Original subtitles

CAPTIONING MADE POSSIBLE BY LIONS GATE ENTERTAINMENT

[TYPING, BEEPING]

IN 1949, A FOREST FIRE BROKE OUT IN MAN GULCH, MONTANA.

SMOKE JUMPERS WERE PARACHUTED IN,

A TEAM OF 15, HEADED BY A FOREMAN NAMED WAG DODGE.

THE FIRE EXPLODED.

IT WAS MOVING OVER 600 FEET A MINUTE,

FASTER THAN MOST PEOPLE COULD EVER RUN

AND SO 15 FIREFIGHTERS WERE TRAPPED.

WAG DODGE HAD AN IDEA.

HE KNEW THAT THEY WOULD LOSE THE RACE

BACK TO THE TOP OF THE RIDGE,

SO HE SUDDENLY STOPPED,

HE LIT A MATCH AND HE LIT A FIRE AT HIS OWN FEET

AND THE FIRE SPREAD AROUND HIM.

I IMAGINE THE OTHER SMOKE JUMPERS THOUGHT THE GUY WAS CRAZY,

BUT HIS IDEA WAS THIS-- IF I BURN THE FUEL AROUND ME,

THEN WHEN THE FIRE COMES AND OVERTAKES ME, I'M SAFE.

I'LL BE IN WHAT CAME TO BE KNOWN AS AN ESCAPE FIRE.

HE TRIED TO GET THE OTHER SMOKE JUMPERS TO JOIN HIM AND NOBODY DID.

THE FIRE OVERTOOK THE CREW,

KILLING 13 MEN AND BURNING 3,200 ACRES.

WAG DODGE SURVIVED NEARLY UNHARMED IN HIS ESCAPE FIRE.

IT'S JUST TRAGIC TO THINK OF THE ANSWER BEING THERE,

BUT JUST IN THE MOMENT NOT ABLE TO SEE IT.

THAT'S HOW IMBEDDED PEOPLE GET IN THE STATUS QUO.

THEY CAN'T RECOGNIZE AN INVENTION WHEN IT'S AMONG THEM

AND THEY CAN'T GIVE UP THEIR OLD HABITS.

WE'RE IN MAN GULCH.

HEALTHCARE, IT'S HEADED FOR REALLY, REALLY BAD TROUBLE.

THE ANSWERS AMONG US, CAN WE PLEASE STOP

AND THINK AND MAKE SENSE OF THE SITUATION

AND GET OUR WAY OUT OF IT? IT'S THE SAME CHALLENGE.

WE HAVE HAD ENOUGH!

[CHEERING AND SHOUTING]

WHAT DO WE WANT?!

HEALTHCARE!

WHEN DO WE WANT IT?!NOW!

ALL I HEAR IS HOW WE'RE GONNA GET MORE PEOPLE ACCESS

TO THE PRESENT SYSTEM AND HOW WE'RE GONNA PAY FOR IT

AND TO ME THAT'S NOT THE ONLY ISSUE.

THE PRESENT SYSTEM DOESN'T WORK AND IT'S GONNA TAKE US DOWN.

WE NEED A WHOLE NEW KIND OF MEDICINE.

HEALTHCARE REFORM WAS A GOOD PLACE TO START,

BUT IT WILL DO LITTLE TO ADDRESS THE ROOT PROBLEMS.

[SIRENS]

WE DON'T HAVE A HEALTHCARE SYSTEM IN THIS COUNTRY.

WE HAVE A DISEASE MANAGEMENT SYSTEM.

PEOPLE OFTEN THINK IT HAS TO BE A NEW DRUG OR A NEW LASER

OR SOMETHING REALLY HIGH TECH AND EXPENSIVE

TO BE POWERFUL AND THEY HAVE A HARD TIME BELIEVING

THAT THESE SIMPLE CHOICES THAT WE MAKE IN OUR LIVES EACH DAY

CAN MAKE SUCH A POWERFUL DIFFERENCE.

WE'RE IN THE GRIP OF A VERY BIG INDUSTRY

AND IT DOESN'T WANT TO STOP MAKING MONEY.

AT THE EXECUTIVE LEVEL, WHAT'S MOST IMPORTANT

IS MEETING WALL STREET'S EXPECTATIONS AND THEY HAVE TO.

THESE FOR PROFIT COMPANIES,

BY LAW, HAVE TO SERVE THE SHAREHOLDERS.

YOU ALMOST FORGET THAT WHAT YOU'RE DOING IS PROVIDING HEALTHCARE.

THE HEALTHCARE SYSTEM IS UNSUSTAINABLE.

WE'RE SPENDING ALMOST TWICE AS MUCH IN AMERICA

AS ANY OTHER COUNTRY ON EARTH.

WE'RE REALLY MORTGAGING THE FUTURE.

NOT JUST THE HEALTH OF HEALTHCARE,

WE'RE TALKING ABOUT THE HEALTH OF THE NATION.

MOMMY, WHAT ARE YOU GOING TO DO?

I GOTTA GO TO WORK.

WHAT ARE YOU GONNA DO AT WORK?

WHAT I DO EVERY DAY, BUDDY.

I LOVE YOU.

I LOVE YOU, TOO!

BYE.

BYE!

IN A COMMUNITY HEALTH CENTER LIKE WHERE I WORK,

YOU SEE CHRONIC ILLNESS,

PEOPLE THAT AREN'T ABLE TO AFFORD THEIR MEDICATIONS,

LOTS OF PSYCHIATRIC ILLNESSES,

BUT THE GOVERNMENT PAYS YOU

BASED ON HOW MANY PATIENTS YOU SEE.

I THINK WE HAVE ABOUT 25 PATIENTS FOR TODAY FOR DR. MARTIN.

I THINK 5 OR 6 OF THEM ARE ON THE WAITING LIST.

IF THEY'RE AN EASY 15 MINUTE,

I'M SURE WE CAN PROBABLY SQUEEZE THEM INTO THE SCHEDULE.

HELLO, MR. FIELDS?

[SPEAKING IN SPANISH]

I NEED TO LISTEN TO YOU.

ALL RIGHT. WHO'S NEXT?

HELLO. HI.

HOW ARE YOU?

WELL, FIRST OF ALL,

MY SON'S IN THE AIR FORCE

AND HE'S GOING TO BE 21 ON SUNDAY.

MM-HMM. AND HE'S NOT HERE.

WHERE'S HE AT?

GERMANY. YEAH?

AND YOU'RE MISSING HIM?

I AM.

AND I MOVED OUT FROM MY BOYFRIEND IN DECEMBER

AND I WORK 6 DAYS A WEEK,

5:30 TO 7:30 AND I'M TIRED.

WHOA. YEAH.

SO, IT SOUNDS LIKE YOU'RE FEELING REALLY OVERWHELMED RIGHT NOW.

SORRY.

DON'T BE SORRY.

DID YOU HAVE ANYTHING IN MIND WHEN YOU CAME IN HERE TODAY?

I WAS ON CELEXA FOR A WHILE AND THAT SEEMED TO HELP.

SO, YOU WERE THINKING ABOUT MEDICATION?

IF YOU CAN THINK OF ANYTHING ELSE.

I'M A LITTLE BIT WISHY WASHY ON THE MEDICATION

BECAUSE MEDICATION IS NOT THE PROBLEM.

IT'S NOT. YEAH.

THE PROBLEM IN YOUR LIFE IS THAT YOU'VE GOT

TOO MANY THINGS GOING ON AND YOU'RE OVERTIRED.

INSTEAD OF BASING THINGS ON OUTCOMES,

ON HOW GOOD OF A JOB WE'RE DOING,

THE GOVERNMENT SETS THE REIMBURSEMENT COMPLETELY

ON THE NUMBER OF PATIENTS THAT WE SEE.

IT DOESN'T MATTER HOW COMPLICATED THEY ARE,

HOW MUCH TIME THAT WE SPEND ON THEM.

IT'S JUST A NUMBER-- ONE, 2, 3, 4, 5.

YOU HAVE TO PLAY THIS GAME WITH, WHAT DOES THIS PATIENT NEED

AND HOW MUCH TIME AM I WILLING TO SPEND WITH THEM

BECAUSE THE ADMINISTRATION IS TELLING YOU,

YOU NEED TO SEE MORE PATIENTS, WE'RE IN THE RED.

AND IF YOU TRY AND BUCK THE SYSTEM, SOMEONE SAYS,

WHAT CAN WE DO TO GET YOUR PRODUCTIVITY UP?

I'M NOT INTERESTED IN GETTING MY PRODUCTIVITY UP.

I'M INTERESTED IN HELPING PATIENTS.

IN THE ERA OF FOR PROFIT MEDICINE,

THE TIME ALLOWED FOR PATIENT VISITS HAS SHRUNK TO A POINT

WHERE YOU'VE GOT 7 MINUTES WITH A PATIENT.

CAN YOU FEEL THIS?

YES.

BARELY?

YEAH. OK.

LOSING THE SENSATION IN YOUR FEET

IS PART OF THE PROGRESSION OF DIABETES, OK?

Dr. Weil: IT COULD GET WORSE.

PEOPLE TALK ABOUT 2-MINUTE DOCTORS...

HMM.

LITERALLY, 30 PATIENTS AN HOUR.

THINGS COULD MOVE IN THAT DIRECTION HERE.

AND THIS IS NOT THE CHOICE OF THE DOCTOR.

AS A PRIMARY CARE PHYSICIAN, WE'RE SUPPOSED TO BE THE PEOPLE

THAT ARE MAKING SURE THE PATIENTS DON'T GET SICK

AND THAT THEY HAVE EVERYTHING THAT THEY NEED

TO MAINTAIN HEALTH...

BUT WE END UP BEING THIS REVOLVING DOOR.

PEOPLE COME IN AND YOU TRY AND FIX ONE THING

AND THEY COME BACK FOR THE SAME THING OVER AND OVER AND OVER.

YOU JUST NEVER GET TO THE BOTTOM

OF WHAT'S CAUSING ALL OF THESE PROBLEMS THAT THEY'RE HAVING.

MICHELLE?

[WOMAN CRYING]

TELL ME WHAT HAPPENED.

I JUST TRIED TO CUT MY ARM OFF.

WHAT WERE YOU TRYING TO DO?

I JUST WANTED TO JUST END IT AND...I'M TIRED OF IT.

I'M SO TIRED OF IT.

ARE YOU TAKING YOUR MEDICATION? YES.

A GREAT DEAL OF WHAT'S DONE IN CONVENTIONAL MEDICINE

IS TO PUT BAND-AIDS ON THINGS OR TO SUPPRESS SYMPTOMS.

HAVE YOU CUT YOURSELF BEFORE?

WHEN I WAS A KID...

YOU USED TO CUT?MM-HMM.

LEXAPRO IS THE ONLY THING YOU'RE ON RIGHT NOW?

MM-HMM.

THIS IS A PROBLEM WITH A LOT OF OUR SUPPRESSIVE TREATMENTS.

THEY MAY KEEP THE DISEASE PROCESS GOING

AND THEY MAY STRENGTHEN IT OVER TIME.

IT'S MUCH BETTER TO TRY TO WORK AT A DEEPER LEVEL.

I'M GONNA MAKE A PHONE CALL AND TRY TO GET SOME WHEELS IN MOTION

SO THAT WE CAN GET YOU THE HELP THAT YOU NEED, OK?

OK, SO, WE NEED THE CRISIS COUNSELOR THEN.

YES, THIS IS DR. MARTIN OVER AT LA CLINICA.

I NEED TO SPEAK WITH THE CRISIS WORKER.

THERE'S NO CRISIS WORKER AT LUNCH TIME?

I HAVE AN ACUTELY SUICIDAL PATIENT

IN MY OFFICE THAT I NEED HELP WITH.

SHE'S STILL TAKING HER LEXAPRO,

BUT IT'S OBVIOUSLY NOT, UH...NOT DOING THE JOB.

WHERE I'M AT RIGHT NOW, PATIENTS ARE IN DESPERATE NEED OF CARE

AND THE WAY THAT THE SYSTEM IS SET UP, YOU CAN'T BE EFFECTIVE.

I BECAME A DOCTOR BECAUSE I CARE ABOUT PATIENTS

AND WORKING HERE, I CAN'T HELP THEM.

[SIGHS]

TO FEEL THAT WAY WHEN YOU COME HOME...

IS...DEMORALIZING.

THERE HAS TO BE A DIFFERENT WAY OF DOING THINGS,

SO I DECIDED TO LEAVE.

IT'S HARD TO SAY GOOD-BYE TO THE PATIENTS.

I TOOK CARE OF THEM AND I WAS RESPONSIBLE FOR THEM

AND JUST WORRYING ABOUT IF SOMEBODY ELSE IS GONNA DO

FOR THEM WHAT THEY NEED.

I WANT TO GIVE TO PEOPLE

AND I WANT TO HELP PEOPLE

AND I WASN'T ABLE TO FIND THAT HERE.

I'M GONNA GO LOOK FOR IT.

THE HISTORY OF HOW THE AMERICAN HEALTH CARE SYSTEM GREW

IS NOT ONE OF ORDER,

IT'S ONE OF SORT OF HAPHAZARD CHAOS.

EVERYBODY'S DOING WHAT MAKES SENSE TO THEM INDIVIDUALLY.

WE PAY HOSPITALS TO BE FULL, SO THEY TRY TO BE FULL.

WE PAY DOCTORS TO SEE PATIENTS, SO THEY SEE A LOT OF PATIENTS.

WE CREATE A PUBLIC EXPECTATION THAT MORE IS BETTER,

WHICH ISN'T ACTUALLY TRUE, SO PEOPLE SEEK MORE.

EVERYBODY'S DOING THEIR JOB.

WE JUST DESIGNED THE JOBS WRONG.

PHYSICIANS ARE WELL INTENTIONED.

EVEN WHEN BAD THINGS HAPPEN,

IT'S NOT BECAUSE PEOPLE HAVE BAD INTENTIONS,

IT'S THAT OUR SYSTEM IS ALL FOULED UP.

WE SPEND A SPECTACULAR AMOUNT OF MONEY ON HEALTHCARE.

JUST SHEER NUMBERS.

$2.7 TRILLION PER YEAR.

THE AVERAGE PER CAPITA COST OF HEALTHCARE

IN THE DEVELOPED WORLD IS ABOUT $3,000.

IN THE UNITED STATES IT WAS AROUND $8,000 ANNUALLY.

WE SPEND ONE HECK OF A LOT OF MONEY.

THE HEALTHCARE SYSTEM ISN'T AFFORDABLE ANYMORE.

WHO PAYS FOR THAT? WHERE DOES THAT MONEY COME FROM?

THIS ALL COMING OUT OF OUR POCKETS.

IT'S YOUR MONEY.

THE REALLY ASTONISHING PART ABOUT THE FACT

THAT WE SPEND MORE IS WE HAVE WORSE HEALTH OUTCOMES.

IF YOU NEED REAL SERIOUS TECHNOLOGY TODAY

LIKE A VERY COMPLEX CARDIAC SURGERY,

YOU'RE LUCKY TO BE IN THIS COUNTRY.

RESCUE CARE IS SECOND TO NONE.

AS AN OVERALL SYSTEM, NO,

WE'RE NOT ANYWHERE NEAR AT THE BEST IN THE WORLD.

I MEAN, LOOK AT OUR RESULTS,

OUR LIFE SPAN ISN'T EVEN IN THE TOP 20.

WE HAVE A DISEASE CARE SYSTEM

AND WE HAVE A VERY PROFITABLE DISEASE CARE SYSTEM.

AND THE DISEASE CARE SYSTEM, ACTUALLY, I MEAN,

IF IT WAS REALLY HONEST WITH ITSELF,

IT DOESN'T WANT YOU TO DIE AND IT DOESN'T WANT YOU TO GET WELL.

IT JUST WANTS YOU TO KEEP COMING BACK

FOR YOUR CARE OF YOUR CHRONIC DISEASE.

MOST OF THIS HUGE EFFORT

OF THE HEALTHCARE INDUSTRY IS DEVOTED TO INTERVENTION,

IN ESTABLISHED DISEASE,

AND THE MAJORITY OF THAT DISEASE

IS LIFESTYLE RELATED AND PREVENTABLE.

I MEAN, TO TALK ABOUT HOW WE SHIFT TOWARD--

AWAY FROM DISEASE INTERVENTION TOWARD DISEASE PREVENTION,

HEALTH PROMOTION, I MEAN, THAT--THAT REQUIRES

A MASSIVE RETHINKING ABOUT MEDICINE

AND HEALTHCARE AT ALL LEVELS OF SOCIETY.

IT HAS TO DO WITH EXPECTATIONS OF PATIENTS.

IT HAS TO DO WITH THE TRAINING OF PHYSICIANS.

IT WILL REQUIRE A HUGE EFFORT.

THERE IS THIS TREMENDOUS INNATE HEALING CAPACITY THAT WE ALL HAVE.

WHEN I SIT WITH A PERSON WHO'S SICK,

ALWAYS AT THE BACK OF MY MIND IS THE QUESTION,

WHAT IS BLOCKING HEALING HERE? WHAT IS PREVENTING IT?

WHAT CAN I DO FROM OUTSIDE THAT CAN FACILITATE THAT PROCESS?

THAT PERSPECTIVE IS MISSING

FROM THE TRAINING OF OUR HEALTH PROFESSIONALS.

WHAT'S WRONG WITH MEDICAL EDUCATION IS THAT IT SIMPLY

DOESN'T ADDRESS WHOLE SUBJECT AREAS

THAT ARE ABSOLUTELY ESSENTIAL TO UNDERSTANDING

HUMAN BEINGS, HEALTH, ILLNESS, AND TREATMENT.

I MEAN, AN OBVIOUS ONE IS NUTRITION,

WHICH IS ALMOST OMITTED FROM MEDICAL EDUCATION.

SO, IN 1994, I STARTED A FELLOWSHIP FOR PEOPLE

WHO HAD COMPLETED MEDICAL SCHOOL TO RETRAIN PHYSICIANS.

WE WANT TO EXPOSE CLINICIANS TO A BROADER WAY

OF SEEING THE PATIENT.

A DEEPER UNDERSTANDING OF HEALING AND A LARGER TOOLBOX

FROM WHICH TO CHOOSE FOR THERAPIES.

MANY CLINICIANS COME HERE FRUSTRATED,

THEY'RE OVERWORKED, THEY'RE OVERWHELMED,

BURIED DEEP UNDERNEATH INSURANCE FORMS

AND 10-MINUTE VISITS AND 30 PATIENTS A DAY.

WHERE ARE YOU FROM?

I'M FROM VIRGINIA.

I ACTUALLY PRACTICE EMERGENCY MEDICINE

AT THE UNIVERSITY OF VIRGINIA IN CHARLOTTESVILLE. GOOD.

THERE HAVE BEEN SOME TRENDS

IN HEALTHCARE THAT MAKE ME UNCOMFORTABLE.

I FELT LIKE THERE'S GOT TO BE SOMETHING DIFFERENT,

SOMETHING BETTER.

ALMOST 40,000 PEOPLE HAVE BEEN STUDIED...

MY MEDICAL TRAINING WAS JUST FOCUSED ON

GIVING THESE PATIENTS PHARMACEUTICALS OR GIVING

THEM EXPENSIVE TESTS TO TREAT THE CONDITION AFTER IT OCCURRED.

I HAD NO KNOWLEDGE OF WAYS TO PREVENT A HEART ATTACK

OR STROKE OR CANCER OR THINGS LIKE THAT.

I HAD TO DO THE FELLOWSHIP BECAUSE IT WAS KIND

OF MY LITTLE RAY OF HOPE THAT THINGS COULD BE BETTER,

THINGS CAN BE DONE DIFFERENTLY

AND SOMEBODY'S GONNA TEACH ME HOW TO DO THAT, SO I'M GONNA DO IT.

IN WESTERN MEDICINE, ALL OF OUR EFFORT IS ON DISPELLING EVIL.

IF SOMEBODY HAS AN INFECTION,

WE GIVE ANTI-INFECTIOUS AGENTS.

IF SOMEBODY HAS HYPERTENSION,

WE GIVE ANTI-HYPERTENSION DRUGS.

IT'S GETTING RID OF THE BAD THING.

WE DO NOTHING ABOUT SUPPORTING THE GOOD,

THAT THE BODY CAN AND WANTS TO BE HEALTHY.

BOTH OF THESE APPROACHES ARE NECESSARY,

BUT IT WOULD BE GREAT

IF WE HAD A BETTER BALANCE IN WESTERN MEDICINE.

THE KINDS OF INTERVENTIONS THAT WE HAVE COME TO FAVOR

IN THIS COUNTRY ARE INHERENTLY COSTLY

BECAUSE THEY'RE DEPENDENT

ON EXPENSIVE TECHNOLOGY AND THAT INCLUDES PHARMACEUTICAL DRUGS.

I THINK THERE'S SOME VERY GOOD DRUGS OUT THERE.

I THING DRUG TREATMENT HAS ITS PLACE.

I TAKE A PHARMACEUTICAL DRUG MYSELF,

BUT IF THERE'S ONE THING THAT I WOULD LOVE TO SEE

YOU BEGIN TO IMPLEMENT IN YOUR OWN PRACTICE

AND TEACH OTHERS ABOUT, IT'S TO TRY TO CHANGE THIS MINDSET

THAT HAS SO COMPLETELY TAKEN HOLD IN OUR CULTURE

ON THE PART OF BOTH DOCTORS AND PATIENTS,

THAT DRUGS ARE THE ONLY LEGITIMATE WAY TO TREAT DISEASE.

I MEAN, WHERE DID THAT IDEA COME FROM?

WE SPEND $300 BILLION A YEAR ON PHARMACEUTICALS.

THAT'S ALMOST AS MUCH AS THE REST OF THE WORLD COMBINED.

$300 BILLION ON DRUGS.

IN THE 1950s, AMERICANS TOOK PHARMACEUTICAL MEDICATION

AT ABOUT 10% OF THE RATE THAT THEY DO NOW.

WE'RE TAUGHT WITH THE COMMERCIALS ON TELEVISION,

WHY DO WE NEED TO WAIT? WE CAN JUST TAKE A PILL RIGHT NOW.

WHEN I WATCH THE NETWORKS,

HALF THE ADS ARE FOR PHARMACEUTICAL AGENTS.

THAT ISN'T TRUE IN CANADA.

IT'S NOT TRUE IN THE UNITED KINGDOM,

IT'S NOT TRUE IN FRANCE AND GERMANY.

THE ONLY OTHER COUNTRY, BY THE WAY, IS NEW ZEALAND.

NEW ZEALAND AND THE UNITED STATES ARE THE ONLY

2 COUNTRIES IN THE WORLD WHERE YOU CAN ADVERTISE PRESCRIPTION DRUGS.

WHAT DOES THAT DO? WELL, IT DRIVES DEMAND.

YOU KNOW, THE ADS ALWAYS END

WITH THE SAME PHRASE-- ASK YOUR DOCTOR.

AND PEOPLE DO.

AND DOCTORS, WANTING TO PLEASE THEIR PATIENTS,

WILL OFTEN PRESCRIBE IT.

Woman: OVERMEDICATING IS A HUGE PROBLEM IN SOCIETY

AND THE MILITARY IS NO EXCEPTION.

THIS IS A NATIONAL PROBLEM FOR US.

YOU KNOW, WE'RE SEEING THE MILITARY JUST BEING A MICROCOSM,

I THINK, OF THE PROBLEM SOCIETY'S HAVING.

Man: SOLDIERS' USE OF PRESCRIPTION DRUGS

HAS TRIPLED IN THE PAST 5 YEARS.

Woman: THE ARMY SAYS THIS IS ALL LINKED

TO THE RISING NUMBER OF SOLDIER SUICIDES.

IN FACT, MORE SOLDIERS DIED LAST YEAR

FROM NON-COMBAT INJURIES THAN DURING WAR.

I CAN SEE WHY THERE'S A LINK BETWEEN OPIATES,

DEPENDENCY, MISUSE, AND SUICIDE.

I WAS TAKING 64 PILLS A DAY

OF COMBINATIONS OF ROXICET AND OXYCONTIN.

THERE'S A CONTRADICTION TO WHAT WE DO.

YOU AS CAREGIVERS ARE TOLD,

YOU'VE GOT TO KEEP ME PAIN FREE.

YOU'RE GONNA DO THAT.

AND WE HAVE TO BE MINDFUL TO THOSE POINTS

IN TIME WHERE YOU CAN INTERVENE AND SAY, ENOUGH'S ENOUGH.

WE HAVE TO FIND THE RIGHT MIX OF TREATMENTS

FOR THE GUYS AND THE ANSWERS ARE NOT IN A STACK OF PILLS.

IF IT HAPPENED TO ME, IT HAPPENS TO A WHOLE LOT

MORE PEOPLE THAT ARE ALMOST INVISIBLE TO THE SYSTEM.

I'VE BEEN SHOT THIS DEPLOYMENT.

8 I.E.D.'s JUST THIS DEPLOYMENT.

I CARRY A LOT OF WEIGHT BECAUSE I'M INFANTRY.

THE MOUNTAINS OF AFGHANISTAN

ARE NOT EASY TO CLIMB, SO COMPRESSED MY BACK.

I WAS TREATED FOR SCIATIC NERVE, BACK,

L-2, L-3, L-4, L-5,

SWELLING, LEFT SIDE OF MY BRAIN,

AND EXTREME P.T.S.D.

WITH 10 YEARS OF ONGOING WARS,

THE AMOUNT OF SUFFERING THAT'S GOING ON

IN THE MILITARY RIGHT NOW IS TREMENDOUS.

WHEN YOU GO OVER INTO A WAR ZONE,

WHERE YOU SEE YOUR BUDDIES DIE

OR YOU GET INJURED,

THAT'S GONNA TAX ANYBODY.

AND WE SEE THAT SUFFERING.

DURING THE AIR EVACS OF WOUNDED SOLDIERS,

THE APPROACH TO PAIN THAT CURRENTLY EXISTS IS TO GET MEDICATIONS.

DO YOU HAVE ANY PAIN RIGHT NOW?

OK, I CAN SEE WHAT YOU CAN HAVE FOR PAIN, ALL RIGHT?

Woman: HE ASKED FOR PAIN MEDICATION.

THEY DON'T SAY HOW MUCH THEY GAVE HIM,

BUT HE CAN HAVE ANYWHERE

BETWEEN 5 AND 10 MILLIGRAMS OF MORPHINE.

I JUST WANT TO SEE WHAT THEY'VE GIVEN HIM.

BECAUSE HE'S REAL SLEEPY? YEAH.

IT'S VERY HARD FOR US AS NURSES TO TREAT FOR PAIN

BECAUSE THERE'S NO THERMOMETER THAT WE CAN STICK IN

AND SAY, OH, IT'S 7 OUT OF 10 PAIN.

WE HAVE TO BASICALLY TREAT THE PATIENT FOR WHATEVER THEY SAY.

AND A LOT OF TIMES PATIENTS BECOME SO DROWSY

THAT THEY'RE NOT AWARE OF HOW MUCH THEY'RE TAKING.

ARE YOU OK?I'M SO UNCOMFORTABLE.

AND I NEED TO PEE AGAIN.

YOU NEED TO GET UP AND PEE? ALL RIGHT.

OK, I NEED SOME HELP OVER HERE.

THE PATIENT JUST FELL OFF THE LITTER.

WAIT, WHAT?

DID HE TRY TO GET UP WITHOUT ANYBODY KNOWING?

NO, I TRIED GETTING HIM UP AND HE JUST ROLLED HIMSELF OUT.

HE'S LIKE REALLY NOT LISTENING VERY WELL.

YEAH, THAT'S WHY YOU DON'T WANT HIM TO FALL AGAIN.

PROBABLY PUT HIM ON THE BOTTOM ON THE OTHER SIDE.

I'M GONNA CHECK HIS CHART REAL QUICK

AND FIND OUT WHAT HE GOT AT THE CASF.

LET ME GET THAT JACKET AWAY FROM HIM.

HE'S LIKE CLUTCHING HIS MEDS.

HERE YOU GO. THIS IS WHAT HE'S GOT LEFT OF THE MORPHINE.

HE WAS ISSUED A BOTTLE TODAY

WITH 20 IN IT AND 10 ARE MISSING.

HE'S TAKEN 10 TABLETS.

THAT'S WHY.OH, MY GOD.

THAT IS RIDICULOUS.

THAT'S WHY HE'S A LITTLE HIGH RIGHT NOW.

THAT'S THE POINT.

HE COULD STOP BREATHING IF HE TOOK TOO MUCH

NARCOTIC AND WE'RE GONNA BE DOING C.P.R.

ON THE PATIENT, SO AT THIS POINT,

WE WON'T ADMINISTER THE MEDICATION.

WE MOVED YOU OVER HERE.

TAKE THEM AWAY FROM HIM.

DO YOU WANT TO DO A PILL COUNT WITH ME?

WE'LL DO IT UP AT THE FRONT.

OK.

OK, SO, WE HAVE 10 DILAUDID.

OK, THIS IS PRAZOSIN.

HE'S GOT LUNESTA.

AND HE ALSO HAS VALIUM.

RIGHT HERE'S THE LORTAB, NAPROXEN.

HE HAS PERCOCET AND HE HAS NORCO, WHICH IS PERCOCET.

I'M NOT SURE WHAT IS WHAT.

UM...

THEY'RE NOT IN THERE?

THESE ARE ALL NAME BRANDS.OH.

THE ONLY THING WE CAN DO IS SEPARATE THEM OUT

BECAUSE THERE'S NO WAY FOR US TO TELL WHICH ARE WHICH.

THESE ARE ALL ONE PERSON'S?

BUT THEY'RE COMBINED, SO WE DON'T KNOW WHAT THEY ARE.

WHERE ARE YOU COMING FROM?

AFGHANISTAN.

AFGHANISTAN. HOW LONG WERE YOU THERE?

9 MONTHS. 9 MONTHS?

WE'RE GLAD TO HAVE YOU HOME.

YOU WANNA TELL ME ABOUT SOME OF THOSE THAT YOU LOST?

A PLATOON OF 23.

CAME OFF THE MOUNTAIN WITH 8.

OFF THE MOUNTAIN WITH ONLY 8?

YOU'VE SEEN A LOT.

LIFT, LIFT! LIFT!

[INDISTINCT] GO!

DARK MATTER IS A DISCOVERY BY ASTRONOMERS

THAT THERE IS A HUGE AMOUNT OF THE UNIVERSE THAT WE CAN'T SEE.

IT'S NOT VISIBLE, BUT IT'S THERE.

WE KNOW IT'S THERE.

AND IN SOME WAYS I THINK OF A LOT

OF WHAT'S HAPPENING IN HEALTHCARE IS KIND OF DARK MATTER.

IT'S UNSEEN, BUT IT'S THERE,

AND IT'S VERY, VERY POWERFUL.

WE TEND TO SEE JUST THE LIGHT OF HEALTHCARE.

WE SEE THE GOODNESS OF HEALTHCARE,

THE POTENTIAL FOR HELPING.

WHEN I WAS AT "U.S. NEWS AND WORLD REPORT,"

I WROTE COVER STORIES ABOUT HOW GREAT

THE NEWEST AND GREATEST TREATMENT

AND PILL AND PROCEDURE WAS.

BUT, IN FACT, THE MORE I LOOKED,

THE MORE I FOUND THAT THERE'S ALL THIS STUFF

IN MEDICINE THAT WE DON'T THINK ABOUT THAT IS ACTUALLY HARMFUL.

WHEN A TEAM FROM DARTMOUTH MEDICAL SCHOOL

MAPPED MEDICARE PAYMENTS, IT FOUND SOME

DISCONCERTING DIFFERENCES FROM ONE PART

OF THE COUNTRY TO ANOTHER.

FOR EXAMPLE, IN 2007,

THE AVERAGE MEDICARE RECIPIENT IN MIAMI

TALLIED MORE THAN $15,000 IN HEALTHCARE BILLS,

WHEREAS A RECIPIENT IN MINNEAPOLIS ONLY COST

THE GOVERNMENT ABOUT HALF THAT AMOUNT.

AND IT WASN'T BECAUSE PROCEDURES

WERE MORE EXPENSIVE IN MIAMI THAN IN MINNEAPOLIS.

THE DARTMOUTH STUDY SHOWED THAT PATIENTS

IN PLACES LIKE MIAMI WERE RECEIVING MORE CARE,

MORE TESTS, MORE DRUGS,

MORE TIME IN THE HOSPITAL,

MORE INVASIVE OPERATIONS,

THAN PATIENTS IN OTHER PARTS OF THE COUNTRY,

EVEN THOUGH THE PATIENTS IN MIAMI

WEREN'T ANY SICKER THAN THEIR NEIGHBORS.

BUT SO WHAT, RIGHT?

WE WANT MORE SPECIALISTS.

WE WANT MORE PROCEDURES.

WE WANT MORE TESTS OR AT LEAST WE THINK WE DO.

AND THAT'S THE PROBLEM

BECAUSE WHAT WE THINK IS BEST FOR US OFTEN ISN'T.

WHAT THE DARTMOUTH GROUP DISCOVERED

IS THAT THE PATIENTS IN THE MOST COSTLY REGIONS,

WHERE MEDICARE SPENT MORE MONEY ON PATIENTS,

THOSE PATIENTS DID NOT HAVE BETTER HEALTH OUTCOMES.

AND, IN FACT, THEY WERE MORE LIKELY TO DIE.

IF YOU LOOK AT HEALTHCARE IN AMERICA,

YOU'RE TWICE AS LIKELY TO GET YOUR KNEE REPLACED

AS YOU ARE IN WESTERN COUNTRIES

WITH THE SAME STANDARD OF LIVING.

YOU'RE 2 OR 3 TIMES AS LIKELY TO GET

A HEART CATHETERIZATION

OR HAVE A STENT IN YOUR CORONARIES.

WE'VE SET UP A SYSTEM THAT OFTEN PUSHES

PHYSICIANS AND HOSPITALS

AND THE ENTIRE HEALTHCARE SYSTEM INTO DOING MORE.

DRIVEN BY THESE PERVERSE ECONOMIC INCENTIVES,

WE ARE DOING A LOT OF PROCEDURES TO PEOPLE THAT THEY DON'T NEED.

TO A MAN WITH A HAMMER,

EVERYTHING LOOKS LIKE A NAIL.

Woman: OK, READY?

NOW, I'M GOING TO GET THE SCISSORS.

Girl: YEAH.

I STARTED GETTING SICK IN MY 30s.

I STARTED HAVING REALLY, REALLY BAD CHEST PAIN.

THERE WE GO, A FLOWER FOR YA.

OH, IT'S SO BEAUTIFUL.

I JUST HAD BEEN IGNORING IT BECAUSE I THOUGHT,

YOU KNOW, I'M ONLY 34 YEARS OLD,

I CAN'T BE HAVING HEART PROBLEMS.

BUT ONE EVENING I SAT STRAIGHT UP IN BED

WITH THE WORST CHEST PAIN.

SO, I WENT INTO THE HOSPITAL

AND THEY TOLD ME I'D HAD A HEART ATTACK.

I WAS 35 AT THE TIME

AND WAS SCHEDULED FOR OPEN HEART SURGERY.

AND I THOUGHT, ONCE I GET THIS,

I WON'T HAVE THE BLOCKAGES ANYMORE,

YOU KNOW, THEY'LL ACTUALLY FIX IT.

LITTLE DID I KNOW THAT IT WAS FOLLOWED BY YEARS

OF THE SAME THING OVER AND OVER AND OVER AGAIN.

A HEART CATH, GET ANOTHER STENT.

HEART CATH, GET ANOTHER STENT.

UNTIL MY DOCTOR SAID TO ME,

I DON'T KNOW WHAT ELSE TO DO FOR YOU.

THERE'S NOTHING ELSE I CAN DO.

CONTRARY TO WHAT MOST PEOPLE BELIEVE,

GETTING A STENT IN YOUR CORONARY,

IF YOU HAVE STABLE CHEST PAIN,

WILL LIKELY RELIEVE YOUR PAIN,

BUT IT WILL NOT HELP YOU LIVE LONGER

AND IT WILL NOT PROTECT YOU FROM HAVING A HEART ATTACK.

IT ONLY REDUCES SYMPTOMS.

AND THE PROBLEM IS, IS THAT SOME OF THOSE PROCEDURES WILL LEAD TO BAD OUTCOMES.

I HAD STARTED DOING RESEARCH ABOUT WHERE IN THE UNITED STATES

DO I HAVE TO GO TO GET THE BEST HEART CARE

AND, IRONICALLY, IT WAS ONLY 2 HOURS AWAY AT THE CLEVELAND CLINIC.

HOW ARE YOU?

I AM GREAT.

LOOK AT THE THINNESS.

I KNOW. YOU LOOK REALLY GOOD.

I HAVE LOST--SINCE LAST YEAR I HAVE LOST 21 POUNDS.

OH, MY GOD.

YVONNE CAME TO SEE ME WHEN SHE WAS SORT OF AT HER WIT'S END.

SHE HAD HAD A BYPASS SURGERY AT AN EARLY AGE,

27 CARDIAC CATHETERIZATIONS, AND WELL OVER 7 STENTS.

DEEP BREATH.

THIS IS JUST AN UNBELIEVABLE AMOUNT OF STENTS AND CARDIAC CATHS.

I'M SORRY, IT'S GONNA GET PRETTY TIGHT.

OH, IT'S ALL RIGHT.

I CAN'T TELL YOU HOW SHOCKED WE WERE WHEN WE SAW HER

THE FIRST TIME BECAUSE HERE WAS A YOUNG WOMAN,

WHOSE DIABETES WAS NOT WELL CONTROLLED.

HER CHOLESTEROL WAS NEVER WELL CONTROLLED

AND HER HIGH BLOOD PRESSURE WAS NEVER WELL CONTROLLED.

BREATHE NORMALLY FOR ME.

IF SOMEONE HAD TALKED TO HER, I THINK SOMEONE

HAD REALLY TEASED OUT HER CHEST PAIN

AND HER SHORTNESS OF BREATH,

I THINK MANY OF HER CARDIAC CATHETERIZATIONS

AND STENTS WOULD NOT HAVE BEEN NECESSARY.

YOU KNOW, YOU HAVE ALL THESE STENTS

AND, YOU KNOW, THESE STENTS, ONCE THEY GO IN,

THEY NEVER COME OUT, AND THEY'RE PART OF YOU.

NOW, WE'RE KIND OF DEALING WITH THE CONSEQUENCES.

WHEN YOU REWARD PHYSICIANS FOR DOING PROCEDURES,

INSTEAD OF TALKING TO PATIENTS,

THAT'S WHAT THEY'RE GONNA DO IS DO PROCEDURES.

THE VAST MAJORITY OF DOCTORS IN THIS COUNTRY

ARE PAID BY A FEE FOR SERVICE SYSTEM.

AND THAT SIMPLY MEANS THAT THEY GET PAID FOR EACH OFFICE VISIT.

IF THEY'RE SURGEONS, THEY GET PAID FOR EACH PROCEDURE.

IF IT'S A RADIOLOGIST,

THEY GET PAID FOR EACH C.T. SCAN THAT THEY DELIVER.

IF I SPENT 5 MINUTES WITH YOU

AND THEN PUT IN ONE OF THESE STENTS,

PROBABLY GET PAID $1,500.

FOR ME TO SPEND 45 MINUTES ON AN ESTABLISHED VISIT

WITH A PATIENT TO MAKE SURE THEY'RE DOING THEIR EXERCISE,

MAKE SURE THEIR DIABETES IS GOING OK,

AND TO TRY TO FIGURE OUT WHAT THEIR TRUE PROBLEM IS,

PROBABLY GET PAID $15.

IT'S A COMPLETELY IRRATIONAL SYSTEM.

FEE FOR SERVICE REWARDS PHYSICIANS FOR DOING MORE.

IT DOESN'T REWARD THEM FOR DOING A BETTER JOB.

IT DOESN'T REWARD THEM FOR KEEPING THEIR PATIENTS HEALTHY.

IT REWARDS THEM FOR DELIVERING MORE CARE.

I WAS TRYING TO FIGURE OUT HOW MUCH YVONNE'S CARE

WOULD HAVE BEEN OVER THE YEARS

AND I THINK IT'S WELL OVER $1.5 MILLION...

BUT IT'S MORE THAN COST.

IT'S JUST SO MUCH MORE THAN MONEY.

THE PSYCHOLOGICAL TRAUMA OF EVERY ONE OF THOSE MULTIPLE CARDIO CATHETERIZATIONS,

EVERY TIME SHE HAD A CHEST PAIN, COMING INTO THE E.R.,

AND, UNFORTUNATELY, THERE ARE LOTS OF YVONNES OUT THERE.

ALTHOUGH WE'VE MADE PROGRESS TECHNOLOGICALLY, YOU KNOW,

WE KNOW HOW TO DO THINGS FOR DISEASES WE COULDN'T HAVE DONE BEFORE,

WE HAVEN'T REALLY EXPERIENCED THE SYSTEMIC IMPROVEMENT

THAT WE WANT THE NEW HEALTHCARE SYSTEM, THAT WE'RE REALLY AFTER.

WE PAY FOR FRAGMENTS OF CARE.

A DOCTOR VISIT, A HOSPITAL STAY,

A LAB TEST, AN AMBULANCE TRIP,

SO BECAUSE WE PAY FOR PIECES,

WE HAVE PIECES AND SO PEOPLE WHO REALLY NEED A COORDINATED SYSTEM,

THEY DON'T GET THAT.

MEDICINE IS VERY [INDISTINCT] NOW.

MEDICINE IS VERY SPECIALIZED.

AND THIS IS REALLY A BIG PROBLEM

WHEN YOU GO TO THE HOSPITAL BECAUSE

THERE ARE SO MANY DIFFERENT PEOPLE

WHO LAY THEIR HANDS ON YOU AND IF THEY'RE NOT

TALKING TO EACH OTHER, YOU CAN'T NECESSARILY GET THE RIGHT DIAGNOSIS.

YOU CAN GET REPEATED TESTS.

YOU CAN GET THINGS HAPPENING TO YOU

THAT PUT YOU IN HARMS WAY BECAUSE NOBODY'S REALLY KEEPING TRACK

OF YOU AS AN INDIVIDUAL PATIENT.

A RECENT STUDY FOUND THAT 187,000 PATIENTS DIE

EACH YEAR FROM HARMFUL CARE IN THE HOSPITAL,

WHICH INCLUDES MEDICAL ERRORS AND DEADLY INFECTIONS.

BASED ON THESE NUMBERS,

THIS WOULD BE THE THIRD LEADING CAUSE OF DEATH

IN THE UNITED STATES,

JUST AFTER HEART DISEASE AND CANCER.

HELLO. DR. ROSS.

I AM BACK IN THE CHEST PAIN CENTER

WITH A PRETTY SICK PATIENT

AND I'M GONNA NEED YOU TO CALL ATTENDING PHONE, TOO.

THE EMERGENCY DEPARTMENT IS THE SAFETY NET OF HEALTHCARE.

WE SEE A LOT OF THE CHRONIC CONDITIONS THAT EFFECT

MANY AMERICANS THAT HAVE GONE UNTREATED

FOR SOMETIMES MONTHS, BUT SOMETIMES YEARS.

AND, OF COURSE, THE NATURAL END POINT

IS GOING TO BE IN THE EMERGENCY DEPARTMENT.

LET ME JUST TAKE A LISTEN TO YOU.

IT WOULD BE SO WONDERFUL IF THEIR CHRONIC HEALTH CONDITIONS

COULD BE PREVENTED THROUGH EFFECTIVE PRIMARY CARE.

THERE'S A SAYING IN HEALTHCARE POLICY

THAT 20% OF THE PATIENTS ACCOUNT FOR 80% OF THE COSTS

AND THE MAJORITY OF THOSE COSTS

ARE WHEN THEY ARE REPEATEDLY HOSPITALIZED.

THEY'RE PATIENTS WITH HEART FAILURE,

THEY'RE MORBIDLY OBESE PATIENTS.

THEY ARE OFTEN POOR PATIENTS, BUT NOT ALWAYS.

ONE OF THE WAYS TO THINK ABOUT SAVING MONEY

IN HEALTHCARE IS TO FOCUS OUR ENERGIES ON THAT 20%

OF PATIENTS AND THINK ABOUT TREATING

THOSE PEOPLE IN A MORE EFFECTIVE WAY.

I JUST WANT TO REVIEW THIS PAIN.

IT'S HERE RIGHT IN THE CENTER OF YOUR CHEST.

OK. AND IS IT STILL TRAVELING INTO YOUR NECK?

IT'S TRAVELING DOWN MY ARM AND MY NECK,

AND MY HEAD AND EARS ARE BUZZING AND RINGING.

OK. WHAT WAS IT, MR. LITTON,

THAT FINALLY MADE YOU SAY, OK, THAT'S IT?

I'M GOING TO THE EMERGENCY DEPARTMENT.

YOU SEE, I'VE BEEN TO THE EMERGENCY DEPARTMENT

A FEW TIMES BEFORE AND THE LAST TIME I WAS HAVING CHEST PAINS,

NOT LIKE THIS, THIS IS A LOT WORSE,

THEY SENT ME HOME WITH THEM.

HOW LONG AGO WAS THAT?

THAT WAS A MONTH AND A HALF AGO.

WHEN I HAD MY FIRST HEART ATTACK,

DID THE CARDIAC CATHETERIZATION, YOU KNOW,

PUT THE THING UP THERE AND THEN PUT A STENT IN MY HEART

BECAUSE I HAD A CLOGGED ARTERY,

AND THAT WORKED FOR A WHILE.

I MEAN, FOR A COUPLE OF WEEKS I FELT LIKE I WAS OK,

AND THEN ALL OF A SUDDEN I STARTED GETTING CHEST PAINS.

SO, HERE I HAM GOING IN AND OUT OF THE HOSPITAL

TO FIND OUT WHAT'S GOING ON.

DO YOU HAVE ANY EATING HABITS

THAT YOU THINK MIGHT BE--

NO, I EAT THE REGULAR FOOD AND STUFF.

WHAT'S THE REGULAR FOOD?

EGGS, SAUSAGE, GRITS, BACON.

WELL, WHAT DO YOU THINK ABOUT YOUR DIET?

A HEALTHY DIET?YEAH.

WHAT DO YOU THINK ABOUT THAT?

I'D DO IT IF I HAD TO.

IF YOU HAD TO.

WELL, YOU HAVE A STENT IN YOUR HEART, RIGHT?

YEAH. ALL RIGHT.

AND YOU'VE HAD HEART ATTACKS AND YOU'RE HERE TODAY WITH CHEST PAIN,

WHEN DO YOU THINK IT WOULD BE GOOD TO TRY IT?

ONCE I FOUND OUT WHAT'S REALLY WRONG WITH ME.

WE'VE BECOME A CULTURE WHERE YOU DRIVE UP,

YOU GET WHAT YOU WANT, YOU GET IT FAST,

YOU GET IT RIGHT AWAY, AND YOU DRIVE OFF.

AND THAT BEING A CLIENT TO HEALTHCARE JUST DOESN'T WORK.

MOST DISEASES DON'T HAPPEN OVER NIGHT.

SOMETIMES THEY'RE RELATED TO LIFESTYLE HABITS.

SOMETIMES IT'S RELATED TO WHAT THE INDIVIDUALS ACTUALLY HAVE ACCESS TO.

I HAVE NO HEALTH INSURANCE.

SOME DAYS I GO TO THE HOSPITAL

AND THAT'S THE ONLY HEALTHCARE I EVER GOT.

I NEVER HAD A PERSONAL DOCTOR, FAMILY DOCTOR,

NOTHING, ALL MY LIFE.

I STOPPED TAKING MY MEDICINE MONTHS AGO

BECAUSE IT WAS TOO MUCH, CAN'T AFFORD IT.

IF YOU GO OUT AND BUY HEART HEALTHY DIET FOOD,

IT'S GONNA COST YOU MORE MONEY THAN ANYTHING.

HIPPOCRATES SAID, LET FOOD BE YOUR MEDICINE

AND MEDICINE BE YOUR FOOD,

AND I THINK THAT'S A GOOD PLACE TO START.

AS A SOCIETY WE HAVE TO MAKE IT EASIER AND MORE AFFORDABLE

FOR PEOPLE TO MAKE BETTER LIFESTYLE CHOICES THAN WORSE ONES.

[DOOR DINGS]

THERE'S THE BRIGHT BLUE SLUSH.

THIS IS RESPONSIBLE FOR INSULIN RESISTANCE

AND METABOLIC SYNDROME AND OBESITY

AND THE ARTIFICIAL COLORS ARE NOT GOOD FOR YOU.

THIS IS A MAJOR REASON WHY WE SEE KIDS GETTING FAT IN THIS COUNTRY.

LET'S SEE WHAT WE GOT HERE.

ONE OF THE GREAT CONTRIBUTIONS IN AMERICA TO WORLD CUISINE,

YOU KNOW, FAKE BREAD.

WE TAKE GRAINS AND WE'VE TURNED THEM INTO PRODUCTS

LIKE THIS WHICH RAPIDLY RAISE BLOOD SUGAR,

PROVOKE INSULIN RESPONSES,

CAUSE INSULIN RESISTANCE AND PROMOTE WEIGHT GAIN

IN GENETICALLY-SUSCEPTIBLE PEOPLE, WHICH IS MOST OF US.

SOME PEOPLE, THIS IS ALL THEY EAT IS FOOD OF THIS SORT.

IT'S NOT WHOLE FOOD AS NATURE PRODUCES IT,

IT'S COMPLETELY CHANGED FOOD AND, YOU KNOW,

AND OUR GRANDPARENTS DID NOT EAT STUFF LIKE THIS.

WE HAVE MADE ALL OF THIS UNHEALTHY FOOD

THE CHEAPEST AND MOST AVAILABLE FOOD.

PEOPLE EAT WHAT'S CHEAP AND WHAT'S AVAILABLE.

McDONALD'S PUT SALADS ON THE MENU,

BUT AS IT TURNS OUT, THE SALAD IS $6.00,

THE BURGER IS 99 CENTS,

AND IF YOU'RE ON A FIXED INCOME,

WHAT ARE YOU GONNA DO FOR YOUR FAMILY?

THESE CALORIES ARE CHEAP ONLY WHEN YOU BUY THEM,

BUT IF YOU LOOK AT THE OVERALL COST TO SOCIETY

OF THESE CHEAP CALORIES THAT ARE SO JUNKY,

THEY'RE REALLY THE MOST EXPENSIVE.

IT'S SCARY HOW FAST OBESITY IS SPREADING IN OUR COUNTRY.

OBESITY LEADS TO HEART DISEASE AND STROKES AND DIABETES.

IF TRENDS CONTINUE THROUGH 2020,

UP TO 1/5 OF HEALTHCARE SPENDING,

OR ALMOST A TRILLION DOLLARS ANNUALLY,

WILL BE DEVOTED TO TREATING

THE CONSEQUENCES OF OBESITY.

IF YOU WANT TO UNDERSTAND HOW AMERICANS

ARE GETTING MORE AND MORE OVERWEIGHT,

IT'S BECAUSE WE HAVEN'T REALLY RETHOUGHT THINGS

THAT WERE PUT INTO PLACE A LONG TIME AGO

WHEN NOBODY REALLY THOUGHT

WHAT THE UNINTENDED CONSEQUENCES MIGHT BE.

THE DEPARTMENT OF AGRICULTURE SUBSIDIZES ALL THE WRONG FOODS.

WE SUBSIDIZE CORN, WE SUBSIDIZE SUGAR, WE SUBSIDIZE WHEAT.

WE DON'T SUBSIDIZE CARROTS.

WE DON'T SUBSIDIZE CELERY AND WE DON'T SUBSIDIZE APPLES.

YOU CAN LAY IT AT THE FEET OF A GUY NAMED RUSTY BUTZ.

HE WAS THE SECRETARY OF AGRICULTURE DURING THE NIXON ADMINISTRATION.

HE WAS THE ONE WHO THOUGHT THAT WE SHOULD SUBSIDIZE

COMMODITIES BECAUSE IT WOULD ALLOW US TO SELL

THESE COMMODITIES ON INTERNATIONAL MARKETS

AND WE'VE MADE ONE HECK OF A LOT OF MONEY.

THE OTHER REASON WE SUBSIDIZE CERTAIN THINGS

IS BECAUSE THEY HAVE POWERFUL LOBBIES.

THE MONEY THAT'S INVOLVED ENDS UP BEING

FUNNELED TOWARDS CONGRESS AND CONGRESS DOESN'T WANT TO FIX IT.

THE AMERICAN HEALTHCARE SYSTEM,

IT'S GENERATING RIVERS OF MONEY THAT ARE FLOWING

INTO VERY FEW POCKETS,

AND THOSE ARE THE POCKETS OF THE MANUFACTURERS OF MEDICAL DEVICES,

THE BIG INSURERS, THE PHARMACEUTICAL COMPANIES,

AND THE OWNERS OF THOSE POCKETS

DO NOT WANT ANYTHING TO FUNDAMENTALLY CHANGE.

I DON'T RECALL ANYTIME TELLING A LIE,

BUT I KNOW THAT THERE WERE MANY TIMES

THAT I DIDN'T DISCLOSE FULL INFORMATION.

I WAS THE COMPANY'S CHIEF SPOKESMAN.

I WAS HEAD OF CORPORATE COMMUNICATIONS,

WHICH MEANS I WAS THE TOP PUBLIC RELATIONS OFFICER FOR THE COMPANY.

WHEN YOU'RE IN THE INNER CIRCLE OF A HEALTH INSURANCE COMPANY,

WHAT'S MOST IMPORTANT IS MEETING WALL STREET'S EXPECTATIONS.

AND THEY HAVE TO, THESE FOR-PROFIT COMPANIES, BY LAW,

HAVE TO SERVE THE SHAREHOLDERS.

PEOPLE GO IN AND OUT OF HEALTH PLANS.

THEY MAY BE A MEMBER OF A HEALTH PLAN FOR A YEAR AND MAYBE NO LONGER.

YOU DON'T NECESSARILY MAKE A LOT OF INVESTMENTS

IN PREVENTIVE CARE FOR SOMEONE WHO'S NOT GOING TO BE A PART

OF YOUR HEALTH PLAN FOR A LONG PERIOD OF TIME.

IT JUST DOESN'T WORK OUT FINANCIALLY.

THE ONLY WAY THAT YOU CAN CONTINUE TO MAKE THE PROFITS

THAT YOU ARE EXPECTED TO MAKE

IS TO CHARGE MORE FOR THE POLICIES.

INSURANCE COMPANIES HAVE ALWAYS BEEN ABLE

TO REGULATE THE RATES THEY CHARGE.

THEY CAN PRETTY MUCH GET AWAY

WITH INCREASING THE RATES AS MUCH AS THEY WANT TO.

YOU ALMOST FORGET THAT WHAT YOU'RE DOING IS PROVIDING HEALTH INSURANCE.

IT'S ALL ABOUT THE NUMBERS AND HOW MANY MILLIONS OF DOLLARS,

IF NOT BILLIONS OF DOLLARS, YOU'RE EARNING IN PROFITS.

IN THE SUMMER OF 2007, I READ ABOUT A HEALTHCARE EXPEDITION

THAT WAS BEING HELD BY REMOTE AREA MEDICAL

A FEW MILES FROM WHERE I GREW UP.

I DECIDED OUT OF CURIOSITY TO GO CHECK THIS OUT.

ALL THESE FOLKS HAVE DRIVEN FROM 4 AND 500 MILES AWAY

WAITING TO GET CARE THAT'S BEING PROVIDED TO THEM FREE.

THE FOLKS WHO WERE THERE WERE NOT TRYING

TO SHIRK THEIR RESPONSIBILITIES.

THEY COULDN'T GET INSURANCE.

THEY EITHER COULDN'T AFFORD IT OR MANY OF THEM WORK

FOR SMALL EMPLOYERS THAT HAD BEEN PURGED BY BIG INSURANCE COMPANIES.

IT WAS EITHER COME AND GET CARE THERE OR NOT GET CARE AT ALL

AND EVERY YEAR THEY HAVE TO TURN PEOPLE AWAY.

IT WAS LIKE SOMETHING THAT I COULD NEVER HAVE IMAGINED

THAT I'D EVER SEE IN THIS COUNTRY.

AND I KNEW WHAT I WAS DOING FOR A LIVING

WAS MAKING IT NECESSARY FOR THOSE FOLKS

TO STAND IN LINE TO WAIT FOR CARE IN OLD STALLS AND BARNS.

I, ULTIMATELY, HAD A CRISIS OF CONSCIENCE

BECAUSE I WAS NOT AT ALL PROUD OF WHAT I WAS DOING.

I HAD DIFFICULTY SLEEPING AT NIGHT.

THERE WERE EVEN TIMES, HONESTLY,

THAT I LOOKED IN THE MIRROR AND I SAID, HOW DID YOU GET HERE?

I JUST COULD NOT CONTINUE DOING WHAT I WAS DOING.

GOOD MORNING.

GOOD MORNING.

OUR FOREFATHERS IN MEDICINE WERE REALLY ABOUT PATIENTS.

IT WAS ABOUT A PASSION FOR HEALING.

WHEN MEDICINE BECAME A BUSINESS,

WE LOST OUR MORAL COMPASS AND I THINK WE'VE GOTTEN

INTO A GREAT DEAL OF TROUBLE BECAUSE OF THAT.

SINCE I HAVE TYPE 2 DIABETES, I TRY TO DO WHAT MY DOCTOR SAYS.

Announcer: MANAGING TYPE 2 DIABETES CAN BE HARD.

ADDING AVANDIA CAN HELP.

THERE WAS A DRUG ON THE MARKET, AVANDIA.

IT GOT FAST TRACKED BY THE FDA.

IT GOT APPROVED VERY QUICKLY.

IT WAS MASSIVELY MARKETED.

AND BY 2006, THIS DRUG BECAME THE LARGEST SELLING

DIABETES DRUG IN THE WORLD.

WE'RE TALKING ABOUT A $3 OR 4 BILLION A YEAR DRUG.

I GOT MY BLOOD SUGAR UNDER CONTROL.

HE REALLY DID.

CAN ADDING AVANDIA HELP YOU?

I WAS DOING A GOOGLE SEARCH AND WHAT I FOUND WAS A WEBSITE

IN THE UNITED KINGDOM WHERE THE CLINICAL TRIALS DONE

WITH AVANDIA WERE ACTUALLY PARTIALLY DISCLOSED.

AND WHAT I SAW, IT ACTUALLY MADE ME PHYSICALLY ILL.

AS I LOOKED AT TRIAL AFTER TRIAL,

THERE WERE MORE HEART ATTACKS IN THE AVANDIA GROUP.

IT WAS SO CONSISTENT.

YOU DIDN'T HAVE TO BE STATISTICIAN OR IN THE WORDS

OF MY OLD FRIEND BOB DYLAN,

"YOU DON'T HAVE TO BE A WEATHER MAN TO KNOW WHICH WAY THE WIND BLOWS."

THERE WAS OBVIOUSLY A PROBLEM,

ABOUT A 30% INCREASE IN THE RISK

OF HEART ATTACK AND RELATED COMPLICATIONS.

AND THE COMPANY DID NOTHING.

THEY TOLD NO ONE.

THEY DID NOT TELL PHYSICIANS.

THEY DID NOT TELL THE FDA AND THEY DID NOT TELL PATIENTS.

Man: CLEVELAND CLINIC CARDIOLOGIST DR. STEVEN NISSEN

DECIDED TO DO HIS OWN REVIEW.

NOW, THE LEADING CAUSE OF DEATH IN DIABETES IS HEART DISEASE.

70% OF ALL THE DEATHS IN DIABETES ARE DUE TO HEART DISEASE.

HAVING A DIABETES DRUG THAT INCREASES

THE RISK OF HEART ATTACK BY NEARLY 1/3

IS A PUBLIC HEALTH CATASTROPHE.

AND THE COMPANY DIDN'T TELL ANYBODY.

Woman: A SENATE INVESTIGATION ACCUSES THE FOOD

AND DRUG ADMINISTRATION OF IGNORING RESEARCH.

FINALLY, THE FDA PUT SEVERE RESTRICTIONS ON THE DRUG.

Woman: YOU DO HAVE, YOU KNOW, A LOT OF MONEY AT STAKE HERE.

Second Woman: GLAXOSMITHKLINE WORKED VERY HARD TO KEEP

THESE NUMBERS FROM THE PUBLIC.

Brian Williams: AN FDA ADVISORY COMMITTEE STARTING HEARING EVIDENCE

ON WHETHER AVANDIA IS SO UNSAFE

IT SHOULD BE PULLED OFF THE MARKET ALTOGETHER.

THERE'S LITIGATION INVOLVED AND THE COMPANY

SET ASIDE $6 BILLION TO SETTLE LAWSUITS.

THE DOCUMENTS ARE COMING OUT IN THESE COURT SUITS.

IT LOOKS WORSE AND WORSE.

THE INDEPENDENT SAFETY OFFICIALS AT THE FDA

ESTIMATES SOMEWHERE BETWEEN 50 AND 200,000 DEATHS

OR HEART ATTACKS DUE TO THE DRUG.

WE'RE NOT TALKING ABOUT A HANDFUL OF PEOPLE HERE.

THIS DRUG WAS THE NUMBER ONE SELLING DIABETES DRUG IN THE WORLD IN 2006.

IT'S JUST A TERRIBLE TRAGEDY FOR PATIENTS.

IT IS VERY HARD TO GET LEGISLATIVE ACTION TO IMPROVE THE FDA

AND TO BETTER REGULATE THE--PARTICULARLY, THE PHARMACEUTICAL INDUSTRY.

IT IS THE ASSUMPTION THAT PEOPLE WHO RUN

GOVERNMENT ARE ELECTED OFFICIALS,

ARE MEMBERS OF CONGRESS, BUT IT'S NOT TRUE IN MANY CASES.

THE POWER LIES WITH CORPORATIONS

AND CORPORATE INTERESTS AND THE LOBBYISTS THAT THEY BUY.

GOOD MORNING, FOLKS, HOW ARE YA?

[BELL DINGS]

I WAS ALMOST SURPRISED AS ANYBODY TO SEE THE REPORTS

THAT I WAS THE MOST FREQUENT VISITOR

TO THE WHITE HOUSE DURING THE HEALTH REFORM DEBATE.

IT WAS IMPORTANT TO KEEP EXPRESSING THE HOSPITALS' POSITION.

IT'S AN EXPENSIVE WORLD TO LIVE IN,

IN TERMS OF GETTING YOUR VOICE HEARD IN D.C.,

BUT THAT'S THE WHOLE FUNCTION OF ADVOCACY.

HOW POWERFUL ARE LOBBYISTS IN THE HEALTHCARE SYSTEM?

[LAUGHING]

INFINITELY.

WHAT GIVES LOBBYISTS POWER IS THE AMOUNT OF MONEY

THEY HAVE FOR CAMPAIGN CONTRIBUTIONS.

WE HAVE BEEN TRYING TO REFORM

THE HEALTHCARE SYSTEM FOR 100 YEARS.

IT GOES BACK TO TEDDY ROOSEVELT.

BUT THESE COMPANIES WILL DO WHATEVER IT TAKES

TO MAKE SURE THERE ARE NO NEW LAWS OR REGULATIONS

THAT WILL HINDER THEIR PROFITS.

I WAS A PART OF EFFORTS GOING BACK

TO THE CLINTON ADMINISTRATION TO MAKE SURE

THERE WAS NO PATIENT'S BILL OF RIGHTS PASSED

BECAUSE IT WOULD HAVE EXPANDED PATIENT'S ABILITY

TO SUE THEIR INSURANCE COMPANY

OR THEIR EMPLOYER IF THEY HAD BEEN DENIED NEEDED COVERAGE.

SO, WE CREATED A FRONT GROUP CALLED THE HEALTH BENEFITS COALITION.

I'D LIKE TO WELCOME YOU TO THE FIRST PRESS CONFERENCE

OF THE HEALTH BENEFITS COALITION.

CORPORATIONS ARE VERY CAREFUL TO CHOOSE NAMES

FOR THESE ORGANIZATIONS TO MAKE PEOPLE THINK

THAT THEY REALLY ARE GRASSROOTS ORGANIZATIONS

AND THEY'RE REALLY NOTHING OF THE KIND.

PART OF THE WHOLE EFFORT IS TO GET PEOPLE ULTIMATELY TO VOTE

AGAINST THEIR OWN SELF-INTEREST.

THE SPIN WAS TO SCARE PEOPLE INTO THINKING THAT PREMIUMS

WOULD GO UP BECAUSE MORE PEOPLE WOULD BE FILING

FRIVOLOUS LAWSUITS, BUT, OF COURSE, THESE PEOPLE

HAD NO IDEA THAT THEY WERE BEING MADE TO BELIEVE

THIS BY THE INSURANCE INDUSTRY.

THE PATIENT'S BILL OF RIGHTS HAD BIPARTISAN SUPPORT,

SENATOR JOHN McCAIN AND SENATOR TED KENNEDY WERE CO-SPONSORS,

BUT IT WAS SO OPPOSED BY THE POWERFUL INSURANCE INDUSTRY,

NO BILL WAS EVER PASSED.

[APPLAUSE]

THE HEALTHCARE REFORM BILL THAT WAS ENACTED

ACHIEVED 2 OF THE INSURANCE INDUSTRY'S MAJOR OBJECTIVES.

IT INCLUDES THE MANDATE, THE REQUIREMENT,

THAT WE ALL HAVE TO BUY THEIR COVERAGE.

THAT WAS JOB NUMBER ONE FOR THEM.

JOB NUMBER 2 WAS TO MAKE SURE THAT THERE WAS NOT A PUBLIC OPTION.

THEY DIDN'T WANT TO HAVE A NEW COMPETITOR.

THEY HAD TO LIVE WITH SOME OF THE NEW CONSUMER PROTECTIONS IN THE BILL.

IT DOES MAKE IT ILLEGAL FOR COMPANIES

TO JUST CANCEL SOMEONE'S POLICY

BECAUSE OF A PRE-EXISTING CONDITION.

WHAT THE INSURANCE INDUSTRY'S OBJECTIVE IS,

IS TO TRY TO WEAKEN THOSE CONSUMER PROTECTIONS OVER TIME

AND TO TRY TO INFLUENCE HOW THE LAW IS BEING IMPLEMENTED.

BECAUSE OF THE MONEY THAT'S INVOLVED,

GETTING PEOPLE TO DO THE RIGHT THING

FOR THE AMERICAN PEOPLE HAS BECOME EXTREMELY DIFFICULT.

[CROWD CHEERING]

PEOPLE NOW, THEY HIT THE PITCH WE THROW.

IF WE CHANGE THE PITCH, THEY'LL HIT THAT ONE, TOO.

BETWEEN THE HEALTHCARE WE HAVE

AND THE HEALTHCARE WE COULD HAVE

LIES NOT JUST A GAP BUT A CHASM.

THAT'S HOW BIG THE DIFFERENCE IS

BETWEEN WHAT WE COULD BE DOING AND WHAT WE ARE DOING.

I THINK WE HAVE TO RECOGNIZE AS A COUNTRY,

WE COULD HAVE A CARE SYSTEM THAT WE CAN SUSTAIN FOR THE LONG HAUL

AND IT WILL BE FAR MORE BETTER PERFORMING

THAN WHAT WE HAVE NOW IF WE GET TOGETHER AND WORK ON IT.

I DON'T BLAME ANYBODY, THEY'RE JUST DOING WHAT MAKES SENSE,

AND WE HAVE TO CHANGE WHAT MAKES SENSE.

IF OUR CIVILIAN HEALTHCARE SYSTEM IS SMOLDERING

AND WE SEE IT'S GONNA CATCH ON FIRE AND BURN PRETTY SOON

AND IS GONNA BE UNSUSTAINABLE

BECAUSE OF THE COSTS, THE MILITARY SYSTEM IS ALREADY ON FIRE.

IT IS A BURNING PLATFORM AND THEY SEE THIS.

THE COSTS ARE GOING THROUGH THE ROOF AND THE ABILITY

TO HELP THESE SERVICE MEMBERS AND THEIR FAMILIES

RECOVER AND REPAIR AND COME BACK TO A FUNCTIONAL LIFE

IS GETTING LESS AND LESS.

I WAS IN THE WORST PLACE IN AFGHANISTAN.

THE KORENGAL, THE WATERPUR,

IT'S THE MOST INTENSE BATTLEGROUND THAT YOU CAN EVER BE IN.

I LOST A LOT OF GOOD MEN.

IT STILL BOTHERS ME TO THIS DAY.

I'M 2 1/2 MONTHS OUT OF COMBAT.

MY VERY BEST FRIEND FROM WAR, HE WAS ON NARCOTICS.

HE OVERDOSED, RESPIRATORY SHUT DOWN.

I LOST HIM...

AND FROM THAT POINT ON,

I REALIZED THAT I DON'T WANT TO BE ON THIS SIDE.

I DON'T WANT TO GO DOWN THE SAME PATH.

I CAME TO WALTER REED.

I WAS ON VALIUM JUST FOR THE ANXIETY.

I WAS ON ANTIDEPRESSANTS.

I WAS ON TRAZODONE, CLONIDINE.

I WAS SO DEPENDENT ON MY PAIN MEDICATION.

THIS...

IS THE MEDICATIONS I WAS ON.

DO YOU UNDERSTAND?

THAT IS HOW MANY MEDICATIONS I WAS ON.

WHEN YOU'RE INJURED, THEY FEED YOU, FEED YOU, FEED YOU ALL THIS STUFF.

IT'S ADDICTIVE. IT IS SO ADDICTIVE.

I'D RATHER BE SHOT AGAIN

THAN GO THROUGH WITHDRAWALS OF COMING OFF THAT MEDICINE.

NO SOLDIER SHOULD HAVE TO GO THROUGH THIS.

AS WE'VE PUSHED MEDICAL INNOVATION AND CAPABILITY

TO THE LEADING EDGE OF THE BATTLEFIELD,

WHERE WE CAN SAVE THEIR LIFE, WE'VE GOT SOME GUYS THAT HAVE

SOME HORRIFIC INJURIES AND THEY'RE GETTING NARCOTICS FOR LONGER PERIOD OF TIME.

THEY CERTAINLY ARE AT RISK TO DEVELOP DEPENDENCY.

AND THAT'S WHAT WE'RE TRYING TO AVOID.

THE ARMY SURGEON GENERAL DIRECTED THAT WE ESTABLISH

THE PAIN MANAGEMENT TASK FORCE

TO TAKE A LOOK AT ALTERNATIVES TO NARCOTICS.

Dr. Jonas: THERE'S VERY LARGE, RANDOMIZED TRIALS

DONE AT MULTIPLE CENTERS

THAT HAVE DEMONSTRATED THAT ACUPUNCTURE WORKS,

SO WE PUT TOGETHER A STUDY TO SEE

IF WE CAN ACTUALLY INSERT THIS SIMPLE ACUPUNCTURE TECHNIQUE

DURING THE AIR EVACS OF WOUNDED SOLDIERS INTO WALTER REED

AND OTHER MEDICAL CENTERS IN THE UNITED STATES.

THE QUESTION WAS, CAN WE RELIEVE THEIR PAIN

AND REDUCE THE AMOUNT OF MEDICATIONS THAT THEY'RE ON,

SO BY THE TIME THEY GET BACK,

THEY'RE NOT SNOWED UNDER ON MULTIPLE MEDICATIONS.

GUTEN MORGEN. WELCOME TO GERMANY.

AND WELCOME HOME.

I KNOW YOU ARE HEADING HOME AND YOU ARE EXCITED.

WHAT IT FIRST SEEMS LIKE STRANGE BED FELLOWS--

HEALING-ORIENTED MIND/BODY PRACTICES

AND SORT OF THE HARD-CORE MILITARY...

ACTUALLY IS AN OPPORTUNITY

THAT THEY JUMPED AT BECAUSE OF THE PRAGMATIC NEED

IN NATURE THAT THE WARS HAVE DRIVEN THEM TO RESPOND TO.

THERE'S A VERY, VERY SMALL CHANCE

OF YOU HAVING INFECTION OR ANY OF THOSE KIND OF PROBLEMS.

I AM VERY SKEPTICAL ABOUT IT,

THIS IDEA THAT PUTTING SOME LITTLE STICK PINS

IN YOUR EAR IS GONNA CURE PAIN ON A 9-HOUR FLIGHT.

IT WEARS ON YOUR LOWER BACK WEARING, YOU KNOW,

A 40-POUND VEST AND IT'S GOT TO THE POINT WHERE THE PAIN

IS RADIATING FROM MY BACK

DOWN TO MY HIPS AND THEN DOWN INTO MY THIGHS.

THAT'S IT.

THAT'S MY DAILY ROUTINE.

THE FIRST ONE'S GOING IN.

HOW'S YOUR PAIN, SIR?

I FEEL LIKE I'M WARMING UP A LITTLE BIT.

IT'S PRETTY IMPRESSIVE,

ESPECIALLY FOR IT TO REACT THAT QUICKLY.

WHEN YOU PUT THE ACUPUNCTURE NEEDLES IN THE EAR,

YOU SEE THE ACTIVITY DROPS DOWN.

SO, WHAT HAS HAPPENED IS YOU HAVE REDUCED THE SIGNALS,

OR THE PROCESSING, OF THE PAIN.

WHEN YOU PROVIDE A SMALL STIMULUS LIKE THAT,

THE BODY RESPONDS BY TRYING TO HEAL ITSELF, TRYING TO REPAIR ITSELF.

IT'LL GO RIGHT THERE.

OK.

GO AHEAD AND BEND DOWN.

THAT'S PRETTY GOOD.

ANY PAIN?

NOT WHEN I'M DOING THAT.

NORMALLY YOU WOULD?

OH, YES.

I HAVEN'T TOUCHED MY TOES IN MONTHS.

THAT MEANS WE'RE GETTING THE NEEDLES IN THE RIGHT PLACE.

OK. I HAVEN'T EVEN GOTTEN NEAR MY TOES

IN MONTHS, UNLESS I DO THIS, YOU KNOW?

HOW ARE YOU DOING?

I'M DOING GOOD.

YEAH, ACTUALLY, I WANT YOU THERE WHEN I GO INTO SURGERY.

HI. HOW ARE YOU FEELING?

I HAVE PAIN, BUT IT'S MORE OF AN ANNOYANCE THAN IT IS PAIN.

JUST SORE.

IF YOU DIDN'T HAVE THE ACUPUNCTURE NEEDLES,

HOW DO YOU THINK YOU WOULD BE FEELING NOW?

I'D BE CHOMPING NARCOTICS.

OH, YOU WOULD? OH, YEAH.

OH, SO, YOU HAVEN'T TAKEN ANYTHING?

NO. BECAUSE OF THAT?

YEP. THAT'S GOOD.

15 YEARS AGO WE DID A CONSENSUS CONFERENCE

AT THE NATIONAL INSTITUTES OF HEALTH

AND WE ASKED THE QUESTION, DO WE HAVE

GOOD EVIDENCE TO SHOW THAT ACUPUNCTURE

IS SAFE AND EFFECTIVE FOR ANY CONDITION?

THEY SAID, ABSOLUTELY.

IT'S BEEN DEMONSTRATED THAT ACUPUNCTURE IS SAFE AND EFFECTIVE,

ESPECIALLY WITH POST- OPERATIVE AND INJURY PAIN.

APPRECIATE IT.

THANK YOU VERY MUCH.

15 YEARS LATER, YOU CAN'T WALK INTO YOUR AVERAGE HOSPITAL TODAY

AND GET ACUPUNCTURE AFTER AN OPERATION.

THE PROBLEM IS NOT THAT IT DOESN'T WORK.

THE PROBLEM IS THAT WE HAVEN'T FIGURED OUT

HOW TO GET IT INTO THE SYSTEM SO THAT WE CAN MAKE

IT WIDELY AVAILABLE TO THE POPULATION.

Woman: IN THE LAST FEW YEARS A PROFOUND CHANGE HAS BEGUN IN AMERICAN MEDICINE.

Man: DR. DEAN ORNISH HAS STUDIED AND WRITTEN

ABOUT DIET AND HEART DISEASE FOR DECADES.

IN MEDICAL SCHOOL I WAS LEARNING HOW TO DO BYPASS SURGERY

WITH MICHAEL DEBAKEY, THE HEART SURGEON.

WE CUT PEOPLE OPEN, WE BYPASSED THEIR BLOCKED ARTERIES,

AND HE WOULD TELL THEM THEY WERE CURED AND THEY'D GO HOME

AND MORE OFTEN THAN NOT, EAT THE SAME JUNK FOOD,

SMOKE AND NOT MANAGE STRESS,

NOT EXERCISE, AND THEN OFTEN THEIR BYPASSES WOULD CLOG UP.

SO, WE'D CUT THEM OPEN,

WE'D BYPASS THEIR BYPASS, SOMETIMES MULTIPLE TIMES.

I SAID THERE'S GOT TO BE A BETTER WAY.

WE SPEND SO MUCH TIME IN MEDICINE MOPPING UP THE FLOOR

AROUND THE SINK THAT'S OVERFLOWING

WITHOUT ALSO TURNING OFF THE FAUCET.

IF WE JUST LITERALLY OR FIGURATIVELY BYPASS THE PROBLEM

WITH ANGIOPLASTIES AND STENTS OR LIFETIMES OF DRUGS

OR OTHER KINDS OF INTERVENTIONS,

THEN MORE OFTEN THAN NOT, THE SAME PROBLEM COMES BACK AGAIN.

BUT WHAT WE'RE FINDING IS THAT IF YOU TURN OFF THE FAUCET,

IF WE TREAT THE UNDERLYING CAUSES,

WHICH TO A LARGE DEGREE ARE NOT SO MUCH OUR GENES

BUT OUR LIFESTYLE, THAT OUR BODIES HAVE A REMARKABLE CAPACITY

TO BEGIN HEALING THEMSELVES AND THESE CHRONIC DISEASES

CAN NOT ONLY BE PREVENTED,

BUT EVEN REVERSED MUCH MORE QUICKLY THAN WE HAD ONCE REALIZED.

WHEN I WENT TO MEDICAL SCHOOL,

I STARTED READING ALL THE MEDICAL LITERATURE

AND REALIZED THAT IN DOGS AND CATS

AND PIGS AND RABBITS AND MONKEYS,

YOU COULD CAUSE THEM TO GET HEART DISEASE

IF YOU PUT THEM ON A BAD DIET AND "X" DIDN'T LET THEM EXERCISE

AND PUT THEM UNDER EMOTIONAL STRESS,

BUT YOU COULD REVERSE IT IF YOU CHANGED THOSE SAME THINGS.

SO, I THOUGHT, WHY SHOULD PEOPLE BE ANY DIFFERENT?

AND EVERYBODY SAID, THAT'S A CRAZY IDEA.

THERE'S NO WAY THAT'S GONNA WORK,

YOU KNOW, WHAT'S THE MATTER WITH YOU?

I SPENT MORE THAN 30 YEARS OF DOING THESE STUDIES,

SHOWING THAT HEART DISEASE COULD BE REVERSED

BY CHANGING WHAT WE EAT, HOW WE RESPOND TO STRESS,

HOW MUCH WE EXERCISE AND HOW MUCH LOVE AND SUPPORT WE HAVE IN OUR LIVES.

IN OUR MODEL THE PHYSICIAN ACTS AS A QUARTERBACK

AND HE OR SHE ASSEMBLES A TEAM OF 5 OTHER PEOPLE TO WORK WITH--

A NURSE, A YOGA TEACHER,

AN EXERCISE PHYSIOLOGIST,

A REGISTERED DIETITIAN, AND A CLINICAL PSYCHOLOGIST.

AND WHEN WE WORK AT THAT LEVEL,

WE FIND THAT PEOPLE ARE MUCH MORE LIKELY TO MAKE

THESE SUSTAINABLE CHANGES AND THE PATIENT LEARNS

HOW TO EMPOWER THEMSELVES AND TO TRANSFORM THEIR LIVES.

25 YEARS AGO I HAD 5 RESTAURANTS IN SAN FRANCISCO.

IT WAS A GREAT LIFE.

I SMOKED 6 CIGARS A DAY, 10 CUPS OF COFFEE,

AND A LOT OF WINE.

IT WAS WONDERFUL.

AND I HAD A MASSIVE HEART ATTACK.

I WAS IN THE HOSPITAL FOR 2 WEEKS.

I COULD HARDLY, UH...

JUST ABOUT WALK 3 STEPS AND I'D HAVE TO STOP AND REST.

I WAS POPPING 20 OR 30 NITRATES A DAY.

BUT THEN DEAN ORNISH WAS STARTING HIS PROGRAM

TO SEE IF YOU CAN REVERSE HEART DISEASE

THROUGH A LIFESTYLE CHANGE

AND HE WENT TO MY DOCTOR AND ASKED IF HE COULD APPROACH ME.

HE TOLD DEAN, HOW LONG IS THE PROGRAM?

HE SAID IT WAS A YEAR.

AND MY DOCTOR TOLD HIM HE WOULDN'T RECOMMEND TAKING ME

BECAUSE HE DIDN'T THINK I WOULD LIVE THE YEAR.

SO, HE FIGURED I WAS GONNA DIE 'CAUSE I WAS IN SUCH BAD SHAPE.

AND NOW 25 YEARS LATER, AND I'M IN PRETTY GOOD SHAPE.

HA HA HA HA.

WE FOUND THAT AFTER A YEAR,

THE MEN WHO MADE THESE INTENSIVE LIFESTYLE CHANGES,

THEIR PHYSICAL HEART DISEASE IMPROVED.

IT CAUSED THEIR BLOCKAGES

TO BECOME LESS BLOCKED IN THEIR ARTERIES.

AND THAT WAS THE FIRST STUDY SHOWN THAT HEART DISEASE WAS REVERSIBLE,

BUT WHEN YOU'RE DOING SOMETHING

THAT HAS NEVER BEEN DONE BEFORE,

IT'S NOT UNIVERSALLY ACCEPTED, TO SAY THE LEAST.

IT WAS, YOU KNOW, THERE WAS A HUGE AMOUNT OF SKEPTICISM AND RESISTANCE.

PEOPLE WOULD SAY, OH, BUT YOU'RE DOING THIS RADICAL INTERVENTION, YOU KNOW.

I SAY, RADICAL? YEAH, LIKE COMPARED TO HAVING YOUR CHEST CUT OPEN?

I MEAN, GIVE ME A BREAK.

WE NEED TO EMPOWER PEOPLE TO CHANGE THEIR LIFESTYLE.

AND IF WE CAN MAKE IT REIMBURSABLE,

THAT REALLY BRINGS IT INTO THE MAINSTREAM.

NOW, AS YOU KNOW, HEART AND BLOOD VESSEL DISEASES

KILL MORE AMERICANS THAN VIRTUALLY EVERYTHING ELSE COMBINED

AND IT'S TREATED WITH THINGS LIKE ANGIOPLASTIES AND STENTS

AND BYPASS SURGERY AND YET, WHAT DOES THE EVIDENCE REALLY SHOW?

UNLESS YOU'RE IN THE MIDDLE OF HAVING A HEART ATTACK,

WHICH 95% OF PEOPLE WHO GET THEM ARE NOT,

THEY DON'T PROLONG YOUR LIFE,

THEY DON'T EVEN PREVENT HEART ATTACKS.

WE HAVE A MODEL THAT WORKS

SIMPLY BY MAKING CHANGES IN DIET AND LIFESTYLES.

AND IN OUR STUDIES FOR THE LAST 33 YEARS,

WE'VE USED VERY HIGH TECH, EXPENSIVE,

STATE-OF-THE-ART MEASURES TO PROVE HOW POWERFUL

THESE VERY SIMPLE AND LOW TECH AND LOW COST INTERVENTIONS CAN BE.

NOW, TO A NEW STUDY THAT SHOWS DIET

MAY BE A KEY TOOL IN THE FIGHT AGAINST CANCER.

THE STUDY WAS CONDUCTED BY DR. DEAN ORNISH,

WHO LOOKED AT PATIENTS WITH EARLY STAGE PROSTATE CANCER.

MORE THAN HALF OF MEN OVER THE AGE OF 50, GET A P.S.A.

TEST EVERY YEAR TO TRY TO DETECT PROSTATE CANCER EARLY.

IT TURNS OUT LOTS AND LOTS OF MEN WHO HAD A CANCER

THAT DIDN'T NEED TO BE TREATED, BUT THEY GOT TREATED ANYWAY

AND IT WAS CAUSING A LOT OF HARM.

THERE'S VERY LITTLE EVIDENCE

THAT THESE CONVENTIONAL TREATMENTS MAKE YOU LIVE LONGER,

BUT THEY CAUSE MANY MEN TO BE IMPOTENT OR INCONTINENT OR BOTH,

AND SO THERE'S A SUBSET OF MEN WHO HAVE DIAGNOSED,

BIOPSY-PROVEN PROSTATE CANCER,

WHO ELECT NOT TO GET TREATED CONVENTIONALLY.

MY PATH CROSSED WITH DEAN'S BECAUSE WE BOTH WANTED HIM

TO TRY AND BRING RIGOROUS CLINICAL TRIAL TESTING

TO THIS HYPOTHESIS THAT LIFESTYLE INTERVENTION

COULD HAVE AN IMPORTANT IMPACT IN MEN WITH EARLY STAGE PROSTATE CANCER.

HOW ARE YOU?

STEVEN. NICE TO SEE YOU.

I'M ONE OF THE BUSIEST SURGEONS IN THE COUNTRY.

HOWEVER, I DON'T BELIEVE EVERY MAN

WITH PROSTATE CANCER NEEDS IMMEDIATE TREATMENTS.

SO, I SIMPLY FOLLOW THEM VERY CAREFULLY

AND YOU TREAT THEM AT THE FIRST SIGN OF PROGRESSION.

IF YOU CAN DELAY TREATMENT, THEN THAT MAN IS NOT AT RISK

FOR SIDE EFFECTS DURING THAT PERIOD OF TIME.

HEY, LIZ.

COME ON IN.

DR. PETER CARROLL AND I COLLABORATED WITH DR. ELIZABETH BLACKBURN,

WHO WON THE NOBEL PRIZE IN MEDICINE

AND SHE HAD DONE A STUDY SHOWING

THAT STRESS CREATES SHORTER TELOMERES.

SO, AS YOUR TELOMERES GET SHORTER, YOUR LIFE GETS SHORTER.

TELOMERES ARE THE ENDS OF CHROMOSOMES

AND CHROMOSOMES HAVE ALL OUR GENETIC INFORMATION ON THEM.

WHEN TELOMERES WEAR DOWN AND GET FRAYED,

THE GENETIC MATERIAL WOULD GET MESSED UP.

THAT PREVENTS TISSUES FROM RENEWING THEMSELVES

IN THE BODY AND DISEASES TAKE HOLD.

I THOUGHT MOST THINGS IN BIOLOGY GO BOTH WAYS,

SO IF BAD THINGS MAKE YOUR TELOMERES SHORTER,

MAYBE GOOD THINGS WILL MAKE THEM LONGER.

SO, WE TOOK THE MEN WITH PROSTATE CANCER TO SEE

IF LIFESTYLE CHANGES CAN AFFECT GENE EXPRESSION AND EVEN TELOMERES.

Robin Roberts: THE RESEARCH FOUND THAT EMBRACING

A LOW-FAT VEGETARIAN DIET,

EXERCISING HALF AN HOUR A DAY,

AND TAKING PART IN DAILY STRESS REDUCING ACTIVITIES

CAN ACTUALLY CHANGE THE REGULATION OF GENES

THAT ARE KEY PLAYERS IN CANCER DEVELOPMENT

AND CONTRIBUTE TO BETTER OVERALL SURVIVAL.

WE FOUND THAT THE MEN WHO UNDERWENT

LIFESTYLE INTERVENTION, THEIR P.S.A. RATES

GENERALLY WENT DOWN AND THEY WERE LESS LIKELY TO REQUIRE TREATMENT.

THE PROGRAM INCREASED THE TELOMERE LENGTH.

WE EVEN FOUND THAT WHEN YOU CHANGE YOUR LIFESTYLE,

OVER 500 GENES WERE CHANGED, AND IN FACT,

TURNING ON THE GENES THAT PREVENT DISEASE,

TURNING OFF THE GENES THAT PROMOTE BREAST CANCER,

PROSTATE CANCER, AND COLON CANCER.

AND EVEN DRUGS, EVEN PHARMA, HASN'T BEEN SHOWN TO DO THAT.

THIS PUTS A LANGUAGE OF NUMBERS

AND MOLECULAR REDOX, THROUGH DEAN ORNISH AND THOSE INTERVENTIONS,

THAT MANY IN THE MEDICAL FIELD, I THINK, FEEL MORE COMFORTABLE WITH.

THESE LIFESTYLE CHANGES CAN NOT ONLY WORK AS WELL AS DRUGS AND SURGERY,

BUT OFTEN EVEN BETTER AT A FRACTION OF THE COST

AND THE ONLY SIDE EFFECTS ARE GOOD ONES.

ALMOST ONE YEAR INTO THE FELLOWSHIP,

I JOINED THIS NEW PRACTICE.

HELLO. HOW ARE YOU?

THEY PROMISED ME THAT I COULD MAKE THE PRACTICE

WHATEVER I WANTED IT TO BE

AND IF I DON'T WANNA SEE 6 PATIENTS AN HOUR,

I DON'T HAVE TO SEE 6 PATIENTS AN HOUR.

WE'RE THE ONLY CLINIC IN SKAMANIA COUNTY,

SO IT'S ABOUT 20,000 PEOPLE, OVERALL,

THAT WE'RE THE ONLY PROVIDERS FOR.

[SPEAKING IN SPANISH]

WE'RE PART OF THE COMMUNITY.

ALL OF US LIVE HERE AND WORK HERE.

HOW ARE YOU TODAY?

PRETTY GOOD, HOW ARE YOU?GOOD.

THERE'S BEEN A LOT OF CHANGE IN ME

IN THAT TRANSITION BETWEEN LA CLINICA AND HERE.

I CAN ACT MORE AS A GUIDE FOR PATIENTS,

TAKING THE TIME TO EDUCATE THEM AND HAVING THEM UNDERSTAND

THAT THERE ARE CHOICES THAT THEY HAVE THE POWER TO MAKE FOR THEMSELVES.

IF YOU HAVE THAT DESIRE TO QUIT SMOKING, WE'LL GET THERE EVENTUALLY.

YEAH. OK?

WE JUST HAVE TO KEEP WORKING TOWARDS THAT.

AND INTERESTINGLY, PATIENTS REALLY RESPOND TO THAT.

DID YOU GO TO THE DIABETES EDUCATION?

YES.

HOW DID THAT--WHAT DID YOU THINK ABOUT THAT?

IT WAS OK. IT KIND OF GAVE ME A MORE IDEA OF WHAT TO EAT.

OK. OK. YOU LOST 5 POUNDS.

MM-HMM. I QUIT DRINKING, TOO, SO...

HOW MUCH WERE YOU DRINKING BEFORE?

6 AND OVER. A DAY?

A DAY, FOR 25 YEARS, SO...

WOW. WHAT MADE YOU DECIDE TO DO THAT?

WELL, THAT HAD TO BE SOMETHING TO DO WITH MY DIABETES.

MM-HMM. I'M REALLY, REALLY PLEASED.

YOU JUST LOOK DIFFERENT.

SO, THAT'S REWARDING FOR ME.

I FEEL DIFFERENT.

[CHUCKLES]

I HAD TO DO SOMETHING.MM-HMM.

I GUESS I NEED TO COME BACK IN A MONTH OR SO.

COME BACK IN ONE MONTH.

ALMOST EVERY STUDY SAYS THAT THE DOCTOR

THAT HAS THE GREATEST IMPACT ON YOUR HEALTH,

IN GENERAL, THE GREATEST IMPACT

ON THE HEALTH OF A POPULATION

IS PRIMARY CARE DOCTORS. WE NEED PRIMARY CARE DOCTORS.

YEAH, YOUR THYROID IS A LITTLE BIT BIG. AH.

WHAT'S HAPPENED TODAY IS WE FOUND OURSELVES IN A POSITION

WHERE WE DON'T HAVE ENOUGH PRIMARY CARE CLINICIANS

TO PROVIDE THAT IMPORTANT FUNDAMENTAL LEVEL OF CARE.

WHEN WAS YOUR LAST MAMMOGRAM AND PAP SMEAR?

HAVE YOU...

UH, 2008.

WHY? WE HAVE UNDERPAID ON A CHRONIC BASIS,

UNDER REWARDED PRIMARY CARE.

SOME WOULD SAY OVER REWARDED SPECIALTY AND SUB-SPECIALTIES.

OK, SO, FIRST TOPIC-- MEDICAID REIMBURSEMENT.

ABOUT 3 WEEKS AGO BECAUSE OF THE STATE BUDGET CRISIS,

WE GOT TOLD WITH VERY LITTLE NOTICE

THAT MEDICARE AND MEDICAID REIMBURSEMENT

WAS GONNA BE CUT BY ABOUT 25%.

SO, TO MAKE UP THAT DIFFERENCE

IN THE REIMBURSEMENT RATES DECREASING,

WE'RE CHANGING TO SHORTER APPOINTMENTS NEXT WEEK,

WE'RE ON TRACK FOR THAT ON TUESDAY.

SO, RIGHT NOW THE ONLY WAY WE HAVE TO MAKE UP

THE DIFFERENCE IS BASICALLY TO SEE MORE PEOPLE?

RIGHT.

[SIGHS]

THAT'S A LITTLE--IT MIGHT BE A LITTLE BIT

OF A CULTURE SHIFT, TOO, FOR THE PATIENTS.

AND IF THEY HAVE A RELATIONSHIP WITH YOU,

FEELING TRUNCATED, THAT'S GOING TO BE A LITTLE BIT

OF A CHANGE AND A LITTLE UNFORTUNATE.

IT'S A FINANCIAL NECESSITY.

THAT'S THE ONLY REASON WE'RE MAKING THE CHANGE, RIGHT?

I MEAN...

BUT YOU HAVE TO HAVE THE TIME TO EDUCATE YOUR PATIENTS

AND THEY DON'T REIMBURSE FOR NUTRITIONAL COUNSELING

OR ANYTHING LIKE THAT,

BUT WE'RE GONNA TALK TO THEM ABOUT STILL, YOU KNOW.

WE ALL KNOW THERE'S THINGS WE CAN DO

AND THOSE THINGS MAKE US ALL FEEL GOOD

AND WE LIKE TO DO THEM,

BUT WE'RE GONNA FEEL REALLY BAD

IF OUR DOORS CLOSE AND THEN WE'RE NOT GONNA HAVE ANYBODY.

CONVENTIONAL WISDOM IS OVER THE NEXT 2 YEARS

WE WILL LIKELY GO OUT OF BUSINESS.

WE'RE FIGHTING EVERYTHING FOR THAT NOT TO HAPPEN,

BUT IT'S BECAUSE THERE ISN'T THE FUNDING GOING

IN TO PRIMARY CARE, IT GOES INTO THE OTHER AREAS

AND IT'S JUST NOT SUSTAINABLE.

DR. MARTIN HAS A LOT MORE TIME WITH PATIENTS RIGHT NOW

BECAUSE SHE'S REALLY RAMPING UP HER SCHEDULE,

BUT SHE'S NOT COVERING HER COSTS,

SO THE REST OF THE PHYSICIANS ARE COVERING HER COSTS RIGHT NOW.

BECAUSE WE'RE A PHYSICIAN-OWNED AND A PHYSICIAN RUN PRACTICE,

SHE'S IN CHARGE OF HER OWN SCHEDULE,

BUT IF THAT REIMBURSEMENT LEVEL IS SMALLER

AND SMALLER, SHE'S GONNA HAVE A LOT LESS TIME

TO SPEND WITH PATIENTS, SO THAT WE CAN AT LEAST

COVER OUR COSTS AND STAY IN BUSINESS.

BECAUSE OF THE BOTTOM LINE,

BECAUSE OF THE CUTS THAT ARE COMING THROUGH THE GOVERNMENT,

IF IT CAME TO THE POINT WHERE THEY COULDN'T PAY ME

ANYMORE, THAT WOULD SUCK, BUT I'M NOT AFRAID

BECAUSE I'VE GOTTEN A LOT OF INSPIRATION FROM THE FELLOWSHIP,

A DIFFERENT PERSPECTIVE THAT THERE'S A DIFFERENT WAY

OF DOING THINGS THAT IS POSSIBLE.

DID YOU HAVE A GOOD DAY TODAY?

UH...YES.

YEAH?

I WOULD PROBABLY LEAVE HEALTHCARE BEFORE I WENT

BACK TO PRACTICING THE WAY I PRACTICED LAST YEAR.

I CHOSE TO GET OFF ALL NARCOTICS,

ALL MEDICINE, EVERYTHING.

SO, JUST TAKE A COUPLE OF MINUTES TO KIND OF ARRIVE.

ALL RIGHT, SO TAKE A BREATH.

[INHALING]

I'M A REDNECK, SOUTH LOUISIANA BOY,

JUST AN OLD HILLBILLY, YOU KNOW.

I DON'T BELIEVE IN THAT STUFF, YOU KNOW, IN EASTERN MEDICINE.

ANYBODY ELSE WOULD LAUGH, YOU KNOW, BE LIKE WHAT IS THAT FOR?

HOLD MY BEER WHILE I SHOOT THIS GATOR,

YOU KNOW? BUT I DECIDED TO GIVE IT A SHOT.

SO, WE GOING TO OPEN UP SOME CHI?

WE GONNA OPEN UP SOME CHI.

THAT'S A GOOD WAY TO THINK OF IT.

OH, WOW. [CHUCKLES] THAT'S THE WAY I LIKE TO LOOK AT IT.

BECAUSE OF THIS PROGRAM THAT'S HERE, THERE'S YOGA...

I'M JUST GOING TO GO AHEAD AND PUT THE LAST ONE IN...

I MEDITATE AND IT HAS OPENED UP A WHOLE NEW WORLD FOR ME.

I'M GOING TO LEAVE THESE IN FOR ABOUT 5, 7 MINUTES,

SOMETHING LIKE THAT, OK?

ROGER THAT.

IT'S WONDERFUL.

[GUNFIRE]

Man: A NEW STUDY FINDS A GROWING NUMBER OF COMBAT VETERANS

ARE BATTLING MENTAL ILLNESS, BUT MANY ARE FINDING IT

DIFFICULT TO GET THE HELP THEY NEED.

POST TRAUMATIC STRESS DISORDER, OR P.T.S.D.,

IT'S AN INDIVIDUAL'S REACTION TO THE EXPOSURES AND EXPERIENCES OF WAR.

WAR IS HELL. IT'S ALWAYS HELL.

SO, YOU PICK YOUR SPOT.

SOLDIERS KNOW IF THEY GO TO WAR AND IF THEY GET A LEG BLOWN OFF,

THAT YOUR MEDICS GOING TO TAKE CARE OF YOU

AND THE SAME THING NEEDS TO APPLY THAT IF YOU HAVE POST TRAUMATIC STRESS,

INVISIBLE AS IT IS, IT'S JUST AS SIGNIFICANT

AS A BULLET WOUND TO THE HEAD OR CHEST.

THE FIRST THING I'D LIKE TO DO IS TEACH YOU

A BREATHING EXERCISE WITH A TARGETED EFFECT

ON POST TRAUMATIC STRESS.

ALL RIGHT, SO, INHALE. [INHALING]

EXHALE. [EXHALING]

CATCHING IT VERY, VERY EARLY AFTER THEIR EXPOSURE

AND ALLOWING THEM TO PROCESS THAT

IS SO CRITICAL IN THE LONG-TERM RECOVERY.

RELEASE THE BREATH IN A SMOOTH, EVEN STREAM OUT.

OK, SO, LET'S GO INTO OUR MEDITATION PRACTICE.

MEDITATION IS SCARY SOMETIMES.

SOMETIMES WHEN YOU GO,

YOU GO TO BAD PLACES IN YOUR HEAD.

I WILL BE AT YOUR SIDE, SHOULD ANYTHING CHALLENGING COME UP FOR YOU.

THAT'S A HEALING PROCESS BECAUSE YOU'RE NOT BOTTLING UP.

IT'S GOING TO A DIFFERENT SECTION

IN YOUR MIND TO WHERE YOU CAN START PROCESSING IT.

SO, FEEL YOURSELF THERE IN YOUR SAFE PLACE.

AND REMEMBER THAT YOU CAN RETURN TO THIS PLACE

AT ANYTIME DURING THE MEDITATION.

LET GO OF THINKING.

DROP BACK IN AWARENESS AND NOTICE HOW A THOUGHT MAY SHOW UP,

SEEMINGLY OUT OF NOWHERE,

OR AN IMAGE MAY SHOW UP AND THEN DISAPPEAR.

AND FEEL YOURSELF OBSERVING ALL THESE CONSTANTLY

CHANGING SENSATIONS AND THOUGHTS AND FEELINGS.

RECOGNIZE THAT YOU ARE THIS SPACIOUS,

WELCOMING, OPEN AWARENESS.

NO MATTER WHAT THOUGHT, NO MATTER WHAT FEELING,

NO MATTER WHAT SENSATION OR CIRCUMSTANCE HAPPENS TO ARISE.

[SHUDDERING]

YOUR ARMS HEAVY, YOUR LEGS HEAVY.

YOU'RE GOOD. YOU'RE GOOD.

I KNOW, I KNOW.

THAT'S SOME SWEAT.

YOU DONE SOME SWEATING.

I WAS ON PRAZOSIN JUST FOR NIGHTMARES.

MEDITATION, IT TAKES THE PLACE OF THAT.

NOTICE WHERE YOU ARE IN THE ROOM, THE PEOPLE AROUND.

THE PAIN...IT'S HARD, YOU KNOW, IT'S REALLY HARD.

YOU GOT TO PUSH THROUGH IT.

BUT THIS PROGRAM HAS JUST INSPIRED ME TO PRESS FORWARD.

THE MEDICATION DEPRESSES YOU.

IT MAKES YOU THINK THAT...

IS ALL YOU'RE EVER GONNA BE IN.

WE'LL END THE PRACTICE TODAY WITH THE COMPLETING STATEMENTS.

MAY EVERYONE BE WELL...

MAY EVERYONE BE HEALTHY...

MAY EVERYONE BE HAPPY.

MAY EVERYONE BE HAPPY.

IF THE MILITARY IS ABLE TO SUCCESSFULLY INTEGRATE ACUPUNCTURE,

MEDITATION AND MIND BODY, YOGA,

THEN WE'LL FIND THAT THE CULTURE AT LARGE WILL LEARN

HOW TO ADOPT IT AND IT WILL HAVE

A TRANSFORMATIVE EFFECT ON OUR HEALTHCARE SYSTEM.

READY?

YES, MA'AM.

THE LIMITATIONS OF HIGH TECH MEDICINE HAVE NEVER BEEN CLEARER,

AT THE SAME TIME THAT THE POWER OF THESE SIMPLE LOW TECH,

LOW COST INTERVENTIONS IS ALSO BECOMING CLEARER.

WE COULD DO A THOUSAND STUDIES WITH A MILLION PATIENTS.

IT WOULD ALWAYS REMAIN ON THE FRINGES.

IT'S ALL ABOUT THE BENJAMIN'S, AS THE RAPPERS WOULD SAY.

IT'S ALL ABOUT THE REIMBURSEMENT.

IF WE CAN CHANGE REIMBURSEMENT, IT'S A GAME CHANGER.

WE CHANGE MEDICAL PRACTICE

AND WE CHANG MEDICAL EDUCATION.

TRYING TO GET MEDICARE TO COVER THE HEART DISEASE PROGRAM

HAS BEEN BY FAR THE HARDEST THING I'VE EVER DONE IN MY ENTIRE LIFE.

MOST INSURANCE COMPANIES WILL FOLLOW MEDICARE'S LEAD,

SO I REALIZE THAT MEDICARE'S THE ROSETTA STONE.

IF WE GET MEDICARE TO COVER IT,

THEN EVERYONE ELSE WILL COVER IT AND IF EVERYONE COVERS IT,

THEN IT BECOMES THE STANDARD OF CARE.

I WANTED TO BRING YOU UP TO DATE ON OUR PROGRESS.

WE'VE BEEN MAKING A LOT.

MEDICARE FINALLY IS GOING TO COVER OUR REVERSING HEART DISEASE PROGRAM.

THAT WAS 16 YEARS IN THE MAKING, AS YOU KNOW.

IT'S NOT LIKE THERE'S ONE LIFESTYLE PROGRAM

FOR HEART DISEASE AND ANOTHER ONE FOR DIABETES

AND ANOTHER ONE FOR CHANGING YOUR GENE EXPRESSION,

ANOTHER ONE FOR PROSTATE CANCER, IT'S ESSENTIALLY THE SAME PROGRAM.

IT'S JUST A QUESTION OF THE DEGREE THAT PEOPLE

ARE WILLING TO MAKE THESE CHANGES.

THAT'S THE KEY POINT, DEAN.

PEOPLE, SO TO SPEAK, HAVE A CONSTITUTIONAL RIGHT TO BE FOOLISH.

HA HA HA.WE HAVE TO RESPECT THAT.

BUT IF WE'RE REALLY TALKING ABOUT TRUE FREEDOM OF CHOICE,

THEY ALREADY PAY FOR THE DRUGS AND SURGERY,

WHAT WE ALSO WANT THEM TO PAY FOR ARE

FOR THOSE PEOPLE WHO ARE MOTIVATED AND WHO WANT TO CHANGE,

TO GIVE THEM THE SUPPORT THAT THEY NEED IN ORDER TO BE ABLE TO DO THAT.

THAT'S PROBABLY TOO LOGICAL FOR THE FEDERAL GOVERNMENT

TO PICK UP ON IMMEDIATELY, BUT WE DIDN'T GET INTO THIS

SITUATION WITH SO MANY AMERICANS OBESE,

WITH THIS LEVEL OF JUVENILE DIABETES, BY ACCIDENT.

WE GOT INTO BECAUSE THERE WERE A WHOLE HOST OF POLICIES

THAT LED US DOWN THIS PATH TO SICK CARE,

RATHER THAN THE FOCUS ON PREVENTION AND WELLNESS.

NOW, THAT MEDICARE'S GONNA COVER THE HEART DISEASE PROGRAM,

THE NEXT STEP WILL BE TYPE 2 DIABETES.

HALF OF AMERICANS WILL BE DIABETIC

OR PRE-DIABETIC IN THE NEXT 10 YEARS. HALF.

IF WE CAN PREVENT THAT AND EVEN REVERSE IT,

THAT'S HOW WE'RE GONNA MAKE TRUE HEALTHCARE,

NOT JUST SICK CARE AVAILABLE,

AT A TIME WHEN THE MEDICAL SYSTEM IS SO BADLY BROKEN.

Woman: ONE COMPANY HAS FIGURED OUT

HOW TO LOWER HEALTHCARE COSTS BY MORE THAN 40%.

IT'S AN IDEA THAT'S RECEIVED NATIONAL ATTENTION.

FOLLOWING THE EXAMPLE OF PLACES LIKE SAFEWAY.

Charlie Gibson: THE SAFEWAY SUPERMARKET CHAIN LOOKED

FOR A WAY TO REIGN IN SPIRALING PREMIUMS

AND HIT ON WHAT SEEMS TO BE A WIN-WIN SOLUTION.

IN 2005, WE HAD A BILLION DOLLAR HEALTHCARE BILL,

RISING AT THE RATE OF $100 MILLION A YEAR.

THESE ARE THE COSTS OF ALL OF OUR DRUGS IN ORDER,

SO DIABETICS ARE ONE THE NUMBER ONE COST OF PRESCRIPTIONS.

YOU CAN SEE HOW MANY SCRIPTS AND THE AVERAGE SCRIPT.

WHAT WE DISCOVERED WAS THAT 70% OF HEALTHCARE COSTS

ARE DRIVEN BY PEOPLE'S BEHAVIORS.

AT MY HEAVIEST, I WAS OVER 200 POUNDS.

I'D HAVE MY PIZZA, I'D HAVE MY COMICS,

I'D HAVE MY D.V.D.s AND THAT WAS THE WEEKEND.

YOU REALIZE ONE DAY, WOW, YOU KNOW, I HAVEN'T WORKED OUT,

I HAVEN'T EXERCISED AND, YOU KNOW, YOU KIND OF GET BUSY

AND IT'S JUST THE LAST THING THAT YOU'RE REALLY CONCERNED ABOUT.

I WAS CHRONICALLY COMING DOWN WITH COLDS

AND I KNEW THAT THERE WAS A HISTORY OF CANCER

IN MY FAMILY AND DIABETES, HEART DISEASE.

I WAS A WALKING DEAD MAN.

NOW, AS A BUSINESS GUY, I THOUGHT IF WE COULD INFLUENCE BEHAVIOR

OF OUR 200,000 PERSON WORKFORCE,

WE COULD HAVE A MATERIAL EFFECT ON HEALTHCARE COSTS.

THE EASIEST STARTING POINT WAS IN THE 30,000 NON-UNION WORKFORCE

AND I BELIEVE THAT WITHIN 4 YEARS

ALL OF OUR EMPLOYEES WILL GET THIS KIND OF HEALTHCARE PLAN.

ALL AMERICANS HAVE ACCEPTED FOR 50 OR MORE YEARS

IN THE AUTOMOBILE INSURANCE INDUSTRY THAT DRIVING RECORD DICTATE PREMIUM.

AND ALL INSURANCE COMPANIES ARE SAYING

IS YOUR BEHAVIOR SHOULD DRIVE THE PREMIUM.

AND HEALTHCARE DOESN'T NEED TO BE IMMUNE TO THAT.

SO, WE PROVIDE INCENTIVES FOR PEOPLE TO ENGAGE IN HEALTHIER BEHAVIOR.

OUR HEALTHCARE PREMIUMS STARTS HERE

AND IF YOU HAVE A BODY MASS INDEX LESS THAN 30,

YOU GET A DISCOUNT.

IF THEY ARE A CONFIRMED A NON-SMOKER,

WE GIVE THEM A DISCOUNT.

IF YOU HAVE CHOLESTEROL UNDER CONTROL,

A DISCOUNT. BLOOD PRESSURE UNDER CONTROL, A DISCOUNT.

AND SO BEHAVIOR BECOMES A FORM OF CURRENCY

FOR PEOPLE TO ACCOMPLISH THEIR LIFESTYLE CHANGES.

WITHOUT THE FINANCIAL INCENTIVES,

THERE'S NO WAY I COULD HAVE GOTTEN TO THE POINT THAT I AM NOW.

IT'S SAVING LITERALLY THOUSANDS OF DOLLARS

OVER THE PAST FEW YEARS BY BEING HEALTHIER.

[INDISTINCT CHATTER]

ARE WE READY TO ROLL?

YES, WE ARE.

ALL RIGHT! LET'S GO! WHOO!

ALL RIGHT.

WHOO!

I NEVER WAS A RUNNER

BEFORE I STARTED THE SAFEWAY RUNNING GROUP.

LITTLE BY LITTLE AS WE WERE HERE IN THE GYM,

THEY JUST KIND OF DRAFTED US IN

AND WE'VE BEEN RUNNING EVER SINCE.

ALL WE DID WAS FACILITATE SMART CHOICES FOR PEOPLE

AND DEVELOPED THIS CULTURE OF HEALTH AND FITNESS.

DID YOU BIKE TO WORK TODAY?

I DID YESTERDAY.

ALL RIGHT.

I'M GOING TO DO IT AGAIN ON FRIDAY.

ALL RIGHT.

IF YOU TALK TO THE EMPLOYEES AROUND HERE

THAT HAVE LOST 35, 50, 60, 100 POUNDS,

THEY WILL TELL YOU WITHOUT A DOUBT

THEY HAVE A BETTER QUALITY OF LIFE.

FOR A LONG PERIOD OF TIME, I WAS HIDING.

I HAD A FULL BEARD.

I HAD DREADS DOWN TO MY WAIST.

I WAS SHUTTING DOWN EMOTIONALLY.

I NOT ONLY HAVE A SECOND CHANCE,

I HAVE THE GREATEST CHANCE BECAUSE I HAVE

A CHANCE TO MAKE MY NEXT 50 YEARS

BETTER THAN MY LAST 50 YEARS.

IT'S STILL A STRUGGLE.

WHEN I'M RUNNING AND IT'S A HOT DAY

AND I FEEL LIKE GIVING UP, IT NEVER FAILS,

I'LL LOOK UP AND I'LL SEE A PERSON

WHO'S OVERWEIGHT ACROSS THE STREET.

MY FIRST THOUGHT IS THAT'S WHY I'M RUNNING

BECAUSE I KNOW WHAT THAT PERSON'S LIKE, IT USED TO BE ME.

LET ME HAVE A SALMON STEAMER BASKET.

COMING RIGHT UP.

YOU CAN'T SAY YOU'RE INTERESTED IN THE CULTURE

OF HEALTH AND FITNESS WITHOUT PROVIDING A FIRST CLASS GYM.

YOU CAN'T HAVE A CAFETERIA THAT DOESN'T HAVE CALORIE COUNTS ON IT.

OUR APPROACH HERE IS COMPLETELY HOLISTIC.

Woman: SAFEWAY'S HEALTHCARE COSTS HAVE REMAINED FLAT

COMPARED TO A 40% JUMP FOR MOST OTHER COMPANIES.

30% OF OUR SMOKERS HAVE QUIT.

21% OF OUR OBESE POPULATION ARE NO LONGER OBESE.

AND SAFEWAY EMPLOYEES WILL BE LESS OF A BURDEN ON THE MEDICARE

OF THE FUTURE BECAUSE THEY HAVE ADAPTED

TO THIS CULTURE OF HEALTH AND FITNESS.

YOU ALLOW AND ENCOURAGE YOUR EMPLOYEES TO BECOME HEALTHIER.

THEY BECOME MORE PRODUCTIVE.

YOUR COMPANY BECOMES MORE COMPETITIVE.

I MEAN, I CAN'T THINK OF A SINGLE NEGATIVE IN DOING THIS.

IF I'M FRUSTRATED BY ANYTHING,

IT'S THAT MORE OF THE NATION HASN'T ADOPTED THIS.

SAFEWAY CORPORATION, THEY'VE ACTUALLY BEEN ABLE TO BEND THE COST CURVE,

THOSE ARE THE KIND OF THINGS THAT ACTUALLY HAVE AN IMPACT.

MAKING MONEY AND DOING GOOD IN THE WORLD ARE NOT MUTUALLY EXCLUSIVE.

I LOST ABOUT 120 POUNDS OVER THE COURSE OF 3 YEARS.

EVEN IF I LOSE 30 MORE POUNDS,

WHICH PROBABLY IS MY ULTIMATE TARGET,

I'M NOT GONNA STOP DOING THIS.

MY ENERGY LEVEL IS UP.

ALL MY HEALTH ISSUES HAVE GONE AWAY.

IT'S NICE TO KNOW THAT I'VE GOT A LONG TIME TO SPEND

WITH MY FAMILY AND I'M GOING TO GET SEE MY SON GROW OLDER

AND GO TO COLLEGE AND ALL THAT FUN STUFF.

IF WE REALLY CAN, PUBLIC AND PRIVATE SIDE,

BEGIN TO MIGRATE PAYMENT FROM PAYING FOR VOLUME,

PAYING FOR HOW MUCH YOU DO,

TO PAYING FOR OUTCOMES,

PAYING FOR HOW WELL YOU DO, HOW WELL THE PATIENT DOES...

THAT WILL CHANGE THE GAME.

PEOPLE WILL START TO SAY, WELL, NOW THE MONEY IS IN HEALTH

AND WELL BEING AND SAFETY AND VITALITY,

NOT IN MORE, MORE, MORE, MORE.

THERE ARE ANSWERS.

WE KNOW WHAT SAFE CARE LOOKS LIKE.

IT'S NOT JUST WE KNOW IT, WE ACTUALLY CAN GO AND VISIT IT.

YOU CAN VISIT A HOSPITAL THAT STOPPED INFECTIONS.

YOU CAN VISIT A HOSPITAL THAT'S ENDING WASTE SLOWLY BUT DOING IT.

YOU CAN VISIT SYSTEMS THAT COORDINATE CARE, NEARLY PERFECTLY.

THE CLEVELAND CLINIC WAS FOUNDED BY 4 PHYSICIANS

AND THEY REALIZED THEY DID BETTER WORKING AS A TEAM

THAN THEY DID AS INDIVIDUAL PRACTITIONERS

AND THEY FORMED A GROUP PRACTICE.

THEY DECIDED THAT WOULD PAY THEMSELVES A SALARY

AND THE MONEY THAT WAS LEFT OVER WOULD GO BACK

INTO GROWING THE ORGANIZATION.

AND THAT MODEL HAS CONTINUED TO THIS DAY.

WE'RE ALL SALARIED,

SO THE DECISION ON WHAT WE DO FOR A PATIENT IS DEPENDENT

UPON WHAT THE PATIENT NEEDS, NOT ON OUR FINANCIAL INCENTIVES.

6 YEARS AGO, BEFORE I BECAME C.E.O.,

I WAS SITTING DOWN SAYING, WHAT PROFESSION AM I IN?

AND I SAID, WELL, I'M IN THE HEALTHCARE PROFESSION.

AND THEN I STOPPED TO THINK,

I'VE NEVER LOOKED AFTER A HEALTHY PERSON

AND MAYBE IT WOULD BE EASIER

TO TAKE CARE OF PEOPLE

AND KEEP THEM FROM GETTING SICK

BEFORE THEY ACTUALLY DID GET SICK.

HOW ARE YOU? HI.

HOW ARE YOU?

YOU KNOW HOW PEOPLE SAY IT TAKES A VILLAGE TO RAISE A CHILD?

IT TAKES A VILLAGE TO MAKE AN UNHEALTHY PATIENT HEALTHY,

IT REALLY DOES.

SHE NEEDS A FOLLOW-UP WITH ME IN 3 MONTHS WITH AN ECHO BEFORE.

PEOPLE WITH CHRONIC DISEASE, WHO COME IN AND OUT HOSPITALS,

BOUNCED IN AND OUT OF E.R.s,

THAT'S WHAT THEY NEED, SOMEONE TO REALLY TAKE AN INTEREST,

HOLD THEM ACCOUNTABLE AND THEN TALK TO THEM,

YOU KNOW, ON A WEEKLY BASIS.

SOMETIMES WE'RE TALKING TO YVONNE ON A DAILY BASIS.

THAT REQUIRES SO MUCH WORK,

BUT WE DO IT BECAUSE WE'RE COMMITTED TO HAVING HER STAY

OUT OF THE HOSPITAL, COMMITTED TO HER LIVING LONGER AND BETTER.

[INDISTINCT]

WE'VE JUST CREATED A COMPLETELY DIFFERENT SYSTEM HERE

AND THE ACTUAL COSTS FOR CARE HERE

IS AMONG THE LOWEST IN THE COUNTRY

AND YET THE OUTCOMES, THE SURVIVAL RATES,

ARE AT THE HIGHEST LEVELS.

WE DON'T HAVE TO SPEND OURSELVES INTO POVERTY ON HEALTHCARE.

WE JUST HAVE TO DO IT DIFFERENTLY.

IT'S REALLY EASY TO FIND ARTICLES OR SPEECHES

FROM 30 YEARS AGO IN WHICH LEADERS WERE CALLING FOR CHANGE,

UNSUSTAINABLE COSTS, PROBLEMS AND OUTCOMES IN QUALITY,

BUT I THINK THE ECONOMIC IMPERATIVES ARE MUCH STRONGER NOW.

WE'RE DEALING WITH THE HEALTH OF A NATION

WHEN WE DEAL WITH WASTE IN HEALTHCARE.

WE ONLY GIVE LIP SERVICE TO PREVENTION

AND WE HAVE TO ASK WHY AS A SOCIETY WE ARE NOT

WORKING TO PREVENT DISEASE AND PROMOTE HEALTH

AND HOW DO WE SHIFT THIS HUGE ENTERPRISE OF DISEASE

INTERVENTION IN THAT DIRECTION.

WE NEED TO CHANGE THE NATURE OF MEDICINE

AND I HOPE OUR NEW GENERATION OF HEALTH PROFESSIONALS

WILL CATALYZE THE SOCIAL MOVEMENT

THAT'S NECESSARY AND ENOUGH PEOPLE GET AROUSED ENOUGH

ABOUT THE SITUATION AND SEE IT FOR WHAT IT IS

AND THEN START SOME KIND OF GRASSROOTS MOVEMENT

TO CHANGE THE POLITICAL BALANCE OF POWER.

WHAT I'M ARGUING FOR IS NOT TO MAKE THINGS TOUGH ON INDUSTRY,

IT'S TO MAKE THINGS SAFE FOR PATIENTS, PUTTING PATIENTS FIRST.

WE HAVE A MOTTO IN MEDICINE, PRIMUM NON NOCERE.

IN LATIN IT MEANS "ABOVE ALL, DO NO HARM."

IF I THINK ABOUT WHAT HEALTHCARE COULD BE LIKE,

IT WOULD HAVE A LOT MORE "CARE" IN IT.

IT WOULD BE A VERY DIFFERENT SYSTEM

THAT PROBABLY WOULD BE LESS HIGH TECH...

AND MORE HIGH TOUCH.

WE HAVE A LOT MORE POWER OVER HOW HEALTHY WE ARE

THAN WE ARE WILLING TO TAKE CREDIT FOR

OR WILLING TO TAKE RESPONSIBILITY FOR.

AND THAT'S PART OF WHAT A REALLY GREAT HEALTHCARE SYSTEM

WOULD DO, IT WOULD EMPOWER PATIENTS.

IT'S SO FRUSTRATING TO KNOW HOW HIGH THE RISKS ARE

AND HOW EASY THE ANSWERS ARE.

THE ANSWER'S AMONG US AND ONLY BY ACCEPTING THE FACT

THAT THE AMERICAN HEALTHCARE SYSTEM IS BADLY BROKEN,

THAT THE STATUS QUO ISN'T WORKING,

THAT IT'S BANKRUPTING OUR NATION,

WILL WE BE ABLE TO SEEK OUT THE ESCAPE FIRES,

THE POTENTIAL SOLUTIONS,

WE CREATE A SUSTAINABLE AND PATIENT-CENTERED SYSTEM FOR THE FUTURE.

HERE'S THE PAPER.

THAT'S EVERY SINGLE SIGNATURE

THAT SAYS THAT YOU'RE GOOD TO GO

TO GET OUT OF WALTER REED AND MOVE ON WITH MY TRAVEL.

RIGHT THERE.

I'M GOING BACK HOME.

HOME TO THE INFANTRY DIVISION, AIRBORNE, AIR ASSAULT.

I CAN'T WAIT TO BE THERE.

[CHUCKLES]

SEE YOU, DUDE.

I DON'T NEED YOU.

DON'T NEED YOU.

DON'T NEED YOU.

NEVER NEEDED YOU.

THEY DIDN'T FORESEE ME EVEN TRYING TO WALK YET,

BUT I'M DOING IT, MAINTAIN MY PAIN.

NOT HAVING TO NEED ALL THESE PILLS.

IT'S BEEN A WILD RIDE, STILL NOT OVER IT,

BUT IT'S BETTER FROM GERMANY, I PROMISE YOU THAT.

LOOK AT THIS.

IT'S A HAPPY TIME IN MY LIFE RIGHT NOW.

I'M SO EXCITED JUST TO FINALLY LEAVE THIS HOSPITAL.

THIS PLACE ACTUALLY GAVE ME THE TOOLS

TO PUT IN MY TOOL BAG SO I CAN GO BACK AND STILL CONTINUE

MY PROCESS OF HEALING AND RECOVERY.

[CELL PHONE BEEPS]

THE BOY FROM CAMPBELL... SEE YOU SOON.

FROM NOAH.

I FEEL LIKE I'M CHANGING.

THANK YOU SO MUCH.

I'M NOT CHANGED... BUT I'M CHANGING.

CAPTIONING MADE POSSIBLE BY LIONS GATE ENTERTAINMENT

CAPTIONED BY THE NATIONAL CAPTIONING INSTITUTE --www.ncicap.org--