Sunday, August 16, 2009

Unsolicited Advice for President Obama

[As sent to his White House email just 10 mins ago]

Sir, I have watched with a lot of interest - and more recently a great deal of dismay - about the efforts to reform America's health care system. I have lived many years overseas where no one had to deal with the sort of indignities Americans face with their healthcare, and yet Americans somehow feel that is normal or even boast about having the best health care in the world.

Sir, I have five advice for you to explain this to the 80% of Americans who has insurance.

First, call it what it is, the US healthcare system is a well-hidden tax that goes up every year. It is a tax that is collected by insurers in cohoots with doctors, on personal income, on the economics of small businesses and on the government (state and federal). It a tax that increases at the decision of insurance companies, without anyone voting for it other than the Board and Management of insurers. Nobody gets to object to how much they pay for health care insurance - they simply see their salary increases disappear without even knowing it, small businesses simply drop coverage to stay in business. Anyone who objects to this hidden tax is welcomed to pay for it with their lives, their family's lives and their wellbeing. Sir, I cannot think of any system that is less American than the current health care system.

Second, sir, you have to remind people who has been deciding on their coverage. If it is not acceptable for governments to decide who should get treated or what treatment should be offered, Americans have been putting up with having those decisions being made by faceless boards of accountants, lawyers and management of insurers. Surely, if anyone wants to talk about "death panels" - tell them they are already in front of them. The question is whether these corporate "death panels" ought to be regulated or have minimal standards or be replaced by independent experts not beholden to insurers.

Third, sir, you have to put US$1 Trillion purported price tag for reform into perspective with what's already signed up for under the status quo, i.e. insurance companies and doctors have already decided that in 10 years, health care should cost US$1T more every year. Health care reform will cost 10% of that but in return we have a shot at taming this cost. Not while the annual impact on the federal deficit will be US$500 bn a year every year and growing. You have to contrast that what the government i.e. tax payers, are already paying every year and emphasize how much the US$1 Trillion (over 10 years) is just a fraction of the expected INCREASE. US$1 Trillion is an abstract figure unless you contrast it to what premium increases under the status quo will mean on burdens for small business and for individuals. The annual cost of reform of US$300 a year for every American should be contrasted with the US$6500 a year they are currently paying and will work out to only 10% of the expected increase in annual health care costs in 10 years.

Fourth, sir, you need to explain this for small businesses. Everyone is talking about how reform may raise taxes and suffocate small businesses. You should remind everyone that health insurance bill is one of the largest expenses for small companies. And these costs are rising faster than inflation and faster than economic growth. You should explain how rising premiums is a tax increase that kills jobs.

Fifth, sir, you should hitch the wagon of reform closer to the successful and popular Medicare. Everytime anyone talks about the public option or government-run health care, they are trying to scare people with the unknown. Tie it to what we know, call it "Medicare for everyone" instead of the public option. Tell people the federal government has been taking care of grandma for the last 40 years.

Thank you for your attention and good luck,

Wednesday, August 12, 2009

London or New York: Which do you prefer?

London or New York: which one do you prefer? That is a question for which you can find equally passionate proponents on each side.

Now that I have had the opportunity to live roughly three-years in both London and in New York, I thought I should venture to compare them head-to-head on some carefully selected – and very exacting - indicators:

1. Better looking city: London

2. Better looking people: New York, definitely and by a long way. The gap is quite large for women, even larger for children and enormous for men.

3. Better coffee: London. They were both doing poorly not too long ago, but now the brewed coffee in London’s Café Nero and Costa beats the drip coffees from New York’s ubiquitous Starbucks.

4. Better airport: London. It’s a case of the worst-vs-the-even-worst: not even the mess that is Healthrow-Gatwick-Stansted-City combination can beats New York’s dreadful JFK-LaGuardia-Newark.

5. More people: New York. Its a fact - being the 5th most populous city in the world while London lies in 25th place. Plus New York definately feels big.

6. More diverse population (in terms of variety): London, with large congregations of all European nationalities, South Asian, Middle-eastern and African.

7. More diverse population (in terms of proportion of minorities): New York, in terms of sheer numbers of Hispanics, Blacks, Eastern Europeans, East Asians from everywhere in the Pacific Rim and (to a lesser extent than London) South Asians and Africans.

8. Better air: New York. Hard to believe … but true.

9. Closer to nature: New York. The city is bathed in all directions by the Hudson River, the Long Island estuary and the Atlantic Ocean. In Manhattan, one can smell the sea and watch the waves. Central Park is as close to nature as one can be in the middle of a metropolis but real unspoiled nature is only minutes away. London has a lot of parklands but it takes longer to be “out” and even then, the “country” is largely nature with huge doses of human-activity.

10. Better parks: London. London has more parks although both has their share of unremarkable ones. Other than Central Park, Riverside Park and Prospect Park, no other New York parks could hold its own again London's old and matured parklands and commons. One to one, though, Central Park beats them all.

11. Safer (from real criminals): London. Statistically London is safer but more evenly spreadout outside Central London. Crime is more ghettorised in New York so it is easier to avoid if one know where to avoid.

12. Safer (from petty disturbances, affray and disorder): New York. Due to heavier policing and a less-boozy culture, the loutish drunken behavior, petty vandalism and fisticuffs that takes place inevitably each weekend in London is quite rare in New York.

13. More old-fashioned: New York. Long time New Yorkers hold on to a romantic view of the past. The city is new(er) but the people have a respect for old-fashioned ways and, for many, remnants of their Mid-Western roots. In general, Americans still want to behave "nicely".

14. More *bling* glamorous: London. It is more into all things flashy, trendy and new although the city is physically older. In London, having a good time means dressing up getting drunk ... and preferably doesn't stop there. In New York, it can also mean dress down, get comfortable and chill-out.

15. Better weather (summer): London. On any dry sunny day in June or July.

16. Better weather (winter): New York. On a cold but crispy, dry and sunny day in January.

17. Better newspaper: New York. Hands down, the New York Times trumps what is left of the proud London broadsheets which have gone silly and downmarket. The Financial Times still beats the Wall Street Journal but the latter has definately deteriorated. The British tabloids beat New York tabloids for entertainment-value – because they have mostly stopped being about news – which makes for a far more depressing read.

18. Less poverty: London. Both cities have a huge range of income groups but the poor, homeless, destitute or new migrants are way more visible in New York. In London, the living standard for the lower income groups and the urban working class is better supported by the Government.

19. Wealthier (imported): London. Nothing boosts the high-end more than having Middle-Eastern money in the summer and Russian money in the winter.

20. Wealthier (self-generated): New York. Stripped of the extremes in wealth and poverty, the average New Yorker is probably better off than the average Londoner. New York simply has a larger body of the professional, managerial, entrepreneurial and creative classes.

21. Better food: London. Better value for money and more “into” food than New Yorkers. New York probably has better middle-range places than London but London gives more bang-for-the-buck.

22. Better Chinatown: New York. By far 2 of the largest Chinatowns in the Western world are in Manhattan and Queens. London's has grown too and it is still more upmarket and "Hong Kong". New York's on the otherhand is square

23. Better supermarkets: London. Its hard to beat the “nation of shop keepers” who has gone on to perfect the art of the supermarket (Tesco) and especially take-away food (M&S). London has better quality and value too.

24. Better shopping: New York. I have been advised as much by “experts” that in terms of range and value New York is heads and shoulders ahead. There is a caveat that one needs to “know” where to find the best stuff for the best prices. In both places, tourists get ripped off.

25. More entrepreneurial: New York. Definitely. There are more small and medium-size businesses and self-employed people in New York, which are apparent

26. More corporate friendly: London. A bigger proportion of businesses and services are corporate-owned-and-run. The London economy is focused on big business. New York on the other hand balances big global corporations with a strong and vibrant core of smaller businesses, entrepreneurs and the self-employed expert.

27. More quirky: New York. Although the British may be better known for eccentricity, New Yorkers are the quintessential individualist and non-conformist they make no apology – in fact, it’s a matter of pride – to be a little strange.

28. More tolerant: New York. Diversity is more lived than as a slogan. No one has yet to ask me casually or otherwise about what is my race. In London, I felt one can hear more racial references.

29. More technologically advanced: London. The use of technology in public services, transportation ("Oyster card vs Metrocard") and the mobile/cellular system is more advanced.

30. Better infrastructure: London – by far. The “Tube” is cleaner and more attractive than New York’s subway (although the trains are better by comparison). New York's are among the worse in the developed world - and overuse is one of the reasons.

31. Cleaner: London. By virtue of poor design – such as not having backstreets for putting the rubbish out of sight – and sheer population density, New York cannot keep itself anywhere near pristine and clean.

32. Smarter people: New York. London may, in fact, be smarter but the British tendency is to play down on the smarts. New York is the opposite, where people try a bit too hard to be intellectual. London has more and larger institutions of higher learning than New York (even counting Princeton which actually lies in New Jersey). But New York benefited from being the intellectual capital of North America and a magnet for some of the best and brightest from the Jewish Diaspora, Eastern Europe and East Asia.

33. Better public services: London. It benefit from being a national capital and the investment (and attention) from having national-politicians who would actually vote the money.

34. More child friendly: New York - hands-down. There are 20 playgrounds of various sizes and features just within Central Park in the middle of Manhattan. One would be hard-pressed to find any in Central London. Going with children to a restaurant in New York is usually a non-event. In London, children are still a bit of an anomaly.

35. Better scene/vibe: New York. It’s hard to beat the happy and good-natured vibrancy of a crowd of young New Yorkers right after work.

36. Better attitude (of people): New York. The energy in New York is often one of purposefulness but tampered by a wonderful (but often well-hidden until needed) sense of common courtesy and decency towards strangers. The archtypical gruff and rude New Yorker is actually not the norm.

37. Better for sightseeing: London. The sheer amount of history and authenticity of attractions is not anything the new world is capable for matching.

38. More creative: New York. The place is totally basked in art and creativity. In New York, to be revered one has to be either wealthy, successful, good looking .... or an artist. The downside is that any place with more art is inevitably more messy and less-predictable.

39. Better cultural environment: London. The number and the quality of cultural institutions – courtesy of the pillage and achievements of the British Empire – are second to none. New York is scores by trying harder - and often succeeding especially in the performance arts) – and otherwise made up by being more accessible and meaningful for the public.

40. Better accessibility to the rest of the world: London. London is almost at the center of the world's population centers. It is almost equidistant from Los Angeles, Cape Town, Buenos Aires, as well as Tokyo/Shanghai. If one were to split the world into two halves: people who live to the east of Penang Island (Malaysia) would tend to look towards the US/New York as the reference point while those living west of Penang would tend to look towards London. Of course, is that New York ended up taking the Pacific Ocean while London takes the whole of Africa and most of the Eurasian landmass.