Europe 2009 - Final thoughts

Europe
October 18th 2009

Published: November 1st 2009

While in Europe this time, I gave some thought to a question that has been nagging me for some months. One opinion piece in the paper criticized President Obama and his administration for trying to Europeanize the United States. Have traveled in Europe several times, and enjoyed each trip, I did not see what was wrong with some Europeanization, but decided on this trip to be looking at what was different and making a comparison.

There are some ways that Europe differs from the USA that are not capable of being changed.
1. It is far more compact, making nearly universal train access a possibility within reasonable travel time frames. Even with high speed trains, America could not do the same.
2. Europe is much older than America. That has implications that are sometimes glaring and sometimes subtle. A 200 year perspective is quite different from one that includes buildings that have been existence for over 1000 years.
3. It is culturally more diverse because of he number of countries and ethnic groups that exist (although America is relatively diverse for a country originally founded by one ethnic group with limited religious diversity).

But there are also differences that are conscious choices, resulting only partially from the inherent differences:

1. Infrastructure - driving through Europe, I am always struck by how well maintained their intercity roads are. I noticed particularly this time how many cable-stayed bridges they have. These bridges have been around for hundreds of years, but were unsuitable for larger structures until advances in cable materials came about in the latter part of the 20th century. The earliest steel cable-stayed bridge in the USA was built in 1972, and the earliest concrete example in 1978. It is only in the last 20 years that these have caught on. So the number of such bridges in Europe does not reflect stylistic differences; it reflects the fact that they have been investing in their infrastructure in the last 20-30 years. The USA - not so much. The average of American bridges is 43 years, and 20% are over 50 years old, the age for which many were designed. It is estimated that we need to spend 140 billion to catch up. I have yet to see an intercity major highway in Europe that is in as poor repair as our nearby I-35 and I-40 (and I don't think the interstates in OK are particularly different from those in other states).

Once inside the cities, things change somewhat. Streets are frequently stone blocks, and the same is often true of sidewalks. This means a much rougher ride, but there is obviously enhanced durability. Street signs in the USA are generally on poles on street corners, while in Europe they are traditionally on the sides of buildings, making them harder to see. But in Europe stoplights are often more visible because they place a smaller replica at or near eye level on the corner, making the light visible even when you are very close.

Traveling between cities, I'll take Europe. In cities ,USA prevails.

2. Multicultural diversity
There are systemic problems in both Europe with acceptance of people of different nationalities, races, religions, and cultures. In the USA we see a lot lately of the sort of xenophobic/racist/nationalistic talk and action that prompts widespread round-ups by the sheriff of Maricopa County in Arizona, attempts to fence out people from a country that shares a 1969 mile border with us, and attempts to proscribe even the most humanitarian health care for those without documents. But there are also problems in Europe, with Muslim riots in France in 2005, racism against the Romani prevalent in several countries, and various sorts of racism in countries such as Denmark and Switzerland. Advantage: no one. Everyone loses at this.

3. Work
There is a greater feeling in Europe that people are entitled to make a decent living wage and have a reasonable lifestyle. In most European countries, the average work week is 35-40 hours, somewhat longer in eastern Europe than in western Europe. But in the USA the average hours per week is about 46, or nearly 4 hours per week more than the highest European country (Austria - 42.4 hours). And retirement ages for both men and women in the USA are higher than in most (but not all) of Europe. Tips are usually included in the charges for meals etc in Europe, reflecting that feeling that servers should be paid a working wage, rather than being reliant on the largess of strangers.

What does this gain the USA? Productivity per work hour is very similar in USA and Europe, although France exceeds the USA. But the longer hours by American workers result in higher GDP per capita. It thus comes down to a philosophical choice. Is production more important than lifestyle? Ideally, the worker could make th choice, but in practice that is rarely possible. Workers in the USA are less protected by laws, and are often forced to work longer hours in order to keep their jobs.As a physician working 50 or more hours per week, I have clearly made my own choice, but we are increasingly seeing physicians who are unwilling to make the same choice, and are choosing shorter hours and less administrative burdens. It remains to be se whether that benefits the country.

4. Health
People in Europe (with exceptions to be sure) enjoy a higher level of health than in the USA. There are multiple reasons for this. First, there has generally been a higher degree of governmental intrusion into the healthcare industry. We are now in this country, for the first time I can remember, engaged seriously in a debate as to whether the same should be true here. Regardless of where you in the political spectrum, it is healthy for the country to decide whether is is better to have unfettered commercial healthcare, or to have more governmental control. It is clear that we waste a lot of money without getting much in return. We have failed to institute preventive measures in many cases. Perhaps more importantly, we have pursued lifestyles that result in poorer health. Nearly a third of our population is obese, lead by the citizens of those two states which have served as a cellar for many “worst” statistics, Alabama and Mississippi. One-third of our children are obese. Supersizing now refers to more than just the size of the french fry order. We don't walk anywhere. Europeans, on the other hand, are much more likely to walk, and Use of public transportation means walking to embarkation points. The USA, Mexico, and New Zealand lead the world in obesity, although Great Britain is catching up (I guess toad in the hole is NOT a diet food).

Despite the fact that we supposedly ended tobacco subsidies, and ignoring the known serious health consequences of tobacco use and addiction, the USA spent $530 million on tobacco subsidies from 1995-2006.

5. Public transportation

There is a much more developed public transportation system in Europe, both within and between cities. Car use is discouraged by the lack of parking, small city streets (in many cases), and the high proce of gasoline and diesel fuel). The subway systems are the equal of any in the USA, but not better. I can't really speak to bus transportation. Trolleys are often available. City centers are generally more compact, making walking them easier.

6. Religion
Europe tends to be somewhat more secular. In contradistinction to the USA, religious fundamentalism is much less prevalent. In fact, some say that Europe is undergoing a wave of “secular fundamentalism”. But in general, religious practices are much more commonly ignored, and rarely play a significant role in politics. It is striking to me that a country founded by people who espoused freedom of religion is now laced with groups who feel that they should be able to enforce their religious beliefs on others.

In summary, then Europe and the USA are similar in some ways, but very different in others. I think that some Europeanization of the USA would probably be a good thing. At the very least, we should be debating these things, rather than engaging in ad hominem attacks on political figures on both sides.

Next year: Venice to Dubrovnik and then Berlin to the Rhineland. See you then.

Europe 2009 - Final thoughts

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