An American In London: Making A Film About The NHS

 

As an American filmmaker who was living in Los Angeles - in the heart of the entertainment industry - some people think I’m crazy for having moved to London. Admittedly, most of my English peers are trying to make the opposite leap across the Atlantic. I guess the grass always seems greener.

I moved to the UK almost 2 years ago. Picking up and leaving your friends, family and network is not easy. For awhile, it was difficult to find work. As an American filmmaker, leaving Hollywood came with a stigma - “He must not have been able to make it in Hollywood, so he must not be very good.” The truth is that while living in LA I made the most money I’ve ever made in life, but life isn’t all about the money - it’s about the journey - and I had other reasons motivating my move to London.

The short and simple answer is that my English wife and I chose to live in the UK because of the NHS.

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In 2015 I met Niralee, the woman who would become my wife. She was a Brit abroad - living in Los Angeles on a temporary visa. Falling in love with someone who doesn’t have the legal ability to permanently live in your home country is a burden, but every day my wife proves to me that it was a burden 100% worth taking. While still dating, Niralee was forced to return to the UK and for a time the distance would test our relationship. It was a test that we passed. 

I proposed on New Years 2017 at the Hogmanay festival in Edinburgh. From then it would be an 8 month journey of finagling the logistics of how we could both live in the same country as husband and wife. We weighed the options, the complications and the amenities of our two countries and decided that it made most sense to marry in the UK. While there were many contributing factors, perhaps the biggest factor was our intentions to start a family and the systems the UK had in place to support us on this next step in our journey.

For the first half of 2017 I was in America, away from my fiancé in a corporate job that was sucking the life out of my creativity. I wanted to leave my job to pursue my artistic ambitions full time and I was lucky enough to have found a partner that would support me in making the difficult transition from being a corporate cog to an independent artistic freelancer.

In the US, access to healthcare is not seen as a human right. Over 150 million people receive healthcare through their employer, meaning that many feel an immense pressure to stick with a work situation that is less than ideal. Not until 2014, under the Affordable Care Act (better known as Obamacare), did America expand healthcare access to more people. While a step in the right direction, ACA still failed to provide Americans with the same access to affordable healthcare that is available to citizens of every other industrialized country. Currently, the ACA has been under constant threat from the conservative majority congress who have made it a top priority to gut this law without providing any responsible alternative.

In the UK on the other hand, my wife had access to the NHS which provides universal healthcare for all citizens made possible by tax dollars. In addition, the UK government currently mandates that employers must provide maternity coverage and job security for female employees who are having a baby. Additionally, my wife is fortunate enough to work for an employer who elected to go above and beyond the government mandate to provide even better maternity coverage. As the dad of a one-year-old, I look back on the past year and I don’t know how we’d have made it had my wife needed to return to work a few weeks after the birth of our daughter - which is what many American women are forced to do. 

While struggling to find my feet as a new full-time freelance filmmaker… in a foreign country… with a baby on the way… the first producer who was willing to take a gamble on me was fittingly a doctor from the NHS - Adnan Raja.

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After meeting at a Kino London networking night, we soon discovered we were kindred spirits as Adnan (Addy) was having a mid-life crisis and wanted to leave his career as a doctor to become a film producer, focusing his niche on healthcare related narrative films. His first project was an ambitious social commentary of the current state of the NHS entitled NORA.

The original vision for NORA was to be a small online release to coincide with the 70th birthday of the NHS. Soon the scope of the project grew as TEDxNHS expressed interest in premiering our film at their event hosted at the British Film Institute’s IMAX screen - the largest screen in the UK. Since it’s premier at the BFI in August 2018, it has gone on to win 14 awards at 10 international film festivals including the Social Political Shorts Festival hosted by Audience Awards which is currently happening until June 11th.

NORA is not another bland healthcare film. It’s a celebration of one of Britain’s most prized institutions, while at the same time it delivers a poignant message. I believe Addy expressed that message perfectly when he said,

This film is about the NHS at a time when healthcare has become an over politicalised discussion. Healthcare should simply be about caring for one another.
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In my films, I always try to come from the perspective of a third party. Although I often pick hot topic sociopolitical issues, I try to let the characters speak honestly from their perspectives rather than being mouthpieces for my agenda. And through this creative honest process, I hope to direct my audience to a place of tolerance vs adding to the division in an already too polarized society. 

From my American perspective, the UK healthcare grass was greener than in the US. I was bewildered to see just how many native Brits were taking their universal healthcare system for granted, but Addy’s perspective on the NHS was quite educational.

Being involved in the daily battles, Addy had become frustrated with NHS leadership or lack thereof. From a hesitancy to embrace new technology, to stifling the creative solutions of junior doctors, this powerful institution was starting to disenfranchise the next generation of healthcare providers by asking too much of them for too little and not valuing what they had to contribute. Some of the disillusioned are even going so far as to consider privatization - a method of for-profit healthcare implementation that has plagued the US for decades.

  • 1/3 of Americans who have health insurance through their employer are underinsured

  • 50% struggle to pay medical bills

  • 41% delayed going to the doctor

Coming from the US, I’ve seen first hand how bad the privatization of healthcare can be, ultimately leading to unnecessary deaths. The US has many issues due to it’s capitalism run-amok, but that’s not to vilify capitalism completely - there is a place for the free market - however, healthcare is not one of those places.

American politicians have continually sided with insurance companies over citizens, allowing them to be an intermediary between patients and doctors - middlemen whose paychecks gets bigger the more they deny coverage.

While abolishing insurance companies altogether would be a tricky situation causing many involved in that industry to lose their jobs, for the greater good of saving lives we have to ask the question - why take money away from the care of the sick to pay a middleman to sit between you and your doctor? And why does that middleman have the authority to determine what care a patient can and cannot receive? That is the harsh reality of the American private healthcare system.

Allow me to use my own life to illustrate:

My daughter Joni was born exactly one year ago at UCLH thanks to a team of amazing surgeons who performed our planned C-section flawlessly. It was a difficult pregnancy which required hospital visits at least every two weeks - an emotional rollercollester with moments where we wondered if we’d ever get to meet our little girl. The stress this caused in our lives was immense, and I can only imagine how much more stress would have been piled on had we been forced to face a financial burden simultaneously. After doing the calculations we figured that if we were uninsured in America our pregnancy would have cost us $70,000. Would our inability to pay a figure so high have resulted in our daughter not being here with us right now?

The average pregnancy in the US costs the individual $8,000 - and that’s when everything goes right. When things go wrong, it’s not uncommon for people to fall into massive debt. Take for example, the Cavatores family from Huston, Texas. Since the tragic death of their 7-month old son, they’ve been drowning in bills while also trying to pick up the pieces from this emotionally devastating experience. Between a combination of deductibles, co-payments and “surprise bills” the Cavatores have been asked to pay well over a million dollars out-of-pocket.

My wife Niralee happened to be pregnant at the same time as the Duchess of Cornwall who chose a private healthcare option here in the UK. She received the best coverage imaginable due to her social position and that only cost her £30,000. Why so low compared to the US? Because when the private healthcare industry has to compete with a public option it can’t afford to gouge the sick to get rich quick.

Another way to illustrate this point is the difference in the cost of drug prices between the UK and US. A new study finds that people with diabetes in the U.S. are paying between 5.7 and 7.5 times more than those in the UK for insulin. And insulin is just one of many, many examples. In an extreme case, Turing Pharmaceuticals bought up the drug Daraprim and immediately raised its price from $13.50 to $750 a tablet.

The questions this begs… is it morally ethical to have an unchecked for profit healthcare system?

The noble men and women who are employed in saving lives deserve proper compensation, but when unchecked capitalism rears it’s ugly head, time and time again we see greedy corporations get filthy rich profiting off of pain.


The truth is that no system is perfect. Not the NHS, and certainly not the American system, but I would argue that the NHS is closer. I believe that the wealthy should have access to private healthcare if they so choose, but the common citizen should also have access to free healthcare as a human right.

I know what you’re thinking. So called “free healthcare” is not free. That’s true. The money has to come from somewhere. The argument is where should that money come from - tax dollars or the patient’s pocket?

It’s true that Americans pay less in taxes than the British, however, British taxes cover more public services. Americans are quick to oppose any tax hike. America was founded on a rebellion against taxation without representation, but what about taxation with representation? If you look at the amount of money that Americans pay into the private sector for the same services that are covered by taxes in the UK, then your average American actually spends more money. But we’re okay with this just as long as you don’t call it “tax”.

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In a way you could say that I moved away from America to escape Donald Trump, however recently Donald has been stalking me. He’s invaded my UK space and on his recent visit he stated that the NHS would be on the table for his “negotiations”.

Of course this statement caused uproar and launched some of the largest protests I’ve seen in my current home city of London despite Trump’s false tweets claiming the protests were a liberal media hoax. While politicians are infamous for lying, the level of lying in Trump’s White House is unprecedented.

In 828 days, President Trump has made 10,111 false or misleading claims.
— The Fact Checker’s database

Why would the British government choose to trust a man like this? They should be standing up to this bully like Hugh Grant’s portrayal of the English Prime Minister in Love, Actually:

Crazy tweets aside, let’s talk about what Trump has actually done to dismantle America: 

With his actions Trump has made his agenda clear. A Trump lead privatization of the NHS will only result in the rich getting richer, the poor get poorer, and ultra-poor dying.


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For me, my film NORA is a love letter to the NHS. It’s honest and admits the NHS’s shortcomings, but it respects it’s mission and it’s heart. My tiny film is my way of giving back to a system that has given me the gift of my child.

You can watch NORA online for FREE until June 11th as part of the Social Political Shorts Festival hosted by Audience Awards. I hope you enjoy the film and please consider voting for us.

You can vote for NORA every day while the festival is live and if you share your vote on Facebook or Twitter (using the link provided when you receive confirmation of your vote) then your 1 vote will count as 3.

 
 

NORA stars Nicci Brighten, Alvaro Cea, Chris Horton, Mike Kelson, Alasdair C. Melrose, Jennifer Preston, Mavin Rasheed, and Rachael Sparkes.

Assistant Director Top Tarasin.

Director of Photography Kamil Iwanowicz.

 
Niralee Patel