What I'm really here for

Of course my main purpose for being here is not to undertake a pseudo-anthrolopological study of the US, but to consider US healthcare, the public disclosure of performance information within this system (or non system?) and think about lessons for the UK. While some of what I do is properly bound by confidentiality and other bits I shall seek to publish more formally, I'm putting up some of my developing thinking up on a sister blog http://hamblinthinking.blogspot.com/ . Please feel free to comment, tell me how I've got it entirely wrong or point me at research which I need to see.

Thanks.

Economics and Airlines

One of the, like d'oh, obvious bits about the states is the need to fly everywhere. SeaTac airport is delightful, not least for the plethora of Alaskan Airways planes. These have the most hilarious tailplanes ever - it's supposed to be a grinning Inuit in traditional dress. Only they got the world's worst artist to paint it so it looks like Liam Gallagher in full wearing a school parka mode.

It's strange though that given the culture of really high levels of service, and with widespread competition in US airlines (we can get access to at least 20 domestic carriers at SeaTac, on a recent trip I had a choice of 5 different airlines), that the experience of flying is so grotty compared with the UK. The service is definitely pre-Branson, and the costs are not cheap, despite the reputation. A return flight to New York cost about the same as it would from London. In short it's like paying BA prices to fly Ryan Air. Fly on a grotty 737, pay for your food, pay for alcohol, pay for the inflight movie (and this on flights as long as a transatlantic crossing). It's worse than al-Italia 10 years ago!

Can anyone point me to some economic literature that explains this apparently unintuitive result?

Which way do the guns point?

A beautiful weekend, so we visited Bainbridge Island in the middle of the Sound. The ferry ride was spectacular: Seattle's amazing skyline guarded by the ethereal presence of Mt Rainier in the background (the snowiest place in the contiguous states I learned today with an average of 60 feet of snow a year - wow).

Bainbridge Island itself is a delight - boasting the best-ice-cream-shop-in-the-world-ever. It also has a tiny but fascinating museum. One of the premier exhibits is a display on the internment of local Japanese-American in California following Pearl Harbour.

Lots of cameos that sum up the complexity of these things - including the story of the local weekly gazette editor heroically defending the rights of Japanese Americans while allowing an open forum of views. This seems to me an exemplar of all I, and I guess, Americans want America to be - you can just see Jimmy Stewart playing the editor.

They also had the traditional high school yearbook class photos for 1941 and 1942. In 1941 there were 45 students - about a quarter of whom were Japanese. In 1942 there were 30. None were Japanese. There was also one of those "our glorious dead" rolls of honour showing those who served and fell. About a fifth had japanese sounding names.

It set me thinking about comparisons with now, and the post-hoc justifications that locals would have made. "Other countries would have done just the same" - absolutely - the British invented concentration camps and our record is nothing to write home about. "There was a war on and people were scared" - this is absolutely true, and you don't how you would react - self-righteousness with hindsight is an ugly thing. "People didn't know any better then" - I'm not so sure this holds. The interners felt the need to justify what they were doing; this was for the Japanese-Americans' protection, to keep them safe from the mob. It doesn't ring true. "If these machine guns are to protect us in the camp from those out there", asked one internee, "why do they point inwards?".

Sulfuric acid

A funny few days, punctuated by rather childish name calling. You will probably have picked up that Hugo Chavez called Dubya the devil at the UN. This has been a major story over here with Faux News having a major hissy fit over this puerile posturing. Clearly Chavez is a chancer, a populist and a bit of a clown, but the reaction over here is interesting. Generally the left are deeply annoyed. Clearly this is a gift for the Republicans with the mid-term elections about six weeks away. Jon Stewart - who is probably the premier satirist over here has summed up this view most robustly . http://www.comedycentral.com/shows/the_daily_show/index.jhtml

More interesting is to consider how the almost universal condemnation of Chavez here - even from people who clearly hate all Bush stands for - stems from the head of government and head of state being the same person. Therefore an attack on the president is somehow conflated with an attack on country. Hence the Post-Intelligencer - which is, to my reading, probably the more liberal of the two local newspapers (and newspapers know their readership - Seattle breaks 80-20 to the Democrats) - headlined this as "Chavez attacks America". Hard to imagine an attack on Tony Blair being seen as an attack on Britain... This may of course explain the advantage that incumbents appear to have in presidential elections - I think I'm right in saying that only three have lost since the 1920s.

Much less commented upon, but in my view much nastier, because it reflects a genuine belief rather than adolescent rhetorical flourishing, has been the reliably lovely Jerry Falwell comparing Hilary Clinton unfavourably to Lucifer. Given his earlier assessment that 9/11 was God's punishment on feminists and Katrina was all the fault of gays this is, I suppose, par for the course, but still deeply depressing as he claims to be an evangelical.

It was curious to read this after attending an excellent church service in the morning. A fine sermon on Colossians 1:1-8 made the point that when Christians stop focusing on the essence of the gospel (Christ) and become more concerned with their own agendas - whatever that may be - they are in danger of behaving exactly like the rest of the world, which has the effect of making Christians entirely unattractive and nullifies the gospel. (Salt losing its saltiness as Christ said). The two juxtaposed made me think how bad it is when Christians behave even worse than the rest of the world.

The encouraging fact is that the vast majority of evangelical christians in the US, indeed even republican supporting evangelical christians, are nothing like Falwell and his pernicious ilk. Further encouragement on these lines came from an article in Real Change (the local equivalent of Big Issue) featuring a prominent liberal churchman. The journalist - looking to line up a bit of christian bashing - suggested to the churchman that all evangelicals were troglodytic, mouth-breathing, quasi-fascistic morons. The liberal's response was interesting enough to repeat verbatim

"I think there are many evangelicals we don't hear much about who ... believe that Jesus was a friend of the poor, women, and people left out of our culture, the persecuted, the maligned. I think Evangelicals are beginning to realize that their [sic] Gospel's been stolen...and saying I think we've all been used".

Well I'm one of them. It's good to know there are many others.

New York New York, so good they... apparently have no traffic regulations

Well sorry about the delay in the next post. A mix of being lazy and being away in New York learning about the US health system. More on the learning about American health on the soon to come sister site, but it was interesting to be in London's only realistic challenger as World capital. Perhaps particularly on the fifth anniversary of 9/11

The big impressions were the uniqueness of the place - what I hadn't realised was that the 5 boroughs is about half the size of greater London but has a population which is 1 million greater, so the population density is far far greater than London's. This is particuarly true of Manhattan. Manhattan is about the same size as zone 1 (the centre of London), but has a resident population of about 1.7 million. The thing about the very centre of London is of course that very few people actually live there (the heavy population density is a mile or so outside of the centre of town) - so the population in zone 1 is little more than 500,000.

The resulting density creates a kind of chaos I wasn't expecting. Particularly in crossing the road. Seriously. The old, iconic, walk/don't walk signs have been largely replaced Euro style little green men, and for some reason these are completely ignored by drivers who chicane around pedestrians using a zebra crossing with impunity. Given the brilliant invective that flows pretty routinely from the locals it was amazing that pedestrians just took this. Truly the car is king.

One sight which may be significant of something is the changing nature of the big yellow taxis. Sure the old Fords were still there with the huge hoods and trunks, but the newest, cleanest cabs..? Toyota people carriers. Those healthcare premiums are starting to bite.

I say tomato - you say tomayto, you say children - I say feet

This will be the last time I put up one of those really lame two nations separated by a common language stunts I promise, but I'm surely allowed one and this one really foxed me.

It is - as Jules said to Vincent - the little differences that you notice, and with three children under eight having no supplies of Calpol (now officially a threat to national security) is something which needs to be rectified (to the childless and, apparently, Americans, Calpol is a paracetamol suspension used in prodigous quantities by the parents of pre-school age children to treat all ailments up to and including bubonic plague). Bowel threateningly tedious perusal of every shelf in just about every local Bartell Drug finally revealed some liquid ibuprofen which I bought in a spirit of "oh that'll do" before my brain exploded through the sheer boredom of it. But the brand label "Pedicare" gave me pause. How, I wondered, are you supposed to apply this to your feet?

More generally, drugstores are the most deliriously odd idea. What sort of business model teams up a tiny little pharmacy with a stationers and a coffee grindery - and how did they ever get investment? Can you go imagine asking for a bankloan to set up a store selling drugs, and stationery, oh and baby strollers. Oh and why we're at it we'll have an espresso bar and be a wholesaler for really unattractive clothing. You'd be out on your ear inside a minute. All the more reason why they are such charming places - a sort of humdrum heritage which is rather reassuring - and presumably why they will all disappear in the next ten years as we relentlessly merge and rationalise our merry way towards uniformity.

As any fule kno, the only way to be allowed to get away with palpably insane business plans now is to be a privatised public service - hence Railtrack deciding their core business was the provision of cappucino bars throughout the south of England and the expected imminent merger between McKinsey's and the UK Civil Service. A little local shop which sells just about everything you might need (admittedly it's probably hidden away in some ridiculous place and I won't be able to work out what it's called but still) where's the profit in that?

The one where everyone runs round manically for a week...

Hey, well we're here and we got online following some general bizzareness with our ISP and lots of help from our wonderful landlady. I managed to develop a problem they had never spotted before. Doncha just lurrrve pioneering.

One week in and we have just about got through the worst of the jetlag/disorientation/culture shock type stuff, most stuff seems to be working now and I LOVE SEATTLE. From a viewpoint of someone coming from a typically anglo Georgio-Victorian good taste-ville there is something thrillingly 21st century about the combination of caffeine and wi-fi that this city runs on.

Anyway more randomness later. To all my friends hooking up here to see what I am up to - love ya. To all my colleagues wanting to see what I am thinking about/working on, they'll be another of these specifically about the work (i.e. less messing about) and e-mails as and when (I'm starting work next week). To anyone crashing, welcome.