Earlier this month a new Sundance award-winning documentary called ESCAPE FIRE: The Fight to Rescue American Healthcare was nationally released to overwhelmingly positive reviews. It was a Critics Pick in the Washington Post and the New York Times. The Times said ESCAPE FIRE “Turns an unwieldy, Medusa-headed topic into a convincingly humane argument for change…This hard-hitting film leaves us finally more hopeful than despairing.”
This author had the opportunity to meet the film’s co-director/producer, Matthew Heineman, at a pre-screening event at Johns Hopkins last month. In an interview with Medgadget, Heineman recently spoke about the movie, what motivated him to make it, and what some of the main problems facing our healthcare system are – and ways to solve them. Check out the trailer and interview below, and then be sure to see the film in select Theatres, on iTunes, and via Video on Demand.
Shiv Gaglani, Medgadget: What motivated you to make ESCAPE FIRE? What is your background in film and healthcare?
Matthew Heineman: My co-director, Susan Froemke, and I began making ESCAPE FIRE about three years ago, just as the healthcare debate was heating up. Like many Americans we were confused by the strong rhetoric surrounding healthcare and the fact that the issue was dividing our country. Traditional media coverage was increasingly hyperbolic and confusing, and it seemed that healthcare became a political football that the politicians were throwing back and forth. We began to ask a few questions, such as, “How did this perverse system come to be?” and “Why was it so difficult to change?”
In terms of interest in healthcare, you can say I had it in my genes because my mother has spent her career as a medical journalist. I was able to see the system up close as well through my father’s long-term battle with cancer—fortunately he’s doing fine now. ESCAPE FIRE resulted mainly from my intellectual curiosity about the system: what it was broken and what could potentially be done to fix it.
In terms of my background, I sort of stumbled into filmmaking. I was a history major at Dartmouth and, after getting rejected by Teach for America, was left deciding what to do next. Three of my friends and I hatched a plan to drive across the country for three months to try and figure out what our generation was about. We brought along a video camera, collected over a hundred hours of footage, which ultimately became my first film, OUR TIME. One thing led to another, and I landed a job at HBO working for two years on a documentary series called THE ALZHEIMER’S PROJECT. That’s where I met my current collaborator Susan, a 4-time Emmy winner & Academy Award nominee.
Medgadget: Based on your extensive research and interviews for the film, what are some major themes that emerged in terms of fixing the healthcare system?
Heineman: Two major, and unexpected, themes really emerged as we were doing our research. We spent a lot of time, about six months, just doing research on healthcare before we even began filming. Early on, it became really clear that we don’t actually have a healthcare system in the US; we have a disease-care system. One statistic that really stood out was that about 75 percent of healthcare costs can be attributed to largely preventable diseases, such as type II diabetes, heart disease, and even some types of cancers. Many of these have a lifestyle component, so one of the themes emphasized in ESCAPE FIRE is the need to change that and implement more prevention rather than treatment. The system has to support the individuals in helping to make that happen.
Another theme that surprised us was the idea of overtreatment, or that more is not necessarily better. We have a fascination in America with quick fixes. As patients we expect pills and procedures when we go to the doctor’s office. That does not necessarily make sense in all situations and may put the patient at added risk, not to mention cost. There is really a concept in medicine, especially amongst patients, that we have the greatest, most high-tech healthcare system in the world, and therefore everything that a doctor does to us is good. It would be good for patients and doctors alike to have a healthy dose of caution and skepticism before proceeding with a potentially unnecessary intervention. Fortunately, some medical and consumer groups have recently launched a campaign called Choosing Wisely to get doctors and patients to do just that.
Medgadget: What do you make of the current medical technology climate? Is there something you would change about it?
Heineman: I’m not an expert in medical technology by any means, but based on what I’ve experienced over the last three years working on ESCAPE FIRE, I think there’s no question that the US is the best place to be if you have a traumatic injury or incredibly rare disorder. We do have the latest and greatest technologies. But there is a price that comes with that. All of it is costing a lot of money, and in some cases is potentially without real benefit and may even pose potential harm. As consumers we have to be cognizant that every time we hit our head we don’t necessarily need an MRI. I really hope that our film can inspire patients to take greater ownership of their own health and become informed consumers of health as well.
Medgadget: We cover many new trends in healthcare, such as the Quantified Self movement and tele-medicine. Are you excited about any trends in particular?
Heineman: Definitely. In particular I’m very excited about the move towards mobile devices and applications as well as electronic health records. In fact, one of my good friends Matt Wiggins started a company called Remedy Systems, which is at the forefront of mobile healthcare. I think there’s enormous potential for these trends to reduce costs, waste, and inefficiencies while at the same time empowering people to take better control of their health.
Medgadget: What is your Escape Fire?
As meta as this sounds, my Escape Fire is the film, ESCAPE FIRE. I hope that the movie can create a paradigm shift in terms of how our country views health and healing. Last month we pre-screened the film at over 60 medical schools in a single night. The fact that it was well-received by one of our target demographics – current and future clinicians – was inspiring to us. A week later we screened the film at the Pentagon, after which the Army Surgeon General said that this film was going to inspire them to do medicine differently.
I’m hopeful that this film will really inspire institutions and individuals to change. I’m optimistic that this type of change – at the local level, hospital by hospital and institution by institution – can contribute to fixing the healthcare system. Given the political gridlock in our nation’s Capitol and the power of the status quo, I’m not holding my breath about sweeping changes from the top-down, from Washington or insurance and pharmaceutical companies. The movement has to come from the bottom-up.
We’re continuing to develop a huge outreach campaign to get the film into communities across the country and trying to provide ways for people to take action once they see the film. We hope Medgadget readers, many of whom are stakeholders in the healthcare system, have the opportunity to view the film and come up with their own “escape fires. “
Matthew Heineman is the director/producer (with Emmy Award-winner and Oscar Nominee Susan Froemke) of ESCAPE FIRE: The Fight to Rescue American Healthcare. The documentary, which is being released by Roadside Attractions/Lionsgate, is currently showing in select Theatres, on iTunes, and via Video on Demand.
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