Saturday, March 24, 2018

half dead

It started innocuous enough.  Three days ago, I noticed a light itch on the lower part of my face, two curious spots on my hands, and a discomfort between my toes as if from athlete's foot.  The itch went with a bit of skin discoloration, suggesting an allergic reaction to shaving that I've never had.  The spots on my hands were circular, with a white center and a deep red periphery.  They were about 4 mm in diameter.  Upon inspection, there was nothing odd between my toes.

Had these three symptoms not appeared at the exact same time, I would have dismissed them without a second though, gone to work and waited for things to improve.  Time heals most ailments better than much else.  But the strange synchrony kept me wondering.  What was going on here?  The next morning I did something I hadn't done in years.  I went to see a doctor.

The Swiss health system is a strange place.  Health insurance is mandatory.  This doesn't just mean everyone needs health insurance.  It means everyone is obliged to register with the national health insurance system that consists of what feels like a hundred providers competing for clients.  You have to choose one of them and prove to your local authority that you've done so.

The morning I went to the doctor, my condition had changed somewhat.  Yellow puss had started to appear on my chin. It had done so in small quantities and dried quickly, but it didn't look pretty.  That's when my family started avoiding me.  The soles of my feet felt as if a million small needles had been inserted in them.  Walking was a murderous pain, but I could still not see anything wrong with my feet.

I had picked my health insurance for its price.  All providers are required by law to offer the same benefits.  The differences lie in customer service, ease of obtaining reimbursements, and the availability of mobile apps and the like.  The monthly premium is calculated based on age, place of residence and deductible, the amount you have to cover yourself per year before your insurance kicks in.  There are no discounts for insuring an entire family and no employer contributions, but since premiums are income-independent, they are relatively low if you earn well.  My own contribution is less than what I paid in the UK.

I decreased my contribution further by accepting to have my freedom to choose a physician curtailed.  For every illness, unless in an emergency, I'd have to consult my family physician – who would pass me on to a specialist if necessary.  Being new to the system, I didn't have a family physician, but the walk-in clinic next door offered itself – with no appointment required and, it turned out, hardly a wait.

The assistant doctor was quick to diagnose something like foot and mouth disease, even though my symptoms didn't exactly match Dr. Google's.  I had no fever, no painful throat, and no pustules on hands, feet or in my mouth.  Plus I wasn't ten years old.  Still, the soothing words of the medic comforted me.  "Just rest a bit", she said.  "You'll be better in a few days.  Concern is only due when worms are starting to emerge from the spots in your face."

The concept of a deductible sounds rather strange with health insurance but it's common practice with car insurance.  And as with car insurance, you have to trawl the new year's offers to identify the best deal and switch health insurance if necessary towards the end of every year.  It sound unnecessarily complicated and rather inefficient to me, but it seems to work well – just like Switzerland in general.

I hobbled back to my flat and stretched out on my sofa.  I had a certificate of incapacity to work – one beautiful long word in German – and no other option that to lie flat and wait.  By Friday afternoon, most needles had been removed from my feet and I could walk nearly normally.  In return, my hands felt as they had after the Challenge Dauphiné when I had cycled for seven hours through freezing rain.  Back then I couldn't open buttons or turns keys with my debilitated hands for a week at least.

Today, the changes continue, for the better for the most part.  My feet are almost fine.  My hands have become speckled with hundreds of dark red spot, some large and translucent like a bag of old blood, but they've got some of their strength back.  The dried puss on my chin is falling of.  My body feels weaker overall than yesterday, but there are no worms.

With the sun shining strongly outside on what feels like the first day of spring at last, my hope runs high that tomorrow will be beautiful, spent by the river or on a ride to the convent where the children can see rabbits, cows, pigs and sheep.  I might not look it, but I consider myself back to normal already.

Tuesday, February 20, 2018

reversal of fortune

On the one hand, there would be £350 million a week to spend on health care, full control over all and everything, and a once-in-a-generation moment to shape the destiny of a country.  On the other hand, there's the feeble reassurance that the country won't be plunged into a Mad Max-style world borrowed from dystopian fiction.

If you've guessed that the statements above relate to Brexit, you've kept up your Brit-watching over the last two years or so.  Britain has decided to rid itself of the strangulations of the EU and march into a bright future.  That's what the leave campaign promised, and that's what the first three statements above reflect.  This was the mood of the leavers before the referendum.

The year and a half since the country voted to leave the EU haven't exactly gone to plan, assuming there was or is a plan.  It doesn't much look like it.  British politicians occasionally visit Brussels to figure out if there anything good for them for when they're not part of the club anymore, only to leave empty-handed.  They've yet to visit with concrete ideas or suggestions to shape the process.

Consequently, it looks as if it's all going down the drain.  There doesn't seem to be a week without revelations of what won't be wonderful in the future. There was the story about Britons needing new licenses to drive abroad because their EU licenses won't be accepted anymore.  A nuisance for vacationers, for sure, but hell for hauliers.  There's just a few hundred commercial permits to the EU for thousands of trucks.

Then there is the staff shortage at the NHS.  It doesn't help that Europeans are leaving in large numbers as long as their post-Brexit migration status is unclear.  Lastly, Kentucky Fried Chicken is temporarily closing hundreds of outlets because of supply problems.  Ok, this last one wasn't related to Brexit, but you get the picture.

It is going to be a total disaster, which is probably why David Davis, the government minister in charge of the process, today tried to reassure an apprehensive country.  Far from the lofty promises before the referendum, Brexit won't be like Mad Max was the best he could come up with.  It's not the brightest prospect, but it's probably all the country can hope for.

Friday, January 26, 2018

lack of respect

No need to revisit a long history with many false starts.  Let's just say that bike sharing properly took off with Paris.  Ten years ago the Velib project was launched.  It was the first major bike-sharing program in a major city that was a major success.  It was also part of a comprehensive strategy to reduce automotive traffic and make the city a better place to be.  Today, motorized traffic in Paris is substantially down compared to ten years ago.

Correlation is not causation.  This bears repeating in these increasingly un-scientific or even science-hostile times, with the loudest shouts from the least literate people.  Correlation is not causation, and yet it's an interesting observation.  At the very least it suggests that traffic can be reduced.

Other big cities followed the Paris lead, London in 2010 and New York in 2013.  There are probably bigger cities in China with bigger bike-sharing schemes, but what do I know?  I know London and New York, and I was a user of the shared bikes in London from day one.  I really liked the bikes.

It seems to defy the laws of engineering, but the shared bikes in London appear not to have any moving parts besides the wheels.  Cables are routed inside the bulky frame.  The headlight is part of it.  The chain is completely enclosed.  Nothing is exposed and nothing can break easily.  The bikes are solid, sturdy and unbelievably heavy.  It's hard to get them to move, but once in motion, they roll like tanks and demand respect.  Notoriously aggressive black cab drivers brake because in case of a collision both sides would suffer damage.  Between rides, the bikes slot into hefty docking stations much like a door shuts on a Mercedes, with a stifled clonk.  The whole system is engineered for durability.

Recently, a number of bike sharing schemes of a much different philosophy have been launched in various parts of Switzerland.  They don't rely on (or even provide) docking stations.  Instead, they try to leverage the power of the internet.  The bikes are networked and locked.  If registered users of the service find one, either by coming across it or checking a live map online, they can scan a code on the bicycle with their phone and unlock it.  After riding around, they drop the bike wherever and lock it, thus ending the rental.

If this sounds eminently convenient, it's not very well thought out.  Everything about the system that I'm exposed to appalls me.  The bicycles look flimsy and are often irredeemably broken.  They seem like cheap Chinese trinkets, though the provider is Singaporean.  I don't see how bikes of such low quality can survive more than a handful of rides by users free of the responsibilities of ownership.  It doesn't help when they're not being ridden.  Not having docking stations, the bikes lean against trees or lie on the ground as if abandoned.  This is no way of treating bicycles.

Then there are the problems with free-floating, self-regulating systems.  Classical economists like them, but they rarely work in practice.  Without a maintenance crew, wrecked bicycles pile up, turning sidewalks into steeplechases and blocking narrow roads.  There's no redistribution of bikes to where they are needed.  The market doesn't sort this out easily.  Getting bicycles ready for masses of commuters arriving at the same time was a major logistical challenge in London.

With the arrogance of a self-proclaimed disruptive startup, the company dumps the bicycles everywhere, no matter whether they're wanted.  Externalities are for society to pick up.  I will have to pay for the removal of broken bikes with my taxes.  I pay for bicycles occupying bike parking spots downtown by having to look longer for a spot for myself.  Early investors might be happy with fast growth at any cost, but this is not a sustainable model.

Free-floating bike sharing has the potential to improve local transport much beyond what docked bicycles can offer.  The flexibility is wonderful.  But there has to be a system behind it that puts respect of the bicycle at its heart.  Once it looks like bike sharing and not like milking a trend, it has the chance to succeed.  I would sign up in a jiffy.

Tuesday, January 23, 2018

happy anniversary

Trump is a complete idiot.

Most people probably voted for Trump for the entertainment.  It's like reality TV, but for real.  Trump does the deranged clown, and the masses can laugh and cheer.  After one year on the job, he is unlikely to have disappointed anyone.  Those repulsed by his ways see themselves confirmed anew every day.  Those who picked him for the wrong reasons would probably do so again.

It doesn't matter that he hasn't built a wall against Mexico with his own small hands and that the American taxpayer will pay for this wall, should construction ever start.  No one cares about the wall.  His tweets are a scream.

How good an entertainer Trump really is can be seen in the sad demise of Saturday Night Live.  This used to be the epitome of political comedy.  A few weeks ago, the Federal Communications Commission had to reclassify it from humor to factual.  What used to be hilariously satirical is now documentary – though no less hilarious for it.

When Fire and Fury, Trump's anniversary gift, was released the other day, I read an interview with the author Michael Wolff.  He claims to just have walked up to the White House one day with the suggestion of covering the first 100 days of the presidency for a book.  No one was responsible for books, and no one showed him the door.  In a move that would have awed Tom Yates from House of Cards, he remained for 200 days, turning to inventory whose presence is not noticed or questioned.  He apparently picked up the best parts by overhearing conversations while waiting in obscurity for appointments that never happened.

The book reveals an angry child with staggering insecurity.  Trump's afraid of being destroyed by anyone and everything.  Fighting back is his default mode of operation (mostly through words rather than actions).  Wolff claims no worries of revenge because of Trump's short attention span.  He only focuses on what's in front of him – as long as it is in front of him.  When he engages in politics, it's in unrelated fits and starts.

There's no vision and no strategy.  Like a monkey throwing darts at a wall, he sometimes hits the target, but what looks like the first step towards success always turns out to be haphazard and of no consequence.  Trump started his job by talking to Taiwan as if it were a country.  This sounds sensible if you ignore diplomatic conventions that only exist because they've existed for ages.  As part of a foreign policy, it would start interesting discussions and might break the deadlock across the Taiwan Straight.  As a monkey's dart, it was soon forgotten.

There have been many more darts over the first year, and a few nuclear hand grenades as well.  They landed to great effect where no one would have expected them.  There were even some legislative accomplishments, though they need an unorthodox perspective to appear as successes.

If you think that earning less than $100k is un-American, the tax reform bill makes perfect sense.  There's simply no reason why anyone choosing to earn less should be rewarded.  Same goes for health care.  Instead of pitying the poor, Trump wants to liberate them from the yoke of socialized medicine.  If you don't want to have to choose between treating an illness and feeding your children, do your patriotic duty and earn a respectable salary.

The masses continue to cheer.