After an unexpectedly long sojourn in China, I returned to Silicon Valley for a week. It caused me to reflect on the different business cultures of my two homes; those differences collectively explain much about the continued dynamism of China's economy.

When visiting the U.S., I am always asking myself "where are all the people?" San Francisco downtown feels empty. I went to my bank, amazed to not see a long line of people getting waiting list numbers. I went to a FedEx ( FDX - news - people ) store, amazed to not see a long line of people getting waiting list numbers. I went to the doctor, amazed to not see a long line of people getting waiting list numbers. Medical care demonstrated how the U.S. and China have completely different cost structures. Dental cleaning in the U.S.: $289. Dental cleaning in China: $13. MRI in the U.S.: $855. MRI in China: $11, using a nearly identical machine.

Those higher U.S. fees earn one big benefit--receiving more than three minutes of the doctor's time for a consultation. A Chinese friend went to the hospital with painful shingles, 45 seconds later he received medicine, a "special recipe passed down from generations."

Medical care underscores that privacy concerns do not limit business in China. That three-minute consultation in China is usually performed with numerous other patients hovering within three feet waiting for their turn. When I am at a notary in Beijing signing a contract, another customer will walk up and start reading my documents. At a Kinkos-like store, I give my passport to scan for a visa application. I turn around for 30 seconds to buy some supplies and another customer is leafing through my visa pages.

In America, even public places seemed private. Arriving at Starbucks ( SBUX - news - people ) in downtown Palo Alto, every single table had one person at it, staring into a laptop (they did multitask, sometimes pulling out a smartphone, typing a SMS, then going back to the PC). Several other people standing around holding laptops, waiting desperately for someone to leave so they could start their own solitary pecking. Rarely does someone say hello …different than the favorite part of my Chinese day. Every middle-aged woman with a baby in China instructs the child "Gei shu shu shuo hello." Translation: "Say hello to uncle." I regularly give 2-year-old little emperors English practice.

I found the entrepreneurial spirit still runs deep in Silicon Valley. Two former colleagues told me they are moving now to startups. But nothing matches the pressure of China. The night I returned, I saw a Chinese dating show ("It Had to Be You"), one where numerous girls give a bachelor thumbs up or down. A manager with a global IT firm went up for his inquisition. Management in a multi-national company used to be the gold star job. But three girls questioned him hard about why he did not start his own company and thus become the big boss. All 24 girls ended up rejecting him. Tough night.

Status-craziness drives title inflation. When I enter a meeting in the Bay Area, I reset my expectations on people's titles. Titles tend to match responsibilities in Silicon Valley. With external image of utmost importance in China, everyone's a partner, CEO, president or vice president; I've had many meetings with individual contributors whose business card says "General Manager."

The U.S. is having healthy debate about the role of government in the economy. This debate exists in China, bur very rarely in public or the media. It's part of a larger difference. The independent institutions that instruct American life--churches, universities, corporations, unions, the media, political parties, even sports leagues--are largely absent as independent actors in China. China essentially has the government and the people, with little in between.

This leaves a large "open space" with no rules and incredible variability of outcomes. I was amazed that no Bay Area drivers drive on the shoulder during rush-hour traffic. Reading Craigslist apartment listings in San Francisco, what you see is what you get. When looking for a place in Beijing, you'll see five different apartment listings with identical "interior pictures" copied right from a home decorating website. Before leaving for the U.S., we used a Chinese overnight mail service and insured a package for 10,000 RMB. Upon return, we followed the identical procedure and the same company told us the insured value limit was 2,000 RMB.

Economic times are challenging for so many in America, and it is a serious matter. China is a country where, underneath the shiny new urban elite, serious and deep poverty remains. Middle-age Chinese have deep memories of difficult times. My elderly friend, when asked why his brother looked different and was much shorter, briefly responded, "he was born in 1950. He never ate until his stomach was full." This same very well-off gentlemen still takes the bus rather than spending an extra $1.25 on a taxi. Walking through our Chinese neighborhood at 9 p.m. (a compound where Land Rovers regularly drive by), most lights are turned off; everyone over 50 is simply saving electricity by watching TV and preparing for bed in the dark.

Another healthy U.S. debate is whether infrastructure stimulus is helping the economy. Magazine articles mention "our crumbling infrastructure." I see the U.S. road system as amazing--roads that go directly from one place to another--office, entry ramp, highway, exit ramp, airport. One Chinese provincial capital, a major city, has an airport route that passes over dirt roads, an abandoned former village, three non-lighted traffic circles, two streets shut down to one lane due to construction, an on-off ramp requiring crossing four lanes in 20 meters, an un-laned road that people wander across aimlessly--and then you finally hit the airport highway. That whole route will change soon as the roads are being torn up to build a subway line.

Despite the challenges facing China, that new subway construction is one tiny example of the country's optimistic, dynamic, purposeful and action-oriented attitude--something not as powerfully felt in the Bay Area. That new subway line may lead to unfair house demolitions, graft, environmental damage, and might not be up to code. But like millions of new ideas, new buildings, new roads, new companies and new technologies, it will "just get done" in China at a cadence that's difficult to comprehend in idyllic California.