That wallet element helps explain the deep-seated
misgivings that have surfaced about Obama's plans
for health reform. A majority of Americans
believe they have adequate health cover. Their
choice of job may be limited by their insurance
requirements (and labour mobility reduced). And
their calculations may be upset " sometimes
disastrously " by accident or illness.

But with most pensioners protected by the state
system known as Medicare, an "I'm all right,
Jack" attitude prevails. It coexists with the
fear that extending the pool of the insured, to
the poorer and more illness-prone, will raise
premiums for the healthy and bring queuing, or
rationing, of care " which is why stories
about the NHS inspire such dread. The principle
that no one should be penalised financially by
illness is trumped by the self-interest of the
majority, then rationalised by the argument that
health is a matter of personal responsibility.

The point is that, when on "normal", the needle
of the US barometer is not only quite a way to
the political right of where it would be in
Europe, but showing a very different atmospheric
level, too. For there is a mean and merciless
streak in mainstream US attitudes, which
tolerates much more in the way of inequality,
deprivation and suffering than is acceptable
here, while incorporating a large and often
sanctimonious quotient of blame.

This transatlantic difference goes far beyond the
healthcare debate. Consider the give-no-quarter
statements out of the US on the release of the
Lockerbie bomber " or the continued
application of the death penalty, or the fact
that excessive violence is far more common a
cause for censorship of US films in Europe than
sex. Or even, in documents emerging from the CIA,
a different tolerance threshold where torture and
terrorism are concerned.