Pretty much what it says on the tin. Suppose that instead of standardizing on 120V for end-user power distribution, the United States standardizes on 230V, much like Eurasia?
If the US had originally adopted 220-230 V AC, the result is that the whole world could end up using something that looks like the Danish 107-2-D1 connector, essentially the Europlug connector with a ground wire that looks like this:
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Just so our Euro and Asian friends know US residences are supplied with 220-240 volt current. At the entry control pannel, where the safety breakers are, it is split with a 110-120 volt leg for most circuts. Where 220 is required, for heating/cooling units, clothing dryers, electric cooking stoves, a 220 line is run. However as I understand it the Hz varies from what is required by Euro standard 220 volt appliances, so correct function cannot be expected.
Yes, in the polyphase system used in the US, 220 is the high voltage. In Europe, the high voltage is 400V, and the low one is 220V. 400V is used by stoves and the like. The system is fundamentally exactly the same, only half the voltage in the US.
I'm no expert, but isn't the really crucial deal the AC frequency - 60Hz vs 50Hz? Which knocks on to film frames per second (30 vs 25 fps respectively) and further to TV standards (NTSC vs PAL and SECAM).