Health, Money and Fear

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altOregon-based EP Paul Hochfel turned his frustration with the medica economic establishment into a documentary film, making his debut at the Boston Film Festival 

Paul Hochfeld had enough. After nearly 30 years practicing emergency medicine in Oregon he was sick and tired of ordering tests that people didn’t need and having no responsible limits on expensive end-of-life care. He felt that the health care system was imploding and he was at the center. So what did he do? He picked up a video camera, of course, and begin making a documentary.

It didn’t happen overnight. In fact, if you’d told Hochfeld three summers ago, when he enrolled in his first (and only) video production class, that he would be screening his own health care documentary at the 2008 Boston Film Festival, he would have called  you delusional.


A few years back, Hochfeld was just dabbling, producing small video projects for friends. He traveled to Tanzania to document the building of a new school and then made a video for a humanitarian water project in Kenya. But the bug for Hochfeld’s current project didn’t take hold until the day he saw “Why We Fight,” a documentary by Eugene Jarecki. The film raises questions about the influence of America’s military industrial complex – the largest industry in the country – over public policy. As interesting as this was, for Hochfeld, it pointed to another question: How is the health care system – America’s second largest industry – hi-jacking public policy?

“I think the seeds of the video started with that,” Hochfeld says.

Hochfeld didn’t really know where he was heading, but he began with the working title: “Our Ailing Health Care: A Physician Explores the Illness”. At first, he simply went to the library and checked out books and journals, boning up on his facts.


“I had never really explored it at that level before,” says Hochfeld.

As he came across people in his reading who seemed to have interesting things to say about the health care system, he tracked down their information, contacted them, and asked them if he could conduct an interview. Much to his surprise, most of them said yes.

“It was unbelievable actually,” he recalls.

Hochfeld ended up arranging seven interviews between Boston and Atlanta. He took a week and half out of his schedule, flew to the East Coast and began traveling from city to city. In terms of production, the original plan was to go simple: two cameras, no operator. Just Hochfeld and the interviewee.


“It was going to be a one-man show,” says Hochfeld with a laugh. “Yeah right.”

After realizing that this wasn’t going to cut it, Hochfeld teamed up with another film maker, his instructor from a video production class he’d taken a couple years prior. Hochfeld credits this move with making a “huge difference” in the final product.

“I think what makes my video work is that even though it’s just an ER doctor doing it, it does have the feel of a professional production.”

Hochfeld completed his interviews in the Spring of 2007, let the tapes sit for the summer, and then entered the editing room last Fall. He whittled and chopped until the piece was a concise 47-minute documentary which he titled “Health, Money and Fear.” 

These days Paul Hochfeld can be found in Corvallis, Oregon, showing his film to various groups of interested doctors and medical academics. They watch the film and then engage in a discussion of the topics in the film. It’s a grassroots effort, but Hochfeld couldn’t be happier with the result.

“People really like it,” says Hochfeld. “I think it resonates with a lot of people’s truth.”

That “truth,” as portrayed by the film, is the idea that a single-payor health care system could save the country untold millions of dollars through such avenues as liability reform, a national EMR, regulations put on pharmaceutical pricing, and adequate pay for primary care physicians.

“Our health care system is a bizarre blend of the worst of capitalism and the worst of socialism,” says Hochfeld. On the socialist side, he explains, you have the patient “with chest pain who one year previously received a cardiac stint on public money who is still smoking, expecting us to do it again.” On the capitalist side, “you have hospitals spending huge amounts of money on proton beam accelerators to marginally help old men have longer survival from prostate cancer, because it pays well, not because it is a good investment of our health care dollars.”

When he gets back from the Boston Film Festival, Hochfeld plans to contact those people who have shown an interest in the film and pursue a multi-city tour in which he shows the video and leads discussions around the country. He doesn’t care about getting paid; he’s asking only that his traveling expenses be covered. His aim is simple: use the film as an educational device and a political tool to affect real health care change.

Hochfeld concludes the film with this plea: “We need to get over our fear of the government and embrace the idea that in health care, somebody needs to be in charge, so that we can keep our eye on the prize, which is health, not profits.”

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