With just four weeks to go until Election Day, the so-called “Obamacare” debate is one that isn’t going anywhere. It was a topic in the first debate between President Barack Obama and Republican candidate Mitt Romney, who pushed through his own healthcare reform while Governor of Massachusetts.
But when audiences see the new documentary Escape Fire: The Fight to Rescue American Healthcare, it quickly becomes evident that the problems go well beyond the disagreements on Capitol Hill. Premiering earlier this year at Sundance, the film, which opened last weekend in select cities and is available On-Demand, focuses on the problems facing various doctors – both in small town, primary care and in specialized care like the Cleveland Clinic – how the U.S. military is using alternative care to help wean soldiers of exorbitant amount of medications, why pharmaceutical drug costs are rising to astronomical costs, and also solutions, including one corporation’s attempt to curb rising costs for their employees.
Directed and produced by Matthew Heineman and Susan Frömke, part of the team behind the Emmy® winning HBO documentary series, “The Alzheimer’s Project,” the two say they set out to show that “we can empower ourselves to be healthier, as individuals and as a country, even before we get sick.”
In my interview with Heineman, he discusses audience reactions, how they kept away from the politics of the issue, the discoveries they made within the military, and why more corporations aren’t taking the lead of one company that has see dramatic improvements from its employees.
Gerrad Hall: As I was watching the documentary, I often found myself shaking my head, my jaw dropped, wondering if this is really a fixable problem. And there are those who argue that, as long as medicine is a business, this will never be solved.
Matthew Heineman: I think, as we say in our film, we have a “disease-care system,” not a healthcare system, a system that profits and is oriented towards sickness, not towards health. It’s fundamentally flawed. We need to shift the focus of healthcare away from disease-care, away from sick-care, which is so expensive, and really try to shift the focus much more towards a true, real healthcare system.
GH: The documentary has shown to several audiences this year at various festivals, including Sundance. What kind of responses have you been hearing?
MH: Two things that Susan [Frömke], my co-director and co-producer, and I tried very early on was to not make a film that was just about the problem, that you walked out of the theatre and you were depressed and hopeless. We really wanted to highlight some solutions or “escape fires,” if you will, that are actually right in front of us. And I think audiences are responding to that. There are so many “cause” films out there that are so depressing and so we really wanted to try to at least allude to the fact that there are solutions out there. And again, I think audiences are reacting to that.
The other thing they’re reacting to is … we also didn’t want to make a film that was purely a bunch of talking heads appear as a film. We really wanted to find human stories and subjects that we could follow over time that would make you invested as a viewer to want to watch the film. So, the story with Sgt. Yates and the arc of his story, we really believe it’s the heart and soul of the film. There’s obviously a lot that we cover, but his story, the story of Dr. Martin, the primary care doctor handcuffed by the system, that was really important to us to find those compelling human narratives. I think audiences are also responding to that.
GH: Did the idea for this come from the recent healthcare debate or do its roots go back further?
MH: Susan and I first collaborated on a project for HBO called “The Alzheimer’s Project,” we were part of the team there working on a large series on Alzheimer’s Disease. We really got along tremendously well and soon after started looking into doing a film on healthcare. I think like many, many Americans, we were appalled at the state of healthcare, we were appalled at the conversation around healthcare; it had become so hyperbolic, so confusing. I think, just as concerned citizens, we just wanted to try to get to the bottom [of it, wondering], “How is this system broken?” “How did it come to be this way?” “Were there people out there trying to fix it?” Healthcare really had become this political football that was being thrown back and forth by both sides in Washington.
GH: Was it difficult gaining access to shoot with the military?
MH: Yeah. I think the military is a wonderfully surprising story for us. Who would think that the military is trying to address the problem of over-medication by using acupuncture, yoga, meditation and other things in lieu of drugs? So when we heard that this was something that they were trying to do, it’s not only a wonderful story but it’s sort of a microcosm to the rest of society, this problem of over-medication, but they’re looking at outside-the-box ways of in which they can fix it.
It did take us many, many, many months to get permission to film that story, to get permission from all three branches of the military that were involved. We got [permission from Transportation], the Surgeon Generals of all three branches, and so it took a long time to get on that plane. Like most things in documentaries, you can dream up a story, but when I met Sgt. Yates in Germany with his hoodie on and in a wheelchair, I had absolutely no idea what was going to happen on the plane ride, I had no idea where that story was going to go.
GH: We’re now literally weeks away from the Presidential Election, and yet there is very little political material, as you mentioned, in the story. Was in difficult in crafting the narrative to stay out of the politics and let the situation speak for itself?
MH: That’s really another thing Susan and I talked a ton about. We spent 6-8 months researching the topic of healthcare before we even turned on our camera. We really wanted to try to make a film that could really inspire a sane conversation around the topic of healthcare and transcend the political bickering. We don’t want to take sides, and we really wanted to make a film we could view as non-partisan or agnostic when it comes to politics and really look at this problem through a somewhat objective – all documentaries are subjective – but we tried to make it as objective as possible in regards to politics. And I think that’s another thing audiences have responded to.
GH: You highlight the company Safeway and the strides they’ve been taking to provide their employees with opportunities to improve their health, which the company in turn views as a benefit to their own efficiency and success. It seems like such a simple step, yet we don’t hear about many companies investing in the health and well being of their own employees. Why do you think that is?
MH: I have a couple answers to that. One, I think the metaphor of “escape fire” is so strong, the idea that our healthcare system is burning, yet there are very simple solutions right in front of us. Why can’t we pay attention to them? Why? And I think Safeway is the perfect example. They had this problem, their healthcare costs were escalating – skyrocketing – and they realized things had to change. They came up with the Safeway Healthy Measures program, incentivizing employees to change their lifestyle and really change the culture of health within that company. So, it’s somewhat frustrating that more people aren’t adopting or at least looking at what Safeway is doing, but at the same time, I think, due to the fact healthcare costs are so high and we really are at a tipping point, I do think more companies are starting to do what Safeway is doing. That program started five years ago and now, almost every big company is trying to do or is doing some variation of what Safeway has done.
GH: What drew you into documentaries?
MH: I fell into filmmaking. I was a history major [at Dartmouth College] and I got rejected from Teach For America, and I kind of had no idea what I wanted to do with my life and I hatched this plan to drive around the country for three months, interview kids from all walks of life to try to figure out what our generation is about. And that was my first film. I fell in love with filmmaking, fell in love with documentary filmmaking, fell in love with having the privilege and the honor of meeting and telling real people’s stories and the connection and the bond that you create with the subject that you film.
I love the documentary form; I love how malleable it is. Even in this film, there are so many creative devices we were allowed to use to tell this story, whether it’s animation or creating the escape fire metaphor by lighting a hill on fire. It’s such a wonderful, malleable form, so I love it.
