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Americans spend more on healthcare than any other nation, but our health ranks significantly below other wealthy nations. That’s because our medical system is driven by profit. Health insurance companies, private hospitals, and Big Pharma promote disease management techniques before strategies for prevention or cure that are best for the patient.

That’s according to the documentary Escape Fire, which begins with the statement that 30 percent of the $2.7 trillion Americans spend on healthcare per year “is wasted and does not improve health.”

The film shows how our system’s “fee for service” structure prioritizes prescriptions and surgery over less invasive methods. It pays doctors and hospitals not for outcome but for volume—the sheer number of visits, tests, prescriptions and surgeries. Former health insurance executive Wendell Potter says corporate influence makes the system resistant to change: “These companies will do whatever it takes to make sure there are no new laws or regulations to hinder their profits.” We’re reminded that the health care industry spent $1.1 billion on federal lobbying in 2009–2010.

Thoughtful profiles illustrate the problem and the alternatives—like that of the woman who had 35 surgical procedures for heart disease before switching doctors. Integrated care to address her high blood pressure, high cholesterol, and diabetes included support for healthy diet and exercise. It saved her life and improved her quality of life. There’s the wounded soldier whose physical and emotional pain was more effectively treated by acupuncture, meditation and counseling than multiple prescriptions for antidepressants and painkillers. And the Safeway employees who lost weight and gained energy through a company program that offers workers practical support and cheaper health insurance for getting fit.

Doctors and policy experts interviewed in the film say our system is in crisis. We need reform far beyond the Affordable Care Act. But there are good examples to follow: the “safe care” of Cleveland Clinic, which keeps costs reasonable and health outcomes high. And Medicare’s decision to accept reimbursement for the program to reverse heart disease that empowers patients to change their diet, exercise, and manage stress. Escape Fire makes a convincing argument that these types of care could heal our national system—and make for a healthier America.

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Valerie Schloredt is the former books editor at YES!, where she led print and online coverage of literature, media, and film, with a focus on social change movements. Valerie worked for the Centre for Crime and Justice Studies in London for seven years, has followed the police reform process in Seattle as a citizen activist since 2010, and continues to monitor developments in both London and Seattle. She lives in Seattle, and speaks English.

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