JUDY WOODRUFF: We continue now with our series
on universal health care.
Tonight, William Brangham and producer Jason
Kane turn to the U.K., where its National
Health Service covers everyone, while it sparks
both inspiration and alarm in the U.S.
This story was filmed before the pandemic
erupted.
WOMAN: good morning to you. Did you have a
good sleep?
WILLIAM BRANGHAM: Even with the help of his
mom, Liam Murphy still struggles to wake up
each day.
ANGELINA MURPHY, Mother of Liam Murphy: I
thought you would be dreaming about Charlotte,
right? Why Charlotte?
WILLIAM BRANGHAM: Liam has Down syndrome,
epilepsy and chronic lung disease. He's dealt
with these since the day he was born.
The 11-year-old lives in Watford, England,
with his parents, Gary and Angelina, and big
sister Laura. They have to be constantly vigilant
for trouble, like this seizure.
ANGELINA MURPHY: Don't start. Don't start.
Don't start. Can you get the mask, please?
No, I can't have that on -- not on the nasal
cannula. Turn it down.
GARY MURPHY, of Liam Murphy: You're all right.
Come on out of that. Come on out.
WILLIAM BRANGHAM: Dozens of times a year,
episodes like this will send Liam to the hospital.
He is always at risk of dying.
Liam's life, and the incredible care he gets,
is a testament to the United Kingdom's National
Health Service, known as the NHS. Residents
of the U.K. pay taxes to the government that
support the NHS.
The government is then the single payer for
health care. It pays doctors and hospitals
and covers nearly all costs. For Liam, that's
all his medicines and hospitalizations. It
pays for caregivers that come several times
a week. The NHS even paid for this chair and
standing frame to help him exercise.
ANGELINA MURPHY: So, he's been up for about
half-an-hour now, hasn't he? So that's really
good, Liam.
GARY MURPHY: No one says, well, that's going
to cost too much, so we're not going to do
it.
WILLIAM BRANGHAM: You have never heard those
words?
GARY MURPHY: No. And if we call an ambulance,
an ambulance will be here in five minutes
to pick Liam up and take him to hospital.
A specialist team will come out, pick him
up, put him on their ventilators, take him
to intensive care.
An intensive care bed will cost 2,000 pounds,
so, $3,500 a night. No one mentions the money.
They just do what you need to do. Without
the NHS, we would be bankrupt. Liam would
probably be not with us.
NARRATOR: On July 5, the new National Health
Service starts.
WILLIAM BRANGHAM: The National Health Service
was built from the wreckage of World War II,
something of a gift from the government to
a battered and impoverished nation, which
welcomed it.
And, today, it's still considered the U.K.'s
great equalizer. Everyone, regardless of profession
or income, has access to that system, from
primary care, to, as needed, the full range
of specialty services.
Do you ever think about how much things are
going to cost when you come to the doctor?
DOLORES CLEMENT, Patient: No, it doesn't cross
my mind. But the thing is, because I'm diabetic,
in England, if you're diabetic, your prescriptions
are free, so I don't have to pay for it anyway.
So, it doesn't cross my mind.
WILLIAM BRANGHAM: Despite those benefits,
per person, the NHS spends less than half
what we spend in the U.S., including a lot
less than we do on administrative costs.
And the NHS generally gets better health outcomes
than we do. Life expectancy is longer here
than in the U.S., in part because people in
the U.K. suffer much lower rates of chronic
diseases, like asthma, diabetes and hypertension.
It's hard to overstate just how beloved the
National Health Service is here in the U.K.
Some people have referred to it as the closest
thing this country has to a national religion.
In fact, in 2018, when the service had its
70th anniversary, they had a huge celebration
here at Westminster Abbey.
When the pandemic hit, a big part of the government's
stay-at-home appeal was, protect the NHS.
BORIS JOHNSON, British Prime Minister: We
must be sure that the infection rate is falling.
WILLIAM BRANGHAM: Even so, disillusion has
grown in recent years. In the rural town of
Dorchester, England, I met 77-year-old Olive
Parfitt.
OLIVE PARFITT, Dorchester, England: I was
supposed to have the operation in August.
And 14 hours before the operation, they canceled
it.
WILLIAM BRANGHAM: Parfitt needs to have her
knee replaced, but she's been on a surgical
waiting list for nearly a year. She said she
took four painkillers just to make this short
stroll.
OLIVE PARFITT: Because I have walked so badly
for over a year, I'm starting to throw the
other knee out.
WILLIAM BRANGHAM: Oh, really? Because you're
compensating?
OLIVE PARFITT: Yes, so you wobble, so makes
it difficult.
If I have a heart attack tomorrow, it's the
best thing. They will take me in. They will
do it. But when you have got what I call disabilities
that are not life-threatening, they can't
cope.
I was told six months, and that was a year
ago. And now, last week, I was told, it's
a year.
WILLIAM BRANGHAM: Parfitt has been a strong
supporter of the NHS her whole life, but now,
after a lifetime of paying in, she feels left
out.
OLIVE PARFITT: Suddenly, when you get to a
certain age and you want to get it back out
again, it's not there anymore.
WILLIAM BRANGHAM: An estimated 10 percent
of U.K. citizens pay out of pocket for supplemental
insurance, in part to avoid long waits. And
these delays also cause tens of thousands
of residents to seek some care abroad.
For people like Parfitt, it's dispiriting.
OLIVE PARFITT: So, you just think, nobody
cares about me anymore. I'm an old girl. Probably,
if you carry on long enough, she will pop
her clock, and then we won't have to worry
with her. I do feel that you become invisible.
WILLIAM BRANGHAM: Funding for the NHS has
been a constant problem and a political flash
point. Different administrations fund the
NHS at different levels, and the U.K.'s recent
austerity measures have delayed upgrades,
and made serious staffing shortages worse.
This has also led to a series of scandals,
as seen in this 2017 BBC report. Emergency
rooms were overflowing. And in recent years,
after being rushed to the hospital, hundreds
of thousands of patients were stuck in ambulances
for over an hour.
SIR ANDREW DILLON, Former CEO, National Institute
for Health and Care Excellence: There are
always choices, and, inevitably, and in every
health care system, there are always limitations
on what the system can do.
WILLIAM BRANGHAM: Sir Andrew Dillon was, until
this spring, the longtime head of the National
Institute for Health and Care Excellence,
known as NICE.
It's a sweet acronym, but some conservatives
in the U.S. liken its work to a death panel.
NICE is one of the NHS' crucial cost-control
mechanisms. It studies evidence to recommend
which treatments and procedures give the most
cost-effective benefit.
SIR ANDREW DILLON: So, making sure that we
really understand the benefits of one option
over another, making sure we really understand
the value for our money, particularly in a
publicly funded system that has to account
for how money is used, is really important.
WILLIAM BRANGHAM: Sir Andrew says, wait times
for elective surgeries, like Olive Parfitt's,
have improved, but funds aren't infinite.
DR. ASHISH JHA, Director, Harvard Global Health
Institute: I love how open and explicit they
are about the fact that there are always choices.
WILLIAM BRANGHAM: Dr. Ashish Jha studies health
systems around the world. He's now the dean
of Brown University's School of Public Health,
and he's been a collaborator on this series
with us.
DR. ASHISH JHA: It's not like, in the U.S.,
we're not making choices. We have rationing
in the U.S. It's primarily based on your ability
to pay and whether you have health insurance
or not.
So, the National Health Service tries to make
explicit the rationing choices it's making.
WILLIAM BRANGHAM: Jha says the U.S. could
learn a thing or two from a fully funded version
of this system, access for everyone, transparent
cost controls, and people rarely going broke
because they got sick.
DR. ASHISH JHA: It's really clear to me that
we could not do a wholesale adoption. Where
I think we get lost is the idea that somehow
we could take the National Health Service
and just import it into America.
And I think what's really lost is all that
context, the history behind the National Health
Service, the meaning people assign it. We
don't have any of that.
But there is a lot we can learn. There are
strengths of it, of the National Service that
we could absolutely do better with in the
U.S.
WILLIAM BRANGHAM: Since we first filmed with
them back in February, Liam Murphy was hospitalized
and in critical condition, this time right
in the middle of the U.K.'s worst stretch
of the pandemic. But he's back home now and
doing OK.
ANGELINA MURPHY: The general ethos that I
have experienced is that nobody has given
up. And every time we have an episode where
it could go either way, we come together and
say, he hasn't given up, therefore, we aren't
giving up, and then the health professionals
go, good enough for me.
WILLIAM BRANGHAM: The Murphys say the NHS
isn't perfect, but it's given them more precious
time with their son.
For the "PBS NewsHour," I'm William Brangham
in Watford, England.
