Paul

New Forest based lawyer from Washington, Tyne & Wear

[Paul @sajpac3]

@afneil It’s a sign of the times we live in that the political messaging is about emotional connection not being rational

[Paul @sajpac3]

@RindikaSailo @DocPriyamMD Exactly . It’s not when you go to bed if you always wake up early anyway

[Paul @sajpac3]

@DocPriyamMD Sadly it’s very hard to stop yourself waking up earlier than you would like

[Paul @sajpac3]

@imjustinrandall Lucky man. Saves a lot of trauma …

[Paul @sajpac3]

@RNCResearch They never learn

[Paul @sajpac3]

@guypbenson Oh Guy….

[Paul @sajpac3]

@PhilipHensher @NABurkinshaw Yes but where he is right is that the 1980s centralised everything on London. Where he is blinkered is that the Industrial Revolution resulted in a tiny number of uber rich families in each northern city and hideous jobs for the rest . Albeit jobs …

[Paul @sajpac3]

@OliverKamm @JohnRentoul What’s sad is how few of those deserve to be considered good PMs - irrespective of party

[tersfees 🇿🇦 @tersfees]

@JackxJewell This will forever be my fav clip from the UK.

[Paul @sajpac3]

@DocPriyamMD They said this about my brothers painful lump . They were wrong. He was dead 6 months later from anaplastic thyroid cancer

[Paul @sajpac3]

@gnshramanathan @DocPriyamMD Anaplastic thyroid cancer is even worse

[Paul @sajpac3]

@DailyMail Dreadful landlady

[SAID CHAABANI @chaabanisaid90]

This divergence is structural, not anecdotal.
The chart shows two things clearly. First, life expectancy rises with income in both countries. Second, the gradient is steeper in the US, especially at the bottom. The gap is not driven by the top 1%. It’s driven by the lower half of the distribution.
Several forces explain it.
Access versus utilization. The UK’s NHS is imperfect, but it provides universal baseline access. In the US, access is fragmented. Preventive care, chronic disease management, and early intervention vary much more by income and geography.
Non-healthcare determinants matter even more. Obesity rates, opioid mortality, firearm deaths, traffic fatalities, and chronic disease prevalence are higher in the US. These are social and behavioral risk factors, not purely clinical ones.
Inequality amplifies outcomes. In the US, income volatility, medical debt risk, housing instability, and geographic segregation are more pronounced. Health tracks socioeconomic stress. The steeper the inequality gradient, the steeper the mortality gradient.
The key takeaway is that healthcare system quality alone does not determine life expectancy. Public health infrastructure, safety nets, social cohesion, and risk behaviors matter just as much.
The US spends more per capita on healthcare.
The UK provides more uniform baseline coverage.
The divergence reflects distribution and social structure more than headline spending.

[Paul @sajpac3]

@MichaelAArouet @PJDunleavy Don’t think many people are surprised

[Paul @sajpac3]

@FraserNelson And yet restaurant reservations in London seem just as hard to get

[The Spectator Index @spectatorindex]

World's best cities for 2026.

1. 🇬🇧 London
2. 🇺🇸 New York
3. 🇫🇷 Paris
4. 🇯🇵 Tokyo
5. 🇪🇸 Madrid
6. 🇸🇬 Singapore
7. 🇮🇹 Rome
8. 🇦🇪 Dubai
9. 🇩🇪 Berlin
10. 🇪🇸 Barcelona

(Resonance Consultancy)

[Paul @sajpac3]

@PhilipHensher @amwilson_opera I depended on them in my childhoods in the 70s & 80s

[Paul @sajpac3]

@Amcinhk @afneil @British_Airways Why have US carriers abandoned first class? Seems odd. American first was never as good as BA first but still better than business ….