The Trouble with America?
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car hogging the outside lane.

Introduction.
Engineering.
Drivers.
Road Culture.

Conclusion.

Solution.
Tips for Visitors.
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Introduction.
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Some facts about the U.S.A... Your chances of being killed or seriously injured in a road accident are about 2.5 times greater than in Britain.  Using 1996 figures: the U.S. had 41,907 fatalities: which equals 15.78 deaths for every 100,000 people: while Britain had 3,598 fatalities: which equals 6.31 deaths per 100,000 people.  If the U.S.A. had the same accident rate as Britain it would of produced about 16,757 fatalities: an enormous difference.    
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To be generous... some of this difference might be explained away by the fact that the U.S.A. has a greater number of vehicles per head of population: [although the same proportion of people still use the roads so this just means a slightly higher occupancy rate per vehicle in Britain.]  If you use the vehicle criteria the figures do not appear quite as bad: U.S.A. equals 20.58 deaths per 100,000 vehicles as opposed to 14.08 deaths per 100,000 vehicles in Britain.  Using this as a comparison... U.S.A. would have produced 28,675 fatalities in 1996.  The bottom line is... it doesn't really matter how you play around with the figures... with over 40,000 deaths every year... the U.S.A. should be doing a lot better.  So why aren't they?
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'The Trouble with America?' is a question... not a definitive answer.  With all the resources available to U.S. Authorities... this is a question they should already have asked... and answered.  This problem has been around for a long time... so 'Answering' the question does not simply mean producing a mountain of Statistics on the subject... it means interpreting the Data: reaching Conclusions: and developing Solutions: a viable long term Strategic Plan for reducing fatalities should already be in place.  There is no reason why fatality rates in the U.S. should be significantly higher than they are in Britain... and that means they should be a lot closer to 20,000 than 40,000.     
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This article is not based on any scientific studies... it is just the observations of one British driver who spent three weeks travelling around California: Nevada: and Arizona during September 2003.
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As an Outsider... travelling to any country, the differences are always a lot more noticeable than the similarities.  Many of the problems which can be seen with drivers on British roads are also self-evident on U.S. roads.  On first impression there doesn't appear to be much of a difference... but with a death rate consistently two and a half times greater than in Britain... there must be some things happening on American roads which aren't happening [to the same extent] on British roads... accidents don't just happen, they happen for reasons.  With that in mind... and with only the experience of one short visit to draw on... the most noticeable differences between the U.S.A. and Britain... 
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Engineering.
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Vehicle Types... all tend to be bigger: cars and trucks: they also seem to have a very high proportion of SUV's: pickups: four wheel drive type vehicles: which don't come off that well in crash tests: [they have a tendency to roll over] so, is vehicle size/type a factor?  
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Unroadworthy Vehicles... One thing that was very unexpected... California is a wealthy State... known for strict omission controls... and so you would probably associate it with high standards for vehicles in general... however they do appear to have a fairly high proportion of older vehicles on their roads... many of which are in a very poor condition.  Vehicles which are... covered in rust: have smashed lights: bumpers hanging off: collision damage: worn tyres: etc. and would definitely attract the attention of the Police in Britain: [who could issue them with a 'Vehicle Defect Notice' and have them removed from the road.]  It is impossible for us to say how big a problem this is... but it would be a surprise if unroadworthy vehicles was not a more serious problem in California than it is in Britain.  
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Law Breaking [Planned]... The availability of cheap, unroadworthy vehicles also encourages those who operate at the very edge of the law, and beyond... to purchase them with the intention of running them into-the-ground and on-the-cheap: i.e. registered at a false address: no insurance: fine avoidance: flouting the road rules: fleeing the scene of any accident: dumping the vehicle when it is no longer of any use: theft and general criminality.
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Law Breaking [Unplanned]... Most vehicles have Number/Licence Plates... some only on the rear... but a significant number of vehicles can be seen driving around with no Licence Plates at all.  This may all be perfectly legal... due to the way that Licence Plates are issued... but in most other developed countries the system is such that there are no valid reasons for driving around without Number/Licence Plates.  This is a loophole that needs to be closed: [as with those that know a vehicle cannot be traced back to them personally:] drivers are far more likely to flout the law: leave the scene of an accident: etc. if they know their vehicle cannot be positively identified: [even if such a course of action has not been planned in advance, it leaves the possibility open, should the need arise.]  A recent study in Britain concluded that such drivers were up to nine times more likely to have an accident than drivers with all their documentation in order. 
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Roads.  Think of roads in the U.S.A. and you immediately think of huge Freeways... roads like you won't find anywhere else in the world.  However... the vast majority of roads are not like that, they are just ordinary roads like you would find anywhere.  As for the Freeways... they look impressive from a distance... very wide: very busy: and lots of flyovers: but up close? not really! they have plenty of width... but not much quality!  
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Perhaps the reason there are so many four-wheel drive vehicles in California is not because people are expecting to be going off-road but because they are expecting to use the L.A. freeway system!  Maybe there is a good reason why the surface has a strange 'ribbed' effect and is full of potholes, but the most likely explanation is simply that they are in a terrible state of disrepair through years of neglect.  Perhaps this is just California and is not typical of the U.S. as a whole?  Apart from the surface... many white lines appear to be faded or have completely disappeared... the edges of roads in general often just peter out and become gravel or dirt rather than having proper edging: [vehicles who go over the edge and then suddenly over-correct can easily go into a sideways spin and then flip over: especially 4wd type vehicles] and there are frequently large concrete blocks where you would expect to see crash barriers.  
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Road Signs.  For many people driving involves doing the same few journeys time and time again... for instance, going from home to work and back again... or doing the school run... so, having to read a map and look for road signs is something which rarely becomes an issue.  Which is just as well... because road signage in the U.S. is often poor and frequently non-existent... with many major intersections on urban roads having no signs at all: [this could be viewed as a minor inconvenience and nothing more serious than that.]  But, when you have poor signage on multi-lane freeways it can cause drivers to make last second decisions... which is something you definitely don't want to be happening... particularly when travelling at speed, a last second decision can easily become the last decision you ever make! 
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Speed Limits.  One of the major factors to look at would obviously be Speed and Speed limits.  Britain tends to have smaller vehicles on average: narrower roads: similar speed limits: [but still travel at slightly higher speeds as more drivers have a tendency to exceed speed limits] so if anything, you would expect Britain to have a higher rate of accidents if the Speed factor was a significant one. 
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The Four-Way Stop.  The 3 or 4 way Intersection where all traffic has to stop is very common in the U.S.  This is something you never find in Britain... there will either be... a set of traffic lights: a roundabout: or the main road will have priority and the lesser road will have a 'Give Way' or 'Stop' sign.  Someone always has a clear priority... no confusion.  This system relies on drivers being cautious and co-operating with one another... with each taking their turn to make a manoeuvre depending on which vehicle reaches the Stop sign first: [although Taxis appear to have excluded themselves from this turn-taking process.]  Surprisingly, this system does appear to work quite well... there is a high degree of co-operation and drivers even seem to take into account that Taxis are going to be a bit quick off the mark and keep out of their way.  Although this might not sound like a very good idea in theory, Americans are obviously used to them... everyone knows what is expected of them... so these Intersections don't appear to be a major problem.  
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Construction.  One problem that is more to do with the physical construction of these Intersections is that they can be found at unexpected points along what is clearly the main road... the Stop sign is not always displayed with sufficient prominence... which means if a driver doesn't see the sign in time they could go straight through the Stop sign at speed and broadside a vehicle pulling out into their path.  Whether this is actually a serious problem? we cannot say off hand! 
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Motorways and Freeways.  In Britain the equivalent of the Freeway is the Motorway... which usually has a speed limit of 70mph... and are generally acknowledged to be... mile for mile... the safest roads that we have: [in medium to low density traffic it is common to see cars travelling at 100mph plus... something the Government is trying to crack down on.]  However, there are some fairly fundamental differences between the two... which means it is generally, safer to travel at speed on Motorways than on Freeways.
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Motorways.  Foremost is their relative size... Motorways tend to be 3-lanes and occasionally 4-lanes... while Freeways are often 6-lanes or more.  As British cities are old they have not been designed to accommodate the car... so only a very small portion of the National Motorway system is in urban areas... they mainly run through rural areas... connecting major urban centres.  Exits are usually well sign posted and average about one every five miles... so drivers have plenty of warning and can choose the appropriate lane in good time: [not that they always do!] and disruption of the traffic flow due to vehicles entering and leaving the system is relatively low. 
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Freeways.  Are quite different in that they are primarily used by traffic moving within large metropolitan areas.  Once you leave the urban centres the roads running between cities tend to get smaller rather than larger.  Because they are basically urban roads they tend to be... quite busy at all hours of the day: have more lanes: and far more Exit/Entry points: [often having several points where traffic is leaving or joining the system within a single mile.]  Wherever traffic is leaving or joining the system extreme caution is required... there is... a lot of lane changing: frequently a critical disparity in lane speeds: with traffic using inside lanes often travelling faster than those in middle lanes.  Any late decisions [because of poor road signage? or any other reason] are potentially dangerous in these circumstances.
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Drivers.  
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Age Difference.  Notably... it is legally possible to start driving at a younger age in the U.S. [17 in Britain.]  16-year-olds are a very high-risk group... so with Americans having easier access to vehicles in general and at a younger age... you would expect a much higher rate of accidents involving the 16-18 age group. 
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Older children don't buckle up --Young children today are more often seated properly in child safety seats, but older kids ride unbuckled and die in car crashes at rates similar to adults, shows recent U.S. data. And 27 states have upgraded related laws since 2001.
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Driver Fatigue.  As with other large countries like Canada and Australia there is one more problem which you don't find in Britain involving driving long distances on roads with very little traffic.  In Britain drivers do get tired, they do fall asleep behind the wheel and they do cause accidents.  However... maintaining concentration can be far more difficult in these large countries where there are few other vehicles... the roads are long and straight... and the landscape does not change for mile after mile.  The distances to be driven can be vast and drivers may start feeling very tired after just a couple of hours driving... even if they have had a good nights sleep.  So, apart from the usual driver fatigue problems... drivers can also fall asleep simply due to a lack of stimulation. 
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Driving Standards.  The standard of driving in Britain is still a very long way from being perfect: [we have all the usual problems with speeding: tailgating: drink driving: etc. etc.]  But, we are not looking for common problems... the explanations we are looking for will be found in the ways that the driving experience differs.  Of all the differences between the types of Vehicles: Road Construction: Law Enforcement: Training: Education: Road Rules: etc. there is one very striking difference between driving in Britain and driving in America... in Britain the 'lane-discipline' is fairly good... while in America it is truly awful!  We are referring to such things as... lane-hogging: lane-hopping: multiple lane-changing: reactionary lane-changing: and overtaking on the inside lanes: [a practise known for good reason as 'undertaking'] all 'high-risk' activities which are rarely seen on British roads but are endemic on U.S. roads... and according to the follow article... jumping red lights should also be included in the list of high-risk activities reaching epidemic proportions.
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Running red lights becoming an epidemic -- The leading excuse cited by the red light runners is "being in a hurry!" But each year crashes caused by driving through red lights result in nearly 1,000 fatalities and 90,000 injuries in the U.S. And it's getting worse.
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This does not mean... that everyone in America is driving badly... it just means that there is a significantly larger minority which have these bad driving habits.  For instance... in Britain there may be just 1% of drivers doing these things... while in America the figure might be nearer 5%... which means the problem would be five times as bad.  [We do not know the exact figures, but the impression is that this particular problem is considerably more than five times as bad.]     
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Frequency and Severity.  No problem is unique to one country.  All the afore mentioned do happen on the roads in both countries... but there are always degrees of offences... extenuating circumstances... and personal perspectives which can be debated.  So... if you want to establish whether one country has a particular problem when compared to another country it is easier to just look for extreme examples... those instances where there is no 'case for the defence'... how often do you see the very bad incidents?  
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Lane-Hogging.  In Britain you will certainly find examples of middle lane-hoggers... and those that are reluctant to move over and allow others to pass because they are intending to overtake more vehicles ahead... but extreme examples are quite rare.   
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In the U.S. when using Interstate highways with 2 or 3 lanes... it is quite common to see vehicles just cruising down the outside lane... not overtaking anyone... in fact there may not be anything on the inside lane for miles: [as in picture-right] and even when there is a queue of traffic behind them they just sit there... mile after mile!.. Why?  

car hogging the outside lane.

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One bad habit.  After a while vehicles behind lose patients and a long line of vehicles may start to pass using the inside lane... in many cases it's hard to tell whether these drivers are... completely unaware of the situation they are creating: simply don't care: believe they are in the right: or are just being 'bloody minded'.  Whatever their reasons they create a situation: [their bad habit of lane-hogging leads to multiple incidents of another bad habit... undertaking] that could very easily be avoided with no cost to themselves.
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Signage.  Says "Slower vehicles use right-hand lane" does this make drivers think that as they are not a 'Slower vehicle' they should not use the right-hand lane?  The equivalent sign in Britain would say "Use right-hand lane unless overtaking" [although, in fact it would actually say use left-hand lane as Britain drives on the opposite side of the road.]  Might it be, some are taking the view that as they are driving near the speed limit anyone wishing to get past them would have to break the law... so their actions actually prevent law-breaking?  It's hard to say what the mind-set of these drivers is! but it needs changing!! 
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Lane-Hopping.  As drivers in Britain don't tend to stubbornly hog the outside lane, 'lane-hopping' and 'undertaking' are rarely necessary... of course it does happen... but it is nothing like as common or as extreme.  In heavy bumper to bumper traffic it is very difficult to make any real progress by doing this... but there are always a few lane-hoppers who keep trying to get into the lane which is moving a bit faster than theirs... often more annoying than dangerous.  In low density traffic this practise is usually unnecessary.  The problem is most serious when it is done in medium density traffic where drivers are... weaving in and out: doing quick reactionary lane-changes: tailgating: squeezing through dangerously small gaps: leaving little margin-of-error: and while moving significantly faster than surrounding vehicles.    
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Multiple lane-changing.  Are those incidents where drivers will cut across a number of lanes in one single movement... sometimes all the way from the outside lanes to an Exit in one go... or from an Entry point to the outside lanes.  This does happen in Britain but is not as bad mainly because... fewer lanes are involved: there are less Exit/Entry points: and better road signage means, a higher percentage of these manoeuvres are 'planned' rather than 'reactionary'.    
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Undertaking.  Lane-Hopping does involve 'undertaking' but this also happens in one-off situations: and not as a measure of last resort: but as a very early action of choice.  In the worst case personally witnessed: on a two lane Interstate highway a large truck [a big-rig] overtook another large truck while a car was close on its tail.  Once past, the truck did not immediately move back to the inside lane: so the car moved over and accelerated up the inside of the truck: at which point the truck started to move back over to the inside lane: [probably while the car was in a blind spot.]  The car had to abort the manoeuvre: one truck was moving in from the outside lane, [and once the driver hit the brakes] it had another truck baring down on it from behind.  Fortunately the truck driver at the rear had already started to brake in anticipation: so this suicide-manoeuvre only resulted in a 'near miss' rather than a serious accident.  
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Other common scenarios... are where drivers are overtaking one vehicle and stay in the outside lane in order to overtake another vehicle up ahead.  This becomes a problem when the overtaking vehicle has other vehicles behind it and: (a) the overtaking vehicle is only marginally quicker than the vehicle it is trying to overtake: (b) the vehicle to be overtaken is still some distance ahead: and the whole manoeuvre takes an inordinate amount of time.  Drivers often lose patience and attempt to pass using the inside lane... sometimes this is successful... sometimes they run out of time/space and the manoeuvre has to be aborted... usually leaving the driver frustrated and angry.  
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Purely in the interest of 'self-preservation' drivers should move over to the inside lane and not allow themselves to get caught up in these high-risk manoeuvres.  Of course there is a question of 'degrees'... but if someone actually had the time and space to overtake you up the inside lane before you caught up with the vehicle ahead... then you would obviously have had plenty of time to move over and let them pass... without impeding your own progress.  Fortunately, most British drivers are fairly considerate about moving over to allow other drivers to pass... and will rarely resort to overtaking up the inside lane.   
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The Freeway Experience.  It is not difficult to see why poor lane-discipline occurs on large urban Freeways, where you might have 6 lanes and a large number of Exit points.  With so many Exit/Entry points there is a lot of activity on the two inside lanes: (lanes 1&2) a lot of slower vehicles will move out to middle lanes (lanes 3&4) to avoid getting caught up in this activity... basically, just pick a lane and stick to it!  Vehicles which join for a relatively short distance don't want to go all the way out to lanes 5&6 just to overtake a few slower vehicles so they move past using the inside lanes. 
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Competition.  Once lane-discipline has broken down: [if it ever existed?] it becomes a free-for-all with drivers just using any lane that suits them.  You end up with a situation where... lane-hogging: lane-hopping: tailgating: multiple lane-changing: reactionary lane-changing: undertaking: and intimidation: all become the norm... consideration and co-operation are out... aggressive competition becomes the order of the day... and that would pretty much describe the American Freeway experience at the moment.
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The Interstate Experience.  The 'Interstate' roads tend to be a lot smaller than the urban Freeways: [although there are exceptions to this, such as the 'New Jersey Turnpike' an enormous road which links... New York - Philadelphia - Baltimore - Washington: and has 6-lanes for cars and 6-lanes for Trucks in each direction] sometimes they are similar to 3-lane Motorways... sometimes like 2-lane duel-carriageways... and sometimes just ordinary single lane roads.  The poor lane-discipline which might be understandable on large Freeways is also endemic on these roads where it could very easily be avoided.  
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A significant number of vehicles [although still a very small percentage] will just sit in the outside lane and won't budge for anyone... if you want to get past then using the inside lane/s becomes the only option.  Even if you are determined to avoid high-risk manoeuvres... 'Interacting' with bad drivers can force you into compromising your own standards.  It is no exaggeration to say... you would see more of these high-risk manoeuvres in a single day on U.S. roads... than you would driving on British roads for a whole year.
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Road Culture
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Every country has a set of official rules for driving on the road... but they also have a complex set of unofficial rules which determines the way drivers Interact with each other.  'Road Culture' includes... the official and unofficial rules: plus a whole range of customs: common practices: and indefinable qualities.  Traffic as a whole takes on a life and character of its own... with a specific... Speed: Tempo: levels of Tolerance: Risk: Aggression: Courtesy: Consideration: and with common practices such as Hand Gestures: Horn Blowing: Rule Breaking: Queuing: Merging: etc. etc.
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This 'Culture' is generally considered to be normal and acceptable behaviour... even though sometimes it breaks the official rules... and sometimes it is just plain illegal.  It is something which has developed over the years... and varies not only between Countries... but between Rural areas: Towns: and Cities.  Not everyone conforms to this common standard and there are strategies for controlling the behaviour of these individuals... usually some form of punishment.  But once the problems become embedded within the Road Culture they are very difficult to eradicate and require a totally different approach.  You cannot change a Road Culture by simply punishing drivers on an ever greater scale.
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Britain and France... have about the same population: similar vehicles: similar rules: and similar road conditions... so it would not be unreasonable to expect them to have a similar rate of fatalities.  Yet Britain has an annual death toll of about 3,500... while France has over 8,000... the difference is simply due to the way drivers 'Interact' with each other: [i.e. their Road Culture.]  Both countries have problems with high-risk Individuals... but France also has the problem of a high-risk Road Culture.
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High-Risk.  All those manoeuvres described in the previous section under the broad heading of 'lane-discipline' are High-Risk.  Occasionally one of these high-risk manoeuvres will result in a 'Near-Miss' [this could be described as... any occasion when a driver has to... unexpectedly hit the brakes: abort a manoeuvre at the last moment: or rely on the good sense of some other driver to get them out of trouble.]  Occasionally one of these near-misses will result in an accident... and occasionally one of these accidents will result in people being seriously injured or killed.  When such high-risk activity is endemic right across the country [i.e. France and U.S.A.] it inevitably results in a high annual rate of fatalities.  While you cannot foresee and prevent individual accidents... you can reduce the level of high-risk activity... and therefore reduce the frequency of near-misses: accidents: injuries: and deaths: for the country as a whole.   
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The greatest influence... on driver behaviour is the prevailing Road Culture.  You can 'explain' to individual drivers why they should refrain from certain bad habits: [like exceeding speed limits] but if everyone else is doing something... they will probably end up doing it as well.  Over time bad habits can become so commonplace that they cease to shock... then become acceptable... then normal.  Everyone knows it's wrong... but everyone does it... because everyone else is doing it!  The problem is not just about controlling individuals... but about changing the collective psyche... and that is the difficult part.
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Sometimes this can be a positive influence... for example... in the U.S. the Road Culture dictates that four-way Stop Intersections work in a particular way... they requires a high degree of inter-driver co-operation... and the vast majority comply.  Unfortunately... the high level of co-operation which has become second nature at these Intersections is pretty much a one-off... co-operation has certainly not replaced competition as one of the core values of driving... and therefore, is not automatically applied in other circumstances.  
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When in Rome.  Driving is an 'Interactive Experience'.  So what can you do when you go to another country and suddenly everyone is Interacting in a totally different way?  Basically, it's a case of 'When in Rome... do as the Romans do'.  The onus is on you to adapt and change... make sure you know the 'Official Rules' of the road... but also try to learn the 'Unofficial Rules' by watching the locals... try to adopt their driving style/customs.  This does not mean that you should adopt ever bad habit you see... every country has a range of driver behaviour... from good to bad... so always aim to be a good example! 
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Conclusion. 
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It is not possible... for us to positively identify every problem associated with American roads by simply driving around the country for a few weeks... however, it is possible to gain some insight into the problems.  The point of this article is only to demonstrate that there may be a wide range of problems: [some obvious: some less so:] and each requires a very different solution.  The U.S. Authorities can have no such excuse! they have huge resources... and they've had plenty of time.  By now they should know in exact detail what all their problems are... and they should also be aware of the conditions that exist in other countries: [such as Britain] which means that certain types of accidents happen far less frequently.  
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Questions and Answers.  There are no straight forward Questions and there are no simple Answers.  If you ask the Authorities... "Why are so many Americans killed in Road Accidents?" they could undoubtedly produce a mountain of Statistics on the subject... detailing every aspect of these Accidents... How: Why: Where: When: Who: types of Vehicles: Road Conditions: etc.  If you then ask... "What kind of accidents are significantly higher on American roads than on British roads?"  Again, they could get out the Statistics... compare the two... and identify the problems.  But then the Questions just start to get more difficult... "What are the various factors which contribute to this higher rate of fatalities?"  Perhaps they would also be able to answer this... but it wouldn't be a simple answer... it would come in the form of a very thick Report.  Ultimately... what you're asking them is... "What can you do to significantly reduce the present level of Road Fatalities?"  And their answer must be... either: (a) We don't know... or (b) We do know... but we're not doing anything about it!  Bottom Line... Statistics are not Answers!  If you don't have the Solutions... then you don't have the Answers!!
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Opinion... [and this is just our opinion, not 'Scientific' proof] America's single biggest problem is... that it suffer from an epidemic of high-risk practices which have become ingrained within its Road Culture.  They need effective strategies for dealing with... the problems of high-risk Individuals: [who come in many forms... see following Article] and the problems of a high-risk Road Culture.  Simply prosecuting more Individuals could be done instantly... but would not solve the problem.  They also need to change some aspects of the Road Culture at the same time... and this has to be done over an extended period of time... using a multi-strategy approach.  
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Older drivers in danger -- While many believe that older drivers are a threat to other drivers, a recent study demonstrates, yet again, that the driving elderly represent a bigger threat to themselves.
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Other Differences.  There may also be differences in such areas as... Education: [Training: Driving Lessons: Courses: etc.] and Enforcement: [Patrols: Speed Cameras: Conviction Rates: Fines: Driving Bans: Imprisonment: etc.] and while these might help explain some of the reasons for a higher accident rate... they are not important in themselves... they are only 'a means to an end'.  The only thing that is important is the 'end product'... the actual behaviour which is visible out on the roads.  All of the afore mentioned are simply 'Tools' which can be used to control or change the behaviour of individuals: [but there are no effective 'Tools' for changing behaviour on a large scale... i.e. for changing the Road Culture.]
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Solution?  
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What is being done?  The short answer would probably be... not very much!  Governments do have a huge amount of expertise and resources devoted to this problem... whole Government Departments: at National Level: State Level: People doing Research: Employers Groups: Safety Campaigners: Police: etc. etc. etc. but for the past decade fatalities have exceeded the 40,000 mark year after year... and show no sign of falling.  Does the U.S. Government have a long term Strategic Plan for getting their annual fatality rate below 20,000? below 30,000?  If not: Why not?  One thing is clear... if you allocate your resources in the same way for the next decade... the results will be a foregone conclusion! 
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Basically, the problem as we see it... everyone just turns up for work and does their own job... each group has their own 'measure of success' to justify their existence: [like how many Fines did they give out.]  But, they are not... working to any Grand Design: there is no Leadership from the Top: there are no ambitious Plans: no long term Strategy: no Great Expectations!  Ultimately... there is only one measure of success which is of any importance... 'The Bottom Line'... and that would indicate that the total achievement for the past decade has been zero!  Failure has not only become acceptable... it is expected!!
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This may sound... like a rather harsh interpretation of the facts.  If all these various groups were disbanded then the accident rate would undoubtedly go much higher.  The fact that the accident rate is not going any lower probably means that the present 'System' has now reached its optimum level of efficiency.  If this is the case... then there will not be any significant reductions until something within the System itself is radically changed.
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What could be done?  If we are right, and the biggest problems are associated with having a high-risk Road Culture... then the answer would be... "Under the present system: not very much!"  There are a whole range of Strategies and Punishments for dealing with those Individuals who's behaviour is illegal and unacceptable.  The problem comes when you try to enforce changes on the 'law-abiding' majority... those who's behaviour may be illegal but still conforms to the prevailing Road Culture.  Nothing will be achieved by simply changing a few laws... success will only come about through a radical change in methods... and a long... sustained effort.  The only people who can make this happen are Politicians... so if U.S. fatalities remain at these high levels for yet another decade... then the finger of blame should be pointed in their direction!!
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Changing a Road Culture.
It is possible... it has been done... but it doesn't happen quickly... and it isn't easy.  The British Government are in the process of trying to make 'Speeding' socially unacceptable... in a way that drink-driving has become.  They may be accused of many things but lacking the 'Political Will' on this issue is not one of them.  However... they are unlikely to have much success as they have... The wrong Offence: The wrong People: The wrong Behaviour: and The wrong Strategies.
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The Wrong Offence.
You cannot solve a whole range of problems by simply targeting one.  The Government are just concentrating on... 'Exceeding Speed Limits', and even that is the wrong problem... the problem is the 'Inappropriate use of Speed' which is something very different... and everyone knows it!  The Police set up speed cameras in places where they know many of the drivers will exceed the speed limit... because it is safe to do so.  Revenue first... Safety a poor second!
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The Wrong People.
One offence... one strategy!  Wide spread use of speed cameras tends to catch out anyone who drives a high mileage: [often professional drivers with a good safety record.]  The basic law-abiding citizen accepts their punishment... while the habitual criminals use false documentation... flout driving bans... and don't pay fines.  If you can't catch criminals... just make criminals out of those you can catch!
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The Wrong Behaviour.
Ultimately... what you want is a uniform standard of Interaction which is Safe: Considerate and Courteous.  For Individuals who's behaviour does not conform with the majority... 'Punishment' can be a useful Tool.  Trouble comes when you start prosecuting those who are already conforming to the prevailing Road Culture... you place them in an impossible situation... and defeat your own objectives.  What should they do when they find themselves in a 30mph zone but all the traffic is travelling at 35mph? go with the flow? or refuse to conform?  When everyone is breaking a rule it is a Road Culture problem... not an Individual problem... so 'Punishment' is not the answer.
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The Wrong Strategies.
This effort is an abject lesson in how not to do it!  They have got everything wrong!  They have lost the moral high ground by it becoming an issue about Revenue instead of Road Safety: [despite their protestations.]  They have failed to win the argument about the 'Speed' problem... they have tried to simplify the issue into a catchy slogan of 'Speed Kills'.  They are simply resorting to 'Punishment' on an ever increasing scale... which only breeds resentment towards the Police: [who are perceived as neglecting other duties.]  They have failed to engage the Public in a pro-active way... they have little public support... and active opposition is growing.  Changing a Road Culture means genuinely altering the collective mind-set of the 'Whole'... not beating people into submission on a large scale.
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Should teens ride with teens? -- Laws limiting the number of teenage passengers who may ride with inexperienced teen drivers are highly supported, says a new survey, but just half of the states have such laws, even though they seem effective.
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U.S. Authorities.  Whenever there is a system of shared responsibility it inevitably results in no-one taking any responsibility: [i.e. Federal and State Politicians.]  The Federal Government should take a lead on this issue: [if for no other reason than it is an incredible waste of resources to do something fifty times when it could be done just once] and establish a system of Best Practice which covers every aspect of the driving experience... based on studies and experience around the world... and develop a range of innovative solutions which addresses the problems of... Individuals: and the deep-seated problems associated with a high-risk Road Culture.  Something States could easily implement without going through the laborious process of developing an entirely new system every time.  
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How could this be done?  With a system such as The Road Supervisors Network it would be possible to address the problems of Individuals... and to systematically change aspects of a Road Culture by taking a well co-ordinated: multi-strategy approach: i.e. target one specific offence [say: lane-hogging] publicize the problem in the Media to everyone: [explain in detail... the problem: future behaviour required: consequences of non-compliance] Road Supervisors to report the most extreme cases... send targeted Information to offenders: [explaining what they are doing wrong] send warning letters to persistent offenders... arrange face to face interviews if necessary.  Follow this up with Police patrols... dealing effectively and expeditiously with anyone still failing/refusing to conform.  Involve... Insurance companies: Employers: Parents: and the General Public: in a pro-active way wherever possible.  When satisfied with results move on to the next problem.
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The Bottom Line... even if there are some factors at work concerning Vehicles: Road Conditions: Education: Enforcement Policy: etc. it is still possible to drive any Vehicle... on any kind of Road... Safely!  It is what drivers do once they get behind the wheel that makes all the difference.  America's biggest problem is that it has a very competitive Road Culture... which has developed into an ill disciplined free-for-all... where high-risk activity has been allowed to flourish.  It needs to change certain aspects of its Road Culture... but doesn't have a System that can do that.  It therefore needs to change the System... but that requires Vision and strong Political leadership... and unfortunately it doesn't have that either!
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The Good News... is that even if you live in a country with a high accident rate, the single most important factors remains under your control... that is... the type of vehicle you purchase: and your own behaviour.  Anyone that uses the roads could be involved in an accident... there are no guarantees... but, you can go a long way to reducing your own personal risk.  If you avoid all the 'high-risk' practices we've mentioned... are tolerant and considerate towards others: avoid getting drawn into disputes: maintain your concentration: plan your journeys: think about each manoeuvre rather than just reacting: maintain a good margin of error: etc. etc. then your chances of becoming a statistic can be relatively low.  If you indulge in all these high-risk activities... then becoming a statistic is only a question of time.  The only thing that you can control or change out on the roads... are your own thoughts... and your own actions.  
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Facts and Tips for Visitors.
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Although accident rates might be a lot higher, there is certainly no reason to avoid driving in the United States.  Hiring a car is easy... fuel is cheap... and the road rules are all fairly similar.  A few things might take a little getting used to... like being on the other side of the road: the four-way Stop signs: the size of the Freeways: and the lack of lane-discipline... but none are major difficulties.  Here are a few facts and tips for anyone thinking of going to the States and hiring a car.  
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Hire Cars.  All major airports have a large selection of car hire easily available... usually automatics with air conditioning.  Deals can often be done... we hired a car: [Sept. 2003] through Avis at San Francisco International Airport... paid for a 'Compact' but actually got a car three groups higher: [classed as 'Luxury'] as we were hiring it for three weeks.  Hiring was quite cheap at $205 per week [for a Lincoln Town Car] but 'Full' Insurance was expensive: [not compulsory] at $150 per week: Plus Tax and sundries an extra $20: making a total of $375 per week... with unlimited mileage.  Usually comes with one basic map of the local area.  
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Tips... check the vehicle has a 'Handbook' otherwise you may never find out how everything works.  Have a look around, inside and out for any damage and make sure it is noted before you leave... otherwise you may be liable for it.  A standard British license is all that is required... plus a credit card which is in the same name as the driver making the hiring: i.e. if you only have one person with a driver's license and only their partner has a credit card, you are likely to have a problem: [you actually get charged at the end of the hiring... so you can then pay with a totally different credit card... or cash if you wish.]   
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Fuel... will inevitably be unleaded.  Most filling stations require you to go in and pay for fuel before you fill up... then read filling instructions carefully... many filling stations are quite old-fashioned and some kind of 'lever' may have to be pulled down/up/across before the pump will work.  
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On the Road... once on the road there are a few things to watch out for... if on the East coast... there are lots of tolls for sections of roads: [anything marked 'Turnpike'] and lots of bridges.  On the West coast there are only tolls on some of the larger bridges such as those around the San Francisco/Bay area.  Stay well out of the way of cable cars... they don't stop [S.F.] and watch out for trams.  Sign posting is often poor or non-existent but at least American cities are not that difficult to get around as they are usually laid out on a 'Grid' system.    
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Four-way Stops... do take a bit of getting used to... this is not the same rules as a roundabout... no-one has priority... everyone takes it in turn to make their manoeuvre depending on who reaches the Stop Line first... caution is needed but drivers are likely to get annoyed with anyone who dithers and doesn't take their turn when its due.  And watch out for Taxis... they have their own rules!
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Interstates... and other main roads which have a single lane each way... often have signs saying 'Turnout' ahead... this is a bit like a lay-by at the side of the road... it is used to allow other vehicles to pass.  Simply pull in... allow vehicles behind to go past and pull out again... it will be greatly appreciated by other drivers... and if you're just sight-seeing it gets them off your tail.
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Freeways.  When on Freeways... plan your route on a map rather than just relying on road signs... try to keep lane changes to a minimum... and be very careful about other vehicles overtaking up your inside... particularly when using an Exit... it happens all the time.  
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Finally... if you show patience with the actions of others... and are considerate with your own... then it is quite easy to avoid conflicts with other drivers... and there is no reason why driving in America should not be a perfectly enjoyable experience.  [If you do have an accident of any kind... the medical bill will be horrendous... so make sure you are well Insured.  For short stays... long stays... or multiple journeys... check out the various packages on offer from American Express Travel Insurance.]
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