South City, Don't Tell Anything

The mix of unadorned industry and graffiti has always fascinated me, as is well known. I fondly remember my first visit to New York City in the mid-eighties when I got my hands on this book about subway graffiti that never let me go. That was always my dream of America.

South San Francisco is mainly home to people who cannot afford the rents in the city. Anyone who reads Bukowski's "Post Office" can imagine what it means to work in low-wage jobs in slaughterhouses and shipping companies in South City.

But the American Dream is alive here just like everywhere else: The predominantly Asian residents work tirelessly to send their children to good schools and perhaps one day move to a better neighborhood.

"South City, Don't Tell Anything" is, of course, a title by the band BAP from Cologne, who once played in the small Barbara Hall in Augsburg in 1984 in front of about 400 people. And even today, I still enjoy listening to Mr. Niedecken's compositions. Although they no longer blow me away musically, according to my theory, the lyrics in German are so powerful that they make up 80% of a song. Ah, and when their album "Amerika" is playing, we get quite sentimental as we look at the skyline of San Francisco from our place.

Refusing to Obey

However, this does not mean that there is a lack of bureaucracy: In institutions like the Department of Motor Vehicles (DMV), the Internal Revenue Service (IRS), and the Immigration and Naturalization Service (INS), red tape is rampant, worse, yes worse than in Germany. Many Germans do not realize this, assuming that everything in America is more efficient and less bureaucratic.

A similar rule applies to time arrangements. If you show up to a casual party at the agreed time, you'll be greeted by people with curlers in their hair, looking at you in confusion. Naturally, the food isn't ready yet, and everything is terribly awkward. So: Always arrive an hour late. Oh, and if you confirmed your attendance a week in advance but don't call the day before to reconfirm, no one will expect you to show up. If you then actually arrive as promised without reconfirming, there won't be any beer in the fridge.

When AOL bought Netscape in 2000 and our workforce moved onto the campus, two worlds collided: At Netscape, it was common to arrive 15 minutes late to meetings. Sometimes it happened that I was sitting alone in the meeting room, discussing everything with the counterparts in Dulles over the phone and sometimes even finishing the conversation by the time the first Netscape people trickled in. Naturally, I made a point of jokingly saying, "Everything's already done, meeting over," and marching back to my cubicle. However, it didn't help much.

How to Change Jobs

For this reason, one should never include a certificate with a cover letter. Nor should you include a passport photo or date of birth, in order to prevent age and racial discrimination. Instead, you send a "resume" as in perlmeister.com/resume.html and then prepare for a phone call that typically goes on for an hour and is conducted by the hiring manager, who assesses the candidate's skills. If that goes well, the candidate is invited for an onsite interview and speaks with about 4-5 people in the first round, each for approximately 30-45 minutes. Further rounds may follow (I've heard that at Google, some folks went troug more than five).

There are strict regulations regarding what the interviewer is allowed to ask in a job interview and what is not permitted. Questions about age, religion, marital status, or country of origin are not allowed. Only "Are you authorized to work legally in the USA?" is permitted.

The easiest way to succeed with an application is if someone who already works there gives a recommendation. In America, personal references are highly valued. Many companies pay $1,000, $2,000, and even more if an employee suggests a candidate who is then hired.

On the application, you also provide about three "references," people who will put in a good word for you. And believe it or not, the hiring managers usually do call these people and ask if they think the candidate is any good.

Shortly before signing the contract, the company then hires a specialist for background checks, who does not verify the authenticity of a diploma certificate, but simply calls the university to ask if the candidate actually studied there. He also calls the listed previous employers to check if the candidate really worked there.

Yahoo!

I had already heard rumors about Yahoo!, but what I learned on the first day really blew me away. It felt like it was suddenly 1996 again, with the internet boom at its peak.

When signing the contract, I already noticed that the HR (Human Resources) people were all completely unconventional. Outwardly, they were the exact opposite of a typical German HR manager, almost hippie-like, but totally sharp and professional. In general, you see this type more often these days in top companies in the Valley: old hippies, people who probably weren't the best in school, but then turned things around and made it big.

In general, the level at Yahoo! is quite a bit higher than at AOL; there are high-caliber people around, it's hard to believe: At my first lunch in the cafeteria, I was introduced to a "Jeremy" along with a dozen other people, and I didn't think much of it until I found out the next day that it was the MySQL guru and author Jeremy Zawodny. Amazing! And also PHP creator Rasmus Lerdorf, a Dane with a Canadian passport, works in our group and regularly joins us for lunch! By the way, someone signals it's time to eat by playing a specific melody on an accordion.

In the introductory class, we were encouraged not to hold back and to assertively push through our ideas. And when, the first few times in the new group, I still asked, "Can we do it this way?" and the answer was always "Yes, of course!" I was truly overwhelmed. Those who know me are aware that sometimes rather unorthodox methods might be used.

Working for Yahoo! instead of AOL has the added advantage that I am no longer associated with questionable business practices, such as the mass distribution of CDs. Moreover, Yahoo! enjoys the complete trust of many people; in fact, people genuinely love Yahoo!

Once I missed the delivery driver at home, so I called the UPS parcel service to have the package delivered not in San Francisco, but at work in Sunnyvale, 50 kilometers away (yes, that's possible in America!). When I gave the new address and mentioned "Yahoo!", the lady on the phone exclaimed happily: "Yahoo! I love it! I'm using it all the time!". I was quite touched by that.

And the gatekeeper at the rocket company Lockheed Martin, through whose premises I am allowed to ride my bike with special permission (much safer than riding along the freeway exits in Silicon Valley), recently called out to me laughing, after I showed my badge: "Yahoooooo!".

The word, by the way, describes the sound that a yodeler makes. A few years ago at Yahoo!, the world record for mass yodeling (with a Guinness Book entry) was set when all the employees gathered in the cafeteria and made yodel-like sounds together.

The company's policy is aimed at providing employees with an environment where they can freely work on crazy ideas. The people are highly motivated, and there are intense discussions on email lists about how to improve the Yahoo! service. In cases of mental and physical exhaustion, there are quiet rooms where one can take a nap.

Additionally, a fitness center, basketball courts, and beach volleyball courts with sand are available. For coffee needs, there is a cafe where baristas (that's what the coffee makers at Starbucks are called) can whip up lattes, espressos, or hot or cold chai for you. And the best part is, it doesn't cost a cent; you just go there with your cup!

If you don't have time to do laundry at home, you can drop off your clothes, which will then be sent to a laundry service for a small fee. The clothes are promptly returned clean and nicely ironed. Once a week, a mobile hairdresser comes to the campus in a bus-like vehicle to cut hair. There's even a mobile dental service that comes once a week if you don't have time to visit a regular dentist. However, I've been skeptical about that so far and will probably continue to visit a conventional dentist.

Oh, and there's something funny to add to my "background check": The specialist actually called my previous employers and even the office at my old university! And even the police in Munich, who confirmed that I was a posterchild citizen. And also my credit report (Rundbrief 05/2004) was obtained to see if my finances are in order. I know all this because I (you can check this box if you agree to the background check) received a copy of the report. It detailed that they kept calling the office at TU Munich forever and no one picked up, hilarious!

Newsletter Top Product: Duraflame Logs

With our new open fireplace in the apartment, the question of firewood procurement arises. If you don't live in the woods but in a big city, it's not so easy to acquire and store enough wood! For big city fireplace enthusiasts, there are "Logs" by a companty called Duraflame, which you simply light up on the paper wrapper. They burn continuously for four (!) hours, creating a nice, clean fire! Naturally, they are bought at Costco in a pack of nine.

Clear the way for Angelika!

Red versus Blue: The Election Outcome in America

Angelika On the night of the election on November 2nd, we watched the US map intently, hoping that the state of Ohio would turn blue and go to presidential candidate Kerry, after Florida was already flashing at us in ominous red.

Because the color red represents the Republican Party and Bush, while blue represents the Democrat Kerry. How fitting, since the strongholds of the Democratic Party are by the water: the coasts of the West and upper East Coast, the areas around the Great Lakes, and let's not forget Hawaii. But the dream is over: we have to endure Bush for four more years with gritted teeth. Sigh!!! Although Bush did not win by a landslide as Michael had gloomily predicted, he not only secured the necessary electoral votes this time but also garnered 3.5 million more popular votes than Kerry.

Even the fact that nearly 85% of people in deep-blue San Francisco voted for Kerry is of little comfort. Scholars are debating why Bush won. The debate over moral values is highly popular. The born-again Christian Bush gathers his flock in the heartland by rallying against abortion and same-sex marriage. In this context, it no longer matters that these followers are digging their own economic graves by voting for a president who favors the wealthy and large corporations and would prefer to crown himself emperor. To be fair, it should be mentioned that the mechanical coloring of the American map leads to gross oversimplifications. For example, Nevada went to Bush and is therefore colored red, but the election outcome was extremely close: 51 percent voted for Bush, 49 percent for Kerry. Similar situations can be found in other states. Purple would be a better color in many cases.

How tragic it is that Bush now has the upper hand, as the Republican Party has also expanded its majority in both houses of parliament. I think with horror about the upcoming nominations to the Supreme Court under Bush, as the judges are appointed for life and shape the legal landscape for decades.

Please Smile: Entry Into the USA

The American Health Insurance System

Every time we sit down with American friends, the topic of the dismal American healthcare system inevitably comes up. The better-informed Americans know and envy the fact that almost all European countries have a single payer health insurance system for everyone. Michael immediately rolls his eyes, knowing that I could discuss this tiresome topic for hours.

Even after almost eight years, I still haven't gotten used to the pitfalls of the American healthcare system. Until now, I was firmly convinced that it would never come to the point in Germany where the American system, which is outrageously expensive and simply a disaster, would be adopted. However, when I look at developments in Germany, such as the in person visit copay, online pharmacies, and dental services, I'm not so sure anymore.

Michael and I always joke that if we ever return to Germany, we won't need to make a big adjustment. Don't get me wrong: of course Germany needs reforms, but I don't quite understand why people look to America in this regard, whose system has been up against the wall for decades. Why not look to Scandinavia? I'm very much in favor of mandating for anyone in the German health ministry proposing changes based on the American model, that they visit an American doctor and an American hospital at least once beforehand. Naturally, this would include dealing with the American health insurance system. They would never spout such nonsense again.

We have repeatedly pointed it out to you: There are millions of working Americans who have no health insurance or are not adequately insured. Currently, 45 million (or 15.6% of the American population) have no health insurance--a record-breaking number.

This army of uninsured people has always existed. However, the recent increase is primarily due to the aftermath of the economic downturn, which is only slowly subsiding. In the U.S., losing your job also means losing your employer-provided health insurance. Although employees can choose to continue paying for their health insurance voluntarily, which I will explain in more detail later, it is expensive and unaffordable for many who no longer have a steady income. Even if you receive unemployment benefits--yes, those exist in the USA as well--you are not automatically covered by health insurance.

Secondly, the number of Americans without health insurance is increasing because insurance premiums have skyrocketed in recent years. Many small and medium-sized businesses can no longer afford this "luxury" and no longer offer health insurance to their employees. Other companies are increasingly passing on the rising costs to their employees, which leads to higher monthly contributions and greater out-of-pocket expenses for them. The problem with the U.S. system, however, is that companies (except in Hawaii) are completely free to decide whether and under what conditions they offer health insurance to their employees.

This is how it happens that companies cover the cost for health insurance entirely, partially, or not at all. Yahoo!, for example, has been paying it all for both of us up to now. Starting in 2005, Michael and I will pay $20 a month together, and Yahoo! will sponsor the rest of the premium. For comparison, our monthly contribution at AOL was $180. At Yahoo!, we can choose between two health insurance companies, and with one of the companies, we can choose from three different plans that differ in terms of co-payments, deductibles, choice of doctors, etc.

In general, the better the company, the better the health insurance options and conditions. Since companies pick the health insurance and models they choose, changing jobs usually means that the employee has to switch health insurance, which can result in the doctor they used to visit no longer being affiliated with the new health insurance. This is different in Germany, where the employee decides which health insurance they want and retains it even when they change jobs.

By the way, on November 2, Californians once again voted on several propositions. Proposition 72 aimed to require companies in California to offer health insurance starting at 50 employees and to pay 80% of the premium starting at 200 employees. Unfortunately, Mr. and Mrs. Californian were lulled by Arnie, who railed against the proposition, and they voted against it. How stupid can you be! Hawaii is the only state that has had a similar law to the proposed Proposition 72 since 1974. No wonder we like it so much there.

Why is it, then, that healthcare costs are exploding in America? As in other industrialized nations, people are living longer and high-tech medicine is continually improving, leading to new and expensive treatment methods.

Then there's the fact that, as is well known, Americans like to go to court. Doctors here fear nothing more than overlooking something and getting hit with a lawsuit for damages. That's why they pay for expensive insurance policies. Naturally, the money has to be recouped somehow.

I also think that the fear of making mistakes is associated with doctors here strictly following a set pattern. If the patient complains about certain symptoms, then this and that must absolutely be done. The automatic reach for the prescription pad also always makes me quite annoyed. It's as if the motto is: The patient is only happy if I prescribe them a pill. Antibiotics are still considered a cure-all here.

Of course, the insured pay for the uninsured as well. Even in America, the medical profession swears the Hippocratic Oath and does not let anyone bleed to death or die. The so-called "Emergency Rooms" (comparable to the emergency admissions in German hospitals) are obligated to treat anyone who "arrives with their head under their arm."

Many uninsured individuals go to the emergency rooms with non-life-threatening conditions because they don't know where else to go, which, of course, ends up being more expensive for the public than a doctor's visit in an office. Naturally, even patients without insurance are billed. However, where there is nothing, nothing can be collected. Therefore, the bills for the insured are slightly increased to compensate for the loss.

The county hospitals (community hospitals), i.e., public hospitals, also do not turn away anyone who does not have health insurance. In San Francisco, the "General Hospital" falls under this category. The hospital administration then negotiates with the patient regarding what they can pay by having the patient disclose their income and financial situation.

The last significant reason for the explosion in costs is the bloated administrative apparatus of the various health insurance companies. Since there are numerous different plans, all of which vary in terms of services and patient co-payments, a large number of people are needed to oversee them. When you make an appointment with a doctor, the receptionist not only asks which health insurance you have but also which plan of the mentioned insurance it is, even though they themselves may not be familiar with it, despite dealing with it every day. Another popular question quickly follows: "And don't you need to see your primary care physician first to get a referral to a specialist?" Aaaahhhhh!!!!

So it remains an unsolvable task to explain all health insurance plans. But I will try to tackle the main models. There once was the following simple model: The patient goes to the doctor or hospital of their choice, and the health insurance pays the rate charged by the doctor or hospital, minus a deductible that the patient covers. Those were the days.

Today, health insurance companies want to cut costs and have more say, which has led to what is known as "Managed Care." Its most important principle is that the respective health insurance company negotiates fixed rates with doctors and hospitals, and the patient is generally only allowed to go to these contracted doctors and hospitals. On the statements that patients receive from their health insurance, they can see the price difference. For example, my internist charged $170 for a visit with a vaccination booster. However, he only received $116 because that was the agreed rate. Additionally, certain - usually more expensive - treatment methods, such as surgeries, must be preapproved by the health insurance company. And that's where the problem lies, because the health insurance company is not independent. After all, it wants to make a profit.

With the "Preferred Provider Organizations (PPO)" model, which we currently have, I can, in principle, visit any doctor. However, I save a lot of money if I go to a doctor who is contracted with my health insurance. Generally, doctors and hospitals enter into contracts with various health insurance companies. But how do I know if my doctor is part of the network? The major health insurance companies have an online directory of doctors and hospitals that you can check. This can also be done by phone, but it usually takes more time because you have to navigate through an annoying phone menu first.

Even if I pick a contracted doctor, an in-office visit fee (called "co-payment" in America) is due at each doctor's visit, unlike in Germany where it is once per quarter. We currently pay $15 (varies by insurance company) per visit. Additionally, there is an annual deductible, which in our case is $250 per person, and it is due when we need X-rays, surgeries, and the like. After meeting the deductible, our insurance covers 90% for those procedures. cases. We pay 10%. Paying 10% of $1,000 is manageable, but 10% of $100,000 is not so easy, which is why the plan limits how much we have to pay out of pocket per year ("out-of-pocket maximum"): $1,250 per person in our case. However, the in-office visit fee does not count towards this.

To illustrate, here's a small example. Let's assume someone gets sick and the hospital bill amounts to a total of $10,000. With the Yahoo! plan we have, we pay a $250 deductible, leaving $9,750. 10% co-insurance of that is $975, so we would have to pay $250 + $975 = $1,225 ourselves, as the maximum ($1,250) has not yet been reached.

Next, the "Point of Service (POS)" model, on the other hand, incorporates the family doctor as a coordinator, meaning the patient commits to always visiting their family doctor first, who will refer them to specialists, whether affiliated with the health insurance or not, if necessary. Here too, the patient incurs lower costs if the family doctor refers them to experts who are contracted with their own health insurance ("in network"). To my knowledge, the family doctor model is also making a comeback in Germany. The idea is that the family doctor holds the reins, knows their patient, and thus prevents unnecessary specialist examinations.

In the third variant, the "Health Maintenance Organizations (HMO)," the patient is only allowed to visit contracted doctors or hospitals; otherwise, the health insurance won't pay for it. Here too, the family doctor usually coordinates upcoming treatments. In its purest form, the HMO even goes as far as the health insurance owning its own hospitals and the doctors being employees of the health insurance, as is the case with Kaiser Permanente. Everything is under one roof. If the patient needs a specialist or lab tests, they are referred internally. Although the choice of doctors is limited, the insurance covers 100% of all costs after a small co-payment. Many patients love this model because it is quite simple in terms of billing.

Another model, the "Self-Insured Health Plans," is becoming increasingly popular, especially among larger companies. The company pays money into its own fund and covers the cost for its employees in case of illness.

The latest trend are the so-called "Health Funds," which various health insurance companies offer in conjunction with employers. The company pays a certain amount per year to the health insurance provider for the respective employee, which the employee can use for incurred costs in case of illness. If they do not use up the fund, the money is carried over to the new year. Once the annual sum is spent, the employee initially pays a higher deductible before the regular insurance covers additional costs. The idea behind this is: The patient acts as their own health manager, deciding when and for what they spend money at the doctor or pharmacy. We could also choose this plan starting in 2005: Yahoo! would pay $1,125 into the fund for both of us. The annual deductible would be $750 for the two of us after the money is used up.

In America, employees decide again at the end of each year which health insurance model they will choose for the coming year. This is also because something always changes. It should be mentioned in passing that dental or eye doctor and glasses insurances are usually separate from the health insurance.

But what does the poor soul do who loses their job and thus their health insurance? The COBRA law (= Consolidated Omnibus Budget Reconciliation Act) comes to the rescue in the USA. The law states that the employee can voluntarily remain insured in the company group insurance for 18 months if they leave the company (even if they resign themselves), as long as the company insurance covers 20 or more employees. However, ex-employees then pay the premium out of their own pocket. AOL's health insurance (without dental and glasses insurance) would have cost us both $643 monthly under COBRA.

Completing COBRA is not only sensible in order to be covered in case of illness, but also to avoid a gap in insurance coverage, for example, if you take a creative break between two jobs. This protects you from being burdened with so-called "pre-existing conditions." "Pre-existing conditions" include all illnesses that were diagnosed or treated six months before joining a new health insurance plan, which can result in no treatment being paid for these illnesses for the first 6-12 months.

The pharmacies located in supermarket chain locations like "Safeway" or drugstores like "Walgreens" and "Rite Aid" surprised me on my first trip to America. Traditional pharmacies, as they are known in Germany, are now on the verge of extinction in America.

Every tourist is amazed by the 100-tablet pack of aspirin on the supermarket shelf, which the customer can even get at a very reasonable price. However, I boldly claim that the stuff is not as strong as in Germany, because headache sufferers usually have to swallow two tablets for it to work. In contrast, prescription medications have completely astronomical prices in America.

The pharmaceutical industry takes advantage of the living with the argument that the high profits are used to develop and test new medications. Oh, really! How important it is, then, that one's health insurance covers prescription medications. To save money, health insurance usually requires the doctor to prescribe so-called "generics" whenever available. This simply means that the patient does not purchase the medication under the original brand name of the manufacturing company, but rather a non-branded product that contains the same chemical ingredients but costs only a fraction.

The drugstore chain "Walgreens" dispenses these "generics" in "stylish" orange plastic containers (see Figure 14). No original packaging or anything of that luxury. You will also search in vain for the classic, neatly folded package insert. However, Walgreens does include a similar, self-made leaflet that describes the composition of the medication, how to take it, what side effects it may cause, and how much the insurance paid for the medication.

The insured also pay the prescription fee. The amount varies depending on the health insurance provider and the specific plan you have chosen. With our new health insurance, Aetna, we pay 5 dollars out of pocket for generics and 15 dollars for brand-name drugs, which we only receive if there is no corresponding generic available.

I find the option of "refill" (refilling) quite practical and consumer-friendly. The doctor then writes on the prescription how many times a patient can refill the medication without having to present a new prescription. This saves annoying doctor visits just because the medication you take regularly is running low.

Finally, I can't help but make a few critical remarks. I am shocked every time by how the doctor's offices look here compared to those in Germany. There's nothing like stylish furniture and tasteful waiting rooms. The treatment rooms are often tiny spaces where only the doctor and the patient can fit--scratched and dented medical cabinets are not uncommon. I admit that a designer desk or the size of the waiting room doesn't say anything about the quality of the treatment. But the height of tastelessness is represented by the fabric or paper gowns that look like hospital nightgowns, which the patient puts on so they don't have to face the doctor completely naked. Long live American prudery. Wouldn't surprise me if I already have been labeled as a difficult patient by some American doctors: "Oh, here she comes again, the one who doesn't want antibiotics and hates the 'modesty gown.'

The record of the month

What do Manfred Deix (the Austrian illustrator) and I have in common? We are both outspoken fans of the Californian group "The Beach Boys". Yes, now it's out! I am a Beach Boys fan! I don't care!

The common opinion is that the Beach Boys only produced trivial music. However, I claim that the Beach Boys are one of the most brilliant bands of all time. Behind all the summer-sun-fast-cars/girls facade is the genius mind of Brian Wilson, who not only composed catchy tunes but also complex melodies that no one else could come up with.

The man wavers between genius and madness. The album "Pet Sounds" from 1966 is just on the edge of that. All aspiring psychiatrists should listen to it. After that, the good Brian occasionally drifted off completely. I once saw a documentary that reported he simply didn't get out of bed for months(!). At times, reporters would come to his bed, and Brian Wilson would give interviews while lying comfortably. By the way, it was a very nice and comfortable bed; I remember nodding in agreement while watching the documentary.

I even once bought the so-called "The Pet Sounds Sessions" double CD, spending a fortune, and it features around 60 ancient studio recordings. Sometimes a song is played for 10 seconds, someone messes up, and everyone laughs and stops.

In any case, after decades of inactivity, Brian Wilson has finally released a definitive album: "Smile." A masterpiece. You have to listen to it about ten times to catch all the nuances, and then you'll be captivated. Getting out of bed was worth it.

Greetings from my bed

Michael und Angelika