British Doctors Respond to American Attacks on NHS
Saturday, November 24, 2018
JAISAL NOOR: More Americans are becoming dissatisfied with an increasingly costly healthcare system that produces substandard results. We take a close look at Britain’s experiment with government run healthcare that remains popular but is facing mounting challenges.
The NHS, or National Health Service, turns 70 this year. Meanwhile, despite spending more on healthcare than any other country, Americans continue to be worse off. The United States is the only large, wealthy country without universal coverage. Polls show record support for single payer healthcare, even among a majority of Republicans, and an increasing number of Democratic officials have voiced their support.
FOX NEWS HOST: The progressive Democrats are vowing to give some form of free single payer health care.
KAMALA HARRIS: Let’s give the taxpayers of the United States a better return on their investment, which means Medicare for all.
DONALD TRUMP: A majority of House Democrats have already signed up for socialist health care. It doesn’t work. It’s good if you don’t mind waiting like five weeks to see a doctor.
JAISAL NOOR: In Britain, the NHS continues to have high approval ratings. Patients don’t pay anything to see a doctor and all prescriptions cost about ten dollars.
JOHN WRIGHT: We have the Commonwealth Institute Report which comes out every couple of years about health care, particularly in the top, in the G7, G8, countries, and the NHS consistently comes number one.
JAISAL NOOR: But the NHS does face its challenges.
BOB GILL: Under the cover of austerity, we’ve had a deliberate defunding of healthcare in this country, so it hasn’t kept up with demand.
SPEAKER: Horror stories coming out of the UK, where they had socialized medicine for decades.
JAISAL NOOR: Some of them are outlined in this recent piece published in Forbes, titled U.K.’s Healthcare Horror Stories Ought to Curb Dems’ Enthusiasm for Single Payer. For a response, we spoke to two British doctors, Dr. Bob Gill of London and Dr. John Wright of Bradford.
JOHN WRIGHT: So I think it’s ill informed. And I think if you work in the hospital where I work, or my GP colleagues, and if you need to see a doctor, if it’s urgent, you can see them within minutes or hours. If it’s not so urgent, you can see them within hours or days.
BOB GILL: The reality is, the Republicans and Donald Trump represent the interests of big business and corporations, and they are the people who’ve got most to fear from socialized medicine.
JAISAL NOOR: The article says the NHS is “imploding. Vacancies for doctors and nurse positions reached an all-time high. Patients are facing interminable wait for care as a result.”
JOHN WRIGHT: Every health service is struggling with the demand. We have more doctors and nurses than we’ve ever had in this country. And the NHS, like other health services internationally, has grown to meet increasing demand. But what happens is that demand grows faster than the supply of services. So we’re always training new doctors, training new nurses to try and keep up. And there may be some vacancy issues in some areas, but a hospital like mine, we have five, six thousand staff, and we have a very small vacancy rate.
BOB GILL: You’re seeing the NHS performance decline on multiple levels; waiting times, delays in treatment, but this is deliberate. How else could a government get away with privatizing a system which is functioning well? So you have to manufacture a crisis, and that’s what the defunding has done. So the headlines you quote are real, the NHS I’m trying to defend is not the original NHS, it’s a part privatized system which is being set up to fail.
JAISAL NOOR: The problem is one of supply and demand. Single payer systems offer “free care,” so patients have no incentive to moderate their demand for care. But government cannot procure enough supply to meet that demand without bankrupting taxpayers. Government officials’ only option is to ration care.
JOHN WRIGHT: So one of the challenges, and this is a big issue around the U.K.-U.S. comparison, so the U.K. spends around eight percent of its GDP on healthcare, whereas the U.S. spends sixteen, seventeen percent of its GDP, so twice as much per GDP per capita. And what happens when you grow health care supply is that you start treating unnecessarily and you overmedicalize what’s going on.
BOB GILL: Well, this is applying market ideology and market terminology to healthcare. I’m a family physician. Nobody comes to my waiting room demanding care. If they don’t feel they need it or they don’t feel they genuinely have a concern, people do not access health care for the fun of it. People access health care based on need. So to apply market justifications to healthcare is completely bogus.
JAISAL NOOR: And despite what American critics say, polls have consistently found that Britons would even support raising taxes to increase funding for the NHS. Meanwhile, some argue Americans need more than just a free National Health Service to address its inequities.
JOHN WRIGHT: I think free access to healthcare is really important and makes a difference to health, but it doesn’t get rid of the health inequalities between higher and lower social class people, higher and lower income people, because the nature of social and economic life is a more important determinant of health and the quality of the healthcare you get.
JAISAL NOOR: Unequal results are the natural byproduct of societal inequity, argues Professor Richard Wilkinson.
RICHARD WILKINSON: A whole range of health and social problems worse. So for instance, the United States has amongst the lowest life expectancy in the developed world, it has the highest rates of homicide, it has high rates of teenage births, high rates of obesity, very large prison populations, low levels of child wellbeing, low levels of social mobility. The only surprise is that they get worse amongst almost the whole population. The biggest effects of increased inequality, the bottom of the social ladder, but even middle class people with good incomes and jobs and so on, education, would do better in all those ways if they lived in a more equal society. So they might live a bit longer, they’d be less likely to be victims of violence, their children liked doing a little bit better at school.
JAISAL NOOR: Stay tuned for our next report from England. We’ll look at gun violence in the United States and the United Kingdom. For The Real News, this is Jaisal Noor.