I had my first encounter with the US healthcare system yesterday.

I went to a GP with a minor ailment, and was told that the charge for the initial visit would be $200. (British readers: forget the official exchange rate. In purchasing power terms, $200 is roughly the equivalent of £200.) After that, it would be $70 a visit.

"So why is it so much more expensive the first time?" I asked politely, concealing my resentment.

"Oh, that's because the doctor has to take a detailed medical background," the receptionist told me.

Then the doctor came in. He didn't say good morning, and only reluctantly shook my hand when I proffered it. He showed me a piece of paper with about a dozen boxes on it: heart disease, diabetes, high blood pressure. "Ever had any of these?" he asked.

I told him no, and that was it - my detailed case history had been taken, and my 15-minute visit netted him about 22 cents a second.

It's no wonder the US spends twice as much as other nations on healthcare, and yet lags behind on basic measures like infant mortality and life expectancy. And nor is it surprising that inability to pay medical costs is the biggest cause of personal bankruptcy in this country.

We're still being bombarded with TV commercials opposing President Obama's healthcare reforms, most of them by the thoroughly sinister US Chamber of Commerce. And when I visited the website of my insurance company the other day, there was a banner ad on the home page: OBAMA'S REFORMS WILL INCREASE YOUR PREMIUMS.

The other day, NBC news did a segment comparing British and American government policies on swine flu. They interviewed a British GP who was also a visiting lecturer at Harvard, and therefore had detailed experience of healthcare on both sides of the Atlantic.

At the end, he threw in a nicely crafted and seemingly casual aside. "Of course the two systems are very different. It's survival of the fittest here. If you've got money you're OK, but if you haven't, you get thrown to the wolves." It was so refreshing to hear this one little home truth amid the overwhelming tide of anti-reform propaganda.

Well, that was a non-event.

First Ida was downgraded to a tropical storm, and then, perhaps offended by this snub, she stumbled ashore and lost the will to live. All she could manage was a stiff breeze and a sprinkling of rain.

I never thought when I came to New Orleans that I'd spend so much time in gay bars. But a large proportion of our friends are gay, and so are many of the best bars in town, so I feel quite at home there now.

Nor did I ever expect to end up devoting so much of my time to football on TV, but you can't really avoid it at the moment unless you want to end up a hermit, rejected and unloved.

The Saints, our local team, are on a roll, having won every one of their eight games so far this season, and as a result the whole town comes to a standstill every time they play. This afternoon, the streets of the French Quarter were empty but for handfuls of bewildered tourists wondering where everyone had gone.

Pam and I watched the game at the Good Friends bar. One big advantage of this was that the staff handed out free shots of ultra-potent Cactus Juice liqueur every time the Saints scored, and the final score was 30-20 to us.

Anyway, the sole topic of conversation all afternoon was football. Not once did I hear the words "hurricane" or "storm" mentioned, which was surprising given that the category two Hurricane Ida is heading straight for us, and is scheduled to arrive tomorrow afternoon.

It was a bit like Katrina, when bars in the Quarter were abuzz all the way through America's worst-ever natural disaster, with many drinkers oblivious of the fact that 80% of their city lay underwater.