01:29:17,569 --> 01:29:19,223 YOU CAN VISIT A HOSPITAL THAT STOPPED INFECTIONS. 1674 01:29:19,266 --> 01:29:22,182 YOU CAN VISIT A HOSPITAL THAT'S ENDING WASTE SLOWLY BUT DOING IT. 1675 01:29:22,226 --> 01:29:26,796 YOU CAN VISIT SYSTEMS THAT COORDINATE CARE, NEARLY PERFECTLY. 1676 01:29:26,839 --> 01:29:30,365 THE CLEVELAND CLINIC WAS FOUNDED BY 4 PHYSICIANS 1677 01:29:30,408 --> 01:29:33,542 AND THEY REALIZED THEY DID BETTER WORKING AS A TEAM 1678 01:29:33,585 --> 01:29:36,022 THAN THEY DID AS INDIVIDUAL PRACTITIONERS 1679 01:29:36,066 --> 01:29:38,721 AND THEY FORMED A GROUP PRACTICE. 1680 01:29:38,764 --> 01:29:41,811 THEY DECIDED THAT WOULD PAY THEMSELVES A SALARY 1681 01:29:41,854 --> 01:29:44,248 AND THE MONEY THAT WAS LEFT OVER WOULD GO BACK 1682 01:29:44,291 --> 01:29:45,945 INTO GROWING THE ORGANIZATION. 1683 01:29:45,989 --> 01:29:49,122 AND THAT MODEL HAS CONTINUED TO THIS DAY. 1684 01:29:49,166 --> 01:29:51,255 WE'RE ALL SALARIED, 1685 01:29:51,298 --> 01:29:53,997 SO THE DECISION ON WHAT WE DO FOR A PATIENT IS DEPENDENT 1686 01:29:54,040 --> 01:29:59,176 UPON WHAT THE PATIENT NEEDS, NOT ON OUR FINANCIAL INCENTIVES. 1687 01:29:59,785 --> 01:30:01,744 6 YEARS AGO, BEFORE I BECAME C.E.O., 1688 01:30:01,787 --> 01:30:04,660 I WAS SITTING DOWN SAYING, WHAT PROFESSION AM I IN? 1689 01:30:04,703 --> 01:30:07,880 AND I SAID, WELL, I'M IN THE HEALTHCARE PROFESSION. 1690 01:30:07,924 --> 01:30:09,012 AND THEN I STOPPED TO THINK, 1691 01:30:09,055 --> 01:30:11,754 I'VE NEVER LOOKED AFTER A HEALTHY PERSON 1692 01:30:11,797 --> 01:30:14,409 AND MAYBE IT WOULD BE EASIER 1693 01:30:14,452 --> 01:30:15,366 TO TAKE CARE OF PEOPLE 1694 01:30:15,410 --> 01:30:16,628 AND KEEP THEM FROM GETTING SICK 1695 01:30:16,672 --> 01:30:19,109 BEFORE THEY ACTUALLY DID GET SICK. 1696 01:30:19,152 --> 01:30:20,676 HOW ARE YOU? HI. 1697 01:30:20,719 --> 01:30:22,286 HOW ARE YOU? 1698 01:30:22,329 --> 01:30:24,549 YOU KNOW HOW PEOPLE SAY IT TAKES A VILLAGE TO RAISE A CHILD? 1699 01:30:24,593 --> 01:30:29,032 IT TAKES A VILLAGE TO MAKE AN UNHEALTHY PATIENT HEALTHY, 1700 01:30:29,075 --> 01:30:30,642 IT REALLY DOES. 1701 01:30:30,686 --> 01:30:33,645 SHE NEEDS A FOLLOW-UP WITH ME IN 3 MONTHS WITH AN ECHO BEFORE. 1702 01:30:33,689 --> 01:30:36,909 PEOPLE WITH CHRONIC DISEASE, WHO COME IN AND OUT HOSPITALS, 1703 01:30:36,953 --> 01:30:38,476 BOUNCED IN AND OUT OF E.R.s, 1704 01:30:38,520 --> 01:30:41,610 THAT'S WHAT THEY NEED, SOMEONE TO REALLY TAKE AN INTEREST, 1705 01:30:41,653 --> 01:30:44,700 HOLD THEM ACCOUNTABLE AND THEN TALK TO THEM, 1706 01:30:44,743 --> 01:30:46,092 YOU KNOW, ON A WEEKLY BASIS. 1707 01:30:46,136 --> 01:30:48,878 SOMETIMES WE'RE TALKING TO YVONNE ON A DAILY BASIS. 1708 01:30:48,921 --> 01:30:52,447 THAT REQUIRES SO MUCH WORK, 1709 01:30:52,490 --> 01:30:56,059 BUT WE DO IT BECAUSE WE'RE COMMITTED TO HAVING HER STAY 1710 01:30:56,102 --> 01:31:02,457 OUT OF THE HOSPITAL, COMMITTED TO HER LIVING LONGER AND BETTER. 1711 01:31:02,500 --> 01:31:03,893 [INDISTINCT] 1712 01:31:03,936 --> 01:31:07,505 WE'VE JUST CREATED A COMPLETELY DIFFERENT SYSTEM HERE 1713 01:31:07,549 --> 01:31:10,421 AND THE ACTUAL COSTS FOR CARE HERE 1714 01:31:10,465 --> 01:31:12,510 IS AMONG THE LOWEST IN THE COUNTRY 1715 01:31:12,554 --> 01:31:16,079 AND YET THE OUTCOMES, THE SURVIVAL RATES, 1716 01:31:16,122 --> 01:31:17,689 ARE AT THE HIGHEST LEVELS. 1717 01:31:17,733 --> 01:31:21,388 WE DON'T HAVE TO SPEND OURSELVES INTO POVERTY ON HEALTHCARE. 1718 01:31:21,432 --> 01:31:24,740 WE JUST HAVE TO DO IT DIFFERENTLY. 1719 01:31:26,872 --> 01:31:30,920 IT'S REALLY EASY TO FIND ARTICLES OR SPEECHES 1720 01:31:30,963 --> 01:31:34,706 FROM 30 YEARS AGO IN WHICH LEADERS WERE CALLING FOR CHANGE, 1721 01:31:34,750 --> 01:31:38,318 UNSUSTAINABLE COSTS, PROBLEMS AND OUTCOMES IN QUALITY, 1722 01:31:38,362 --> 01:31:42,148 BUT I THINK THE ECONOMIC IMPERATIVES ARE MUCH STRONGER NOW. 1723 01:31:42,192 --> 01:31:43,976 WE'RE DEALING WITH THE HEALTH OF A NATION 1724 01:31:44,020 --> 01:31:46,370 WHEN WE DEAL WITH WASTE IN HEALTHCARE. 1725 01:31:47,153 --> 01:31:49,504 WE ONLY GIVE LIP SERVICE TO PREVENTION 1726 01:31:49,547 --> 01:31:52,376 AND WE HAVE TO ASK WHY AS A SOCIETY WE ARE NOT 1727 01:31:52,419 --> 01:31:55,118 WORKING TO PREVENT DISEASE AND PROMOTE HEALTH 1728 01:31:55,161 --> 01:31:59,514 AND HOW DO WE SHIFT THIS HUGE ENTERPRISE OF DISEASE 1729 01:31:59,557 --> 01:32:02,038 INTERVENTION IN THAT DIRECTION. 1730 01:32:02,647 --> 01:32:04,693 WE NEED TO CHANGE THE NATURE OF MEDICINE 1731 01:32:04,736 --> 01:32:08,348 AND I HOPE OUR NEW GENERATION OF HEALTH PROFESSIONALS 1732 01:32:08,392 --> 01:32:10,437 WILL CATALYZE THE SOCIAL MOVEMENT 1733 01:32:10,481 --> 01:32:14,572 THAT'S NECESSARY AND ENOUGH PEOPLE GET AROUSED ENOUGH 1734 01:32:14,616 --> 01:32:16,879 ABOUT THE SITUATION AND SEE IT FOR WHAT IT IS 1735 01:32:16,922 --> 01:32:19,577 AND THEN START SOME KIND OF GRASSROOTS MOVEMENT 1736 01:32:19,621 --> 01:32:23,581 TO CHANGE THE POLITICAL BALANCE OF POWER. 1737 01:32:23,625 --> 01:32:27,498 WHAT I'M ARGUING FOR IS NOT TO MAKE THINGS TOUGH ON INDUSTRY, 1738 01:32:27,542 --> 01:32:31,197 IT'S TO MAKE THINGS SAFE FOR PATIENTS, PUTTING PATIENTS FIRST. 1739 01:32:31,241 --> 01:32:35,158 WE HAVE A MOTTO IN MEDICINE, PRIMUM NON NOCERE. 1740 01:32:35,201 --> 01:32:39,249 IN LATIN IT MEANS "ABOVE ALL, DO NO HARM." 1741 01:32:41,643 --> 01:32:45,603 IF I THINK ABOUT WHAT HEALTHCARE COULD BE LIKE, 1742 01:32:45,647 --> 01:32:47,997 IT WOULD HAVE A LOT MORE "CARE" IN IT. 1743 01:32:48,040 --> 01:32:50,434 IT WOULD BE A VERY DIFFERENT SYSTEM 1744 01:32:50,477 --> 01:32:53,393 THAT PROBABLY WOULD BE LESS HIGH TECH... 1745 01:32:53,437 --> 01:32:56,396 AND MORE HIGH TOUCH. 1746 01:32:56,440 --> 01:32:59,661 WE HAVE A LOT MORE POWER OVER HOW HEALTHY WE ARE 1747 01:32:59,704 --> 01:33:02,707 THAN WE ARE WILLING TO TAKE CREDIT FOR 1748 01:33:02,751 --> 01:33:05,101 OR WILLING TO TAKE RESPONSIBILITY FOR. 1749 01:33:05,144 --> 01:33:09,758 AND THAT'S PART OF WHAT A REALLY GREAT HEALTHCARE SYSTEM 1750 01:33:09,801 --> 01:33:13,675 WOULD DO, IT WOULD EMPOWER PATIENTS. 1751 01:33:13,718 --> 01:33:16,852 IT'S SO FRUSTRATING TO KNOW HOW HIGH THE RISKS ARE 1752 01:33:16,895 --> 01:33:19,506 AND HOW EASY THE ANSWERS ARE. 1753 01:33:20,638 --> 01:33:24,642 THE ANSWER'S AMONG US AND ONLY BY ACCEPTING THE FACT 1754 01:33:24,686 --> 01:33:27,514 THAT THE AMERICAN HEALTHCARE SYSTEM IS BADLY BROKEN, 1755 01:33:27,558 --> 01:33:29,995 THAT THE STATUS QUO ISN'T WORKING, 1756 01:33:30,039 --> 01:33:31,736 THAT IT'S BANKRUPTING OUR NATION, 1757 01:33:31,780 --> 01:33:35,610 WILL WE BE ABLE TO SEEK OUT THE ESCAPE FIRES, 1758 01:33:35,653 --> 01:33:37,394 THE POTENTIAL SOLUTIONS, 1759 01:33:37,437 --> 01:33:42,312 WE CREATE A SUSTAINABLE AND PATIENT-CENTERED SYSTEM FOR THE FUTURE. 1760 01:33:59,155 --> 01:34:01,636 HERE'S THE PAPER. 1761 01:34:01,853 --> 01:34:05,291 THAT'S EVERY SINGLE SIGNATURE 1762 01:34:05,335 --> 01:34:06,728 THAT SAYS THAT YOU'RE GOOD TO GO 1763 01:34:06,771 --> 01:34:11,384 TO GET OUT OF WALTER REED AND MOVE ON WITH MY TRAVEL. 1764 01:34:11,428 --> 01:34:13,648 RIGHT THERE. 1765 01:34:29,272 --> 01:34:30,665 I'M GOING BACK HOME. 1766 01:34:30,708 --> 01:34:34,712 HOME TO THE INFANTRY DIVISION, AIRBORNE, AIR ASSAULT. 1767 01:34:34,756 --> 01:34:37,802 I CAN'T WAIT TO BE THERE. 1768 01:34:40,152 --> 01:34:42,415 [CHUCKLES] 1769 01:34:42,851 --> 01:34:44,461 SEE YOU, DUDE. 1770 01:34:44,504 --> 01:34:46,376 I DON'T NEED YOU. 1771 01:34:46,419 --> 01:34:49,074 DON'T NEED YOU. 1772 01:34:49,118 --> 01:34:51,381 DON'T NEED YOU. 1773 01:34:51,424 --> 01:34:54,166 NEVER NEEDED YOU. 1774 01:34:56,516 --> 01:35:00,216 THEY DIDN'T FORESEE ME EVEN TRYING TO WALK YET, 1775 01:35:00,259 --> 01:35:03,915 BUT I'M DOING IT, MAINTAIN MY PAIN. 1776 01:35:03,959 --> 01:35:06,178 NOT HAVING TO NEED ALL THESE PILLS. 1777 01:35:06,222 --> 01:35:09,660 IT'S BEEN A WILD RIDE, STILL NOT OVER IT, 1778 01:35:09,704 --> 01:35:14,491 BUT IT'S BETTER FROM GERMANY, I PROMISE YOU THAT. 1779 01:35:14,534 --> 01:35:16,362 LOOK AT THIS. 1780 01:35:16,406 --> 01:35:20,410 IT'S A HAPPY TIME IN MY LIFE RIGHT NOW. 1781 01:35:21,150 --> 01:35:26,329 I'M SO EXCITED JUST TO FINALLY LEAVE THIS HOSPITAL. 1782 01:35:26,851 --> 01:35:29,767 THIS PLACE ACTUALLY GAVE ME THE TOOLS 1783 01:35:29,811 --> 01:35:34,119 TO PUT IN MY TOOL BAG SO I CAN GO BACK AND STILL CONTINUE 1784 01:35:34,163 --> 01:35:39,342 MY PROCESS OF HEALING AND RECOVERY. 1785 01:35:39,385 --> 01:35:40,822 [CELL PHONE BEEPS] 1786 01:35:40,865 --> 01:35:45,304 THE BOY FROM CAMPBELL... SEE YOU SOON. 1787 01:35:45,348 --> 01:35:48,177 FROM NOAH. 1788 01:35:52,921 --> 01:35:56,315 I FEEL LIKE I'M CHANGING. 1789 01:35:56,359 --> 01:35:57,795 THANK YOU SO MUCH. 1790 01:35:57,839 --> 01:36:00,842 I'M NOT CHANGED... BUT I'M CHANGING. 1791 01:36:55,505 --> 01:36:58,290 CAPTIONING MADE POSSIBLE BY LIONS GATE ENTERTAINMENT 1792 01:36:58,334 --> 01:36:59,944 CAPTIONED BY THE NATIONAL CAPTIONING INSTITUTE --www.ncicap.org--