Escape Fire: The Fight to Rescue American Healthcare

Hot topic gets a human touch
By Ann Hornaday
Friday, October 5, 2012

“We don’t have a health-care system, we have a disease care system.”

“Americans pay for the world’s most expensive medical care, and some of the world’s worst outcomes.”

“I’m sick and tired of being sick and tired.”

Those laments form the disheartening takeaway from “Escape Fire: The Fight to Rescue American Healthcare,” Matthew Heineman and Susan Froemke’s sobering, often infuriating documentary about medical care in 21st-century America.

It’s difficult to believe that, after all the demagoguery about death panels, rationing and encroaching socialism that passed for public debate about the Affordable Care Act, we might have something to learn about the way health care is delivered in this country. But in this lucid look behind the scenes at hospitals, doctors’ offices and the most intimate corners of patients’ lives, the shortcomings and ways forward emerge in stark relief. (The title of “Escape Fire” refers to the fires that smoke jumpers set in order to halt encroaching conflagrations.)

Many of the arguments of “Escape Fire” sound familiar: Because of the fee-for-service insurance system, doctors spend too little time with patients; they’re incentivized to provide expensive interventions rather than more effective preventive advice; and they can’t compensate such integrative measures as yoga, nutrition and exercise.

Froemke and Heineman give human faces to those self-evident observations, by way of a young, burnt-out primary care physician in Oregon; a patient in Ohio who has undergone more than 20 catheterizations and several stent implantations before she receives holistic (and far more effective) care for her heart condition; and the health-care visionaries Dean Ornish and Andrew Weil, who provide persuasive testimony about how changes in lifestyle have more healing properties than expensive (and heavily marketed) pharmaceuticals.

By far the most moving voice in “Escape Fire” belongs to Sgt. Robert Yates, an infantryman whom we see returning from Afghanistan with overwhelming physical and psychological injuries. Addicted to painkillers, the self-described “redneck from Louisiana” enters a revolutionary program of meditation and acupuncture at Walter Reed Army Medical Center, with astonishing, affecting results.

Although Froemke and Heineman have made a point of releasing “Escape Fire” during the height of the campaign season, they don’t use the film to grind any political axes. Aside from a few on-screen titles describing modest reforms that took place “in 2010,” and snippets from a congressional hearing or two, they avoid the kind of simplistic partisan points Michael Moore scored in his health-care documentary, “Sicko.”

They’re so restrained that they diplomatically identify Don Berwick -- one of the most level-headed subjects in “Escape Fire” -- simply as “Head of Medicare and Medicaid, 2010-2011.”

They don’t add that Berwick, who might have helped steer the monstrously ineffective fee-for-service juggernaut toward a more common-sense, outcome-oriented direction, was President Obama’s recess appointment after the nomination was stalled by Senate Republicans.

Contains some thematic material.