Thursday, October 25, 2012

Our crazy health-care system

I had little initial interest in Escape Fire: The Fight to Rescue American Healthcare, a documentary about the American health care system. I expected another politically motivated screed devoted to ripping the Affordable Care Act, which has been pejoratively tagged as Obamacare, a name so widely used even the president seems to have accepted it. I was relieved to discover that Escape Fire doesn't focus on the pros and cons of the Affordable Care Act, but instead tries to take a more sweeping look at the underlying assumptions of American health care. The documentary begins by reminding us that there's something terribly alarming about a health care system that requires an expenditure of $2.7 trillion a year, as it did in 2011. Escape Fire also argues that we're not getting our money's worth. Directors Matthew Heineman and Susan Froemke -- through a series of cogent interviews and well-selected examples -- try to emphasize "out-of-the-box" approaches to health care. They build much of the movie around arguments advanced by two well-known health proponents: Dr. Andrew Weil and Dr. Dean Ornish: We tend to treat disease rather than working to foster health. One of the most striking examples in the film involves the pressures faced by physicians in a system in which reimbursement is based on per-visit treatment. Dr. Erin Martin, a primary-care doc, quits her job in Oregon because she's expected to see more patients and spend less time with each of them. The directors also draw on examples from the military -- the story of a soldier wounded in Afghanistan is especially revealing -- and point an accusatory finger at pharmaceutical companies that benefit from a drug-happy society in which too many believe that all health solutions can be found in small plastic bottles. Well-informed audiences may not find anything strikingly new here, and a movie such as Escape Fire poses a steep commercial challenge. Will escape-hungry audiences shell out hard-earned dollars for what amounts to an educational experience? Those who do should leave the theater with plenty to ponder.

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