Sunday, March 10, 2013

CNN: "Escape Fire: The Fight to Rescue American Healthcare", already had a theatrical release, unusual for the network


CNN tonight aired the two hour documentary by Matthew Heinenam,  “Escape Fire: The Fight to Rescue American Healthcare”.The metaphor in the title comes from a forest fire fighting technique demonstrated as the film opens.  

The film seems to be a close rework of the film aired previewed at the West End Cinema in Washington DC on Oct, 7, 2012 (see movies blog).  CNN has repackaged the work under the brand "CNN Films" and apparently lengthened if to almost a full two hours (probably by restoring deleted scenes).  I'll re-summarize a few of the points here.

This is the first time that I can recall that CNN aired a documentary in something close to the original theatrical format. Usually CNN originates its own documentaries, some of which would obviously lend themselves to theatrical adaptation (such as Anderson Cooper's "Planet in Peril").   
  
The focus of the film was reimbursement system of health care as a business, which encourages doctors to see as many patients as possible and see them repeatedly for the same problems, rather than prevent or fix the problems.  This is the problem with the “fee for service” model. We we could call it a "profitable disease care system".  
  
Innovations were many, however.  The Cleveland Clinic hires all doctors on salaries, and puts profits back into the hospital and has one of the lowest costs of any hospital company in the nation.  One female patent had over 27 stents before going to the Clinic.  Stents are said not to prevent actual heart attacks. Apparent she also had two bypasses.  She had the stents before risk factors were controlled. 
  
One session showed a tidewater Virginia doctor giving acupuncture to a wounded soldier.
  
Another sequence showed a family man with many stents back in the hospital repeatedly for heart disease systems, and he wasn’t that old.

  
The link for the film is here.
  
Sanjay Gupta held a half hour town hall afterwards, which he also titled "Rescuing Health Care" and explained particularly how many stents are unnecessary.  70% of stents and angioplasties are done in patients with symptomatic heart disease and unstable angina.  

Supporting Gupta (and the film) is a report from ABC News on Feb, 28, 2012 by Carrie Gann, "For coronary artery diseases, meds are efficient as stents", link here.

It's possible to have acceptable EKG's but irregular heartbeat associated with increasing hypertension and narrowing of coronary arteries.  The latest information suggests that stents are not that helpful.  Bypass surgery is often done quickly, but can also fail.  Some patients may do as well with just medication and no surgical intervention.

People vary as to temperament how much intervention they want.  Some people with tolerable symptoms (anginas, palpitations, etc) may do better doing very little unless they are willing to submit to invasive procedures and try everything.   There seems to be a wide gap in opinion as to how aggressive surgery should be,  Remember that TV host David Letterman was hauled into emergency coronary bypass surgery in January 2000 but has done well since.  Esquire Magazine poked fun at him for joining "the Zipper Club".

Gupta showed a number of medical devices and explained how the cost is so high.  (That portion was also on an earlier special.)

Compare this film with Michael Moore's "Sicko".

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