The musings of a physician who served the community for over six decades
367 Topics
Downtown A discussion about downtown area in Philadelphia and connections from today with its historical past.
West of Broad A collection of articles about the area west of Broad Street, Philadelphia, Pennsylvania.
Delaware (State of) Originally the "lower counties" of Pennsylvania, and thus one of three Quaker colonies founded by William Penn, Delaware has developed its own set of traditions and history.
Religious Philadelphia William Penn wanted a colony with religious freedom. A considerable number, if not the majority, of American religious denominations were founded in this city. The main misconception about religious Philadelphia is that it is Quaker-dominated. But the broader misconception is that it is not Quaker-dominated.
Particular Sights to See:Center City Taxi drivers tell tourists that Center City is a "shining city on a hill". During the Industrial Era, the city almost urbanized out to the county line, and then retreated. Right now, the urban center is surrounded by a semi-deserted ring of former factories.
Philadelphia's Middle Urban Ring Philadelphia grew rapidly for seventy years after the Civil War, then gradually lost population. Skyscrapers drain population upwards, suburbs beckon outwards. The result: a ring around center city, mixed prosperous and dilapidated. Future in doubt.
Historical Motor Excursion North of Philadelphia The narrow waist of New Jersey was the upper border of William Penn's vast land holdings, and the outer edge of Quaker influence. In 1776-77, Lord Howe made this strip the main highway of his attempt to subjugate the Colonies.
Land Tour Around Delaware Bay Start in Philadelphia, take two days to tour around Delaware Bay. Down the New Jersey side to Cape May, ferry over to Lewes, tour up to Dover and New Castle, visit Winterthur, Longwood Gardens, Brandywine Battlefield and art museum, then back to Philadelphia. Try it!
Tourist Trips Around Philadelphia and the Quaker Colonies The states of Pennsylvania, Delaware, and southern New Jersey all belonged to William Penn the Quaker. He was the largest private landholder in American history. Using explicit directions, comprehensive touring of the Quaker Colonies takes seven full days. Local residents would need a couple dozen one-day trips to get up to speed.
Touring Philadelphia's Western Regions Philadelpia County had two hundred farms in 1950, but is now thickly settled in all directions. Western regions along the Schuylkill are still spread out somewhat; with many historic estates.
Up the King's High Way New Jersey has a narrow waistline, with New York harbor at one end, and Delaware Bay on the other. Traffic and history travelled the Kings Highway along this path between New York and Philadelphia.
Arch Street: from Sixth to Second When the large meeting house at Fourth and Arch was built, many Quakers moved their houses to the area. At that time, "North of Market" implied the Quaker region of town.
Up Market Street to Sixth and Walnut Millions of eye patients have been asked to read the passage from Franklin's autobiography, "I walked up Market Street, etc." which is commonly printed on eye-test cards. Here's your chance to do it.
Sixth and Walnut over to Broad and Sansom In 1751, the Pennsylvania Hospital at 8th and Spruce was 'way out in the country. Now it is in the center of a city, but the area still remains dominated by medical institutions.
Montgomery and Bucks Counties The Philadelphia metropolitan region has five Pennsylvania counties, four New Jersey counties, one northern county in the state of Delaware. Here are the four Pennsylvania suburban ones.
Northern Overland Escape Path of the Philadelphia Tories 1 of 1 (16) Grievances provoking the American Revolutionary War left many Philadelphians unprovoked. Loyalists often fled to Canada, especially Kingston, Ontario. Decades later the flow of dissidents reversed, Canadian anti-royalists taking refuge south of the border.
City Hall to Chestnut Hill There are lots of ways to go from City Hall to Chestnut Hill, including the train from Suburban Station, or from 11th and Market. This tour imagines your driving your car out the Ben Franklin Parkway to Kelly Drive, and then up the Wissahickon.
Philadelphia Reflections is a history of the area around Philadelphia, PA
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Philadelphia Revelations
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George R. Fisher, III, M.D.
Obituary
George R. Fisher, III, M.D.
Age: 97 of Philadelphia, formerly of Haddonfield
Dr. George Ross Fisher of Philadelphia died on March 9, 2023, surrounded by his loving family.
Born in 1925 in Erie, Pennsylvania, to two teachers, George and Margaret Fisher, he grew up in Pittsburgh, later attending The Lawrenceville School and Yale University (graduating early because of the war). He was very proud of the fact that he was the only person who ever graduated from Yale with a Bachelor of Science in English Literature. He attended Columbia University’s College of Physicians and Surgeons where he met the love of his life, fellow medical student, and future renowned Philadelphia radiologist Mary Stuart Blakely. While dating, they entertained themselves by dressing up in evening attire and crashing fancy Manhattan weddings. They married in 1950 and were each other’s true loves, mutual admirers, and life partners until Mary Stuart passed away in 2006. A Columbia faculty member wrote of him, “This young man’s personality is way off the beaten track, and cannot be evaluated by the customary methods.”
After training at the Pennsylvania Hospital in Philadelphia where he was Chief Resident in Medicine, and spending a year at the NIH, he opened a practice in Endocrinology on Spruce Street where he practiced for sixty years. He also consulted regularly for the employees of Strawbridge and Clothier as well as the Hospital for the Mentally Retarded at Stockley, Delaware. He was beloved by his patients, his guiding philosophy being the adage, “Listen to your patient – he’s telling you his diagnosis.” His patients also told him their stories which gave him an education in all things Philadelphia, the city he passionately loved and which he went on to chronicle in this online blog. Many of these blogs were adapted into a history-oriented tour book, Philadelphia Revelations: Twenty Tours of the Delaware Valley.
He was a true Renaissance Man, interested in everything and everyone, remembering everything he read or heard in complete detail, and endowed with a penetrating intellect which cut to the heart of whatever was being discussed, whether it be medicine, history, literature, economics, investments, politics, science or even lawn care for his home in Haddonfield, NJ where he and his wife raised their four children. He was an “early adopter.” Memories of his children from the 1960s include being taken to visit his colleagues working on the UNIVAC computer at Penn; the air-mail version of the London Economist on the dining room table; and his work on developing a proprietary medical office software using Fortran. His dedication to patients and to his profession extended to his many years representing Pennsylvania to the American Medical Association.
After retiring from his practice in 2003, he started his pioneering “just-in-time” Ross & Perry publishing company, which printed more than 300 new and reprint titles, ranging from Flight Manual for the SR-71 Blackbird Spy Plane (his best seller!) to Terse Verse, a collection of a hundred mostly humorous haikus. He authored four books. In 2013 at age 88, he ran as a Republican for New Jersey Assemblyman for the 6th district (he lost).
A gregarious extrovert, he loved meeting his fellow Philadelphians well into his nineties at the Shakespeare Society, the Global Interdependence Center, the College of Physicians, the Right Angle Club, the Union League, the Haddonfield 65 Club, and the Franklin Inn. He faithfully attended Quaker Meeting in Haddonfield NJ for over 60 years. Later in life he was fortunate to be joined in his life, travels, and adventures by his dear friend Dr. Janice Gordon.
He passed away peacefully, held in the Light and surrounded by his family as they sang to him and read aloud the love letters that he and his wife penned throughout their courtship. In addition to his children – George, Miriam, Margaret, and Stuart – he leaves his three children-in-law, eight grandchildren, three great-grandchildren, and his younger brother, John.
A memorial service, followed by a reception, will be held at the Friends Meeting in Haddonfield New Jersey on April 1 at one in the afternoon. Memorial contributions may be sent to Haddonfield Friends Meeting, 47 Friends Avenue, Haddonfield, NJ 08033.
THERE are a number of supermarkets in Philadelphia called Grand Union Stores, but the grocery conglomerate was founded in 1872. That Union was the Northern side in The American Civil War, and it is reported that life-sized replicas of Abraham Lincoln were once a common feature in the stores. Much earlier than that, the Grand Union was a term that meant the first American national flag, adopted in 1775, and created by a Philadelphia milliner, Margaret Manny. It was, however, quite similar to the flag of the British East India Company, and the Grand Union they were both talking about was the Union of England and Scotland of 1707. The jack of the Grand Union flag, soon to be replaced with a ring of thirteen stars, represented the crosses of England and Scotland, superimposed. When Northern Ireland joined the United Kingdom, the cross of Ireland was superimposed, to give the present form of the Union Jack. In 1775, the considerable colonial sentiment still hoped that hostilities would achieve a status for America along the lines of the other members of the United Kingdom.
"Betsy Ross" Flag
Although the number of stripes in the national flag briefly increased to fifteen at the time of admission of Kentucky and Vermont, stripes soon reverted to thirteen to symbolize the original thirteen states. After that single exception, only the stars in the jack increased to match the number of current states.
The early use of the Grand Union Flag is in some dispute, but it may possibly have been used by George Washington in the various battles around Boston and Charlestown. It was most certainly flown by John Paul Jones on his ship the Alfred . Because of its resemblance to the flag of the nation we were fighting to overthrow, it is understandable that there would soon be a desire to change it. That is what happened in 1777, although just who first had the idea is still open to dispute and myth-making.
America has had three flag acts:
The Flag Act of June 14, 1777 was passed by the Second Continental Congress (under the Articles of Confederation, of course. June 14 is now called Flag Day.) "Resolved, That the flag of the United States be made of thirteen stripes, alternate red and white; that the union be thirteen stars, white in a blue field, representing a new Constellation."
The Flag Act of January 13, 1794 (1 Stat. 341)
An Act making an alteration in the Flag of the United States.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress Assembled, That from and after the first day of May, Anno Domini, one thousand seven hundred and ninety-five, the flag of the United States, be fifteen stripes alternate red and white. That the Union be fifteen stars, white in a blue field.
The Flag Act of April 4, 1818 (3 Stat. 415)
An Act to establish the flag of the United States.
Be it enacted by the Senate and House of Representatives of the United States of America, in Congress Assembled, That from and after the fourth day of July next, the flag of the United States be thirteen horizontal stripes, alternate red and white: that the union be twenty stars, white in a blue field.
And be it further enacted, That on the admission of every new state into the Union, one star be added to the union of the flag; and that such addition shall take effect of the fourth day of July then next succeeding such admission.
Richard Romm, a rising historical scholar with a special interest in early Philadelphia, recently educated the Right Angle Club in the history of the Schuylkill Fishing Club in the State in Schuylkill, and was immediately accepted into membership. Of the Right Angle, that is, which is an old club by some standards, but scarcely a hundred years old in the eyes of the really old, old clubs.
The State in Schuylkill is an eating club, originally a fishing and eating club, apparently organized around the annual shad run up the river. The clubhouse, or Castle, was moved several times, in response to damming of the river, and is now located on the grounds of, or adjoining the edge of, Nicholas Biddle's estate on the Delaware River called Andalusia. One by one, the Atlantic Ocean rivers of America have been dammed and their annual shad migrations brought to an end, except through the city of Richmond, Va, so there was little point in moving The Castle to follow the fish. It remains, overlooking Delaware in spite of its name.
There seems to have been several name changes, the most important of which was to change the Colony of Schuylkill to the State of Schuylkill for obvious reasons. Originally, the Castle was roughly opposite the falls of Fairmount on the West Bank of the Schuylkill at about Girard Avenue; thus, from 1732 to 1822 located on Baron Warner's property called Eaglesfield. In 1822 it moved to Rambo's Rock (the Rambo family is said to be the oldest European settler family in Pennsylvania) opposite Bartram's Gardens, then finally in 1887 to Andalusia, Nicholas Biddle's country estate. The club was founded in 1732, and dates of movings are possibly hazy, possibly somewhat because of the reluctance of club officers to return the calls of inquiring historians. The State in Schuylkill claims to be the oldest organized men's club in the world, an honor contested by White's in London. The roots of this argument are found tangled in the vital issue of whether their age should be based on the formal organization of the clubs, or on the establishment of the coffee houses which housed the original clubs. Four books are said to have been written about club history, but we depend here on Mr. Romm.
Chief Tammenend
There is also an unclear relationship with Chief Tammenend, possibly traceable to the shad run, but in any event to the Indian chief depicted with William Penn in the paintings by Benjamin West and Edward Hicks. May 1 is St. Tammany's day, growing into the fancy that he was the "Patron Saint of America", before a branch of the nation-wide Tammany association opened in New York and sort of tarnished up the name. Other traditions of the Fishing club have to do with wearing Mandarin hats, possibly having to do with the export of ginseng which was once abundant in our colonial suburbs, with a return cargo of Chinese dishware. All of the cooking is done by official citizens of the club. The quantities of food are remarkable; one 19th Century menu listed eleven pounds of meat per member. The club drink is a punch, the famous Fishhouse Punch, widely recognized to be rather strong. Its inventor is reputed to be Edward Shippen Willing, on the occasion of the first visit to the clubhouse by women guests. The quantity of alcoholic beverage at these events is especially remarkable in view of the Quaker origins of many original members of the club, but not necessarily of the guests. Among the various guests were Generals Grant, Meade, and McClellan. Dinner begins with two traditional toasts: to George Washington, and to Captain Sam Morris. Washington was appropriate enough, having a history of drinking a bottle of Madeira every day at lunch. But Sam? Captain Sam the Quaker?
Free Quaker Meetinghouse, Fifth and Arch Streets
Somewhere in this tradition are allusions to the Free Quakers, Quakers who abandoned the peace testimony to fight the British. There is also the tradition of hostility to British rule which antedates the Revolution and may have some connection to the fanciful contention that their little state was not really part of Penn's colony. Captain (of the City Troop) Sam was a stalwart, possibly the sole founder, of the Gloucester (N.J.) Fox-hunting club. The history is passed down that 22 of the original 26 members of the First City Troop were members of the fox-hunting club, and many if not most were Quakers. The first "Governor" of the State in Schuylkill was Thomas Stretch, but the second Governor, from 1766 until his death, was Captain Sam. He was repeatedly referred to as the life of the club and held in the highest esteem by all. He was "read out" of the main Quaker Meeting, not so much for his drinking as for his flouting of Quaker belief in pacifism. He reputedly led a saber charge at the Battle of Trenton and was a leader of the City Troop in that revolution within a revolution at James Wilson's house, which rescued at least four future signers of the Constitution from a mob of militia which momentarily turned Jacobin.
Naturally, descendants of Quakers on both side of this uproar have been reluctant to say much about it. But somewhere within the history of Samuel Morris must be some important clues about the 18th Century splits within the Quaker Church, to say nothing of the revolt of the three Quaker colonies against British rule.
BEFORE we talk about retirees reading books in a retirement community, reflect for a moment about reading in your own home during the working years. Most suburban homes do not have many books in evidence. It's possible to stand in the center of most suburban living rooms unable to see a single book, while it's hard not to see a television set. Increasingly, a home computer is only a few steps from the front door, but the evolution from desktop to laptop to portable telephone to tablet is too rapid to make generalizations. Everyone says books are going to disappear soon, and newspapers maybe even sooner. But there are still said to be a million books constantly in transit on 18-wheeler trucks between print shops and wholesale depositories, night and day. Right now, the producers, publishers and merchandizers of printed material are in turmoil and decline, so they talk about it a lot. But ultimately it is the reading public which will decide what it wants and force the suppliers to give it to them.
reading
It seems to me that what the reading public wants most is to find time to read. The suburban home has so few books because the sort of person who lives in the suburbs to be near the school system, just doesn't have time to read after the day's work and commuting. Helicopter parents spend a lot of time hauling the kids to mandatory kid entertainments, as can easily be seen by driving past a high school in the afternoon and observing the lines of cars with waiting mothers. They make the best of it as a social occasion for mothers with shiny cars, but they really do it to be sure the kids don't get mixed up with recreational drugs. Anyway, they do it, and it all eats up their discretionary time for reading. Meanwhile, their's no local bookstore to buy books, even unread books. They may think they will catch up on their reading after they retire, but that's becoming increasingly unlikely in my observation. They are getting out of the habit of reading. By the time they retire, they will find it's almost like going back to school. You must find other readers, readers groups, conversations about books over the bridge table, books lying about. The first economy a struggling news paper makes is to cut down the size and number of book reviews, because there are no bookstores to take out advertising, and advertising is what pays for newspapers. There's one good feature about that; what book chatter there is, is not so confined to recent books. Some people are bookish and other people are golf-ish, and a growing number of people are simply TV-ish. It's a struggle to find time for work and the family, and books on top of that. No matter what level of reading the working people may be doing, it's declining in favor of deferred reading when they finally retire.
Retirement Community
Having visited quite a number of retirement communities, I find the community's library is a good place to assess the institution and its typical inhabitant. When it's newly built, a library area is set aside, usually without many books. The first few waves of residents quickly fill up the space with books they brought from home. During the first ten years it is possible to guess what sort of person lives there by the books they brought and deposited, or died and left to the library. The space, more or less empty at first, gets full and something must be discarded. Enlarging the library is an economic issue, so the size at which it halts will to considerable degree reflect the willingness equilibrium to pay for new construction, both by the book lovers, and by the book enemies, the golfers and the administrators. Ultimately book congestion gets to the point where someone simply must cull out some old books to make room for the new. In another essay I have described the use of volunteers to exchange books of no lasting interest for more books of real interest to real residents, through a used-book exchange. But someone must organize the process, often recruited by an administrator who has learned to be horrified of construction which cannot be rented, but must be cleaned and cared for. If passive resistance is a new term to you, this is the place to learn about it. The residents have short memories, lack drive and follow-through. So inertia tends to win, and lack of reading feeds on itself because there is nothing to read. What's apparently needed here is an organization of bookish people that extends to all retirement communities, probably with a paid staff, an annual meeting, Internet connections. And therefore an immortality which can outlive and outlast the passive resistance. Good ideas then have a means to spread and help support other good ideas; somehow the costs must be supported until a few True Believers in Books can write a bequest in their wills to sustain it. And activate their intention, so to speak.
One of the largely unrecognized reasons for the success of the American Revolution was that the Colonies had a higher level of literacy than the Mother Countries. Thomas Paine, for example, printed 150,000 copies of Common Sense on the rickety old printing presses of the 18th century, when there were fewer than three million white inhabitants of the thirteen colonies. And who was mainly responsible for that? It was Benjamin Franklin with his invention and popularization of the lending library. If Ben could find time to start libraries in 1742, and Andrew Carnegie was later found willing to pay for dozens of them, surely the time and energy can be marshaled in the 21st century to establish a first-class library system throughout the retirement communities of the nation.
Overview. To be brief about it, spending for healthcare now crowds toward the end of life, mostly after age 65, while the money to pay for it is generated well before 65. Disregarding the complicated history of how we got here, in effect, we borrow from an interest-free account at Medicare to pay Medicare for Medicare, without earning interest on the money idled in the meantime, sometimes for as long as forty years. Potentially, the two age groups could unify their finances and get more or less dual savings. That's the dream advanced by the single-payer advocates, but on examination, the cost, politics, and complexities of actually unifying entire delivery systems would soon overwhelm total- merger enthusiasts. Unfortunately, the revenue has fallen too far behind the costs to make this completely possible. It is nevertheless contended here, only the financial transfers need to be unified, using Health Savings Accounts as a transfer vehicle, and allowing compound interest to extend beyond the boundaries of insurance programs. Such simplification, while not easy, would achieve most of the savings of unifying whole insurance programs, particularly the incentive to keep what you don't use, for your retirement. Among other things, it would solve most of the Constitutional problems, and avoids most of the delivery system obstacles. Indeed, a financial network is about all we could manage, but it is adequate for the need. Because of its towering cost components, even integrating the financial transfers might take longer than we anticipate.
But massive numbers are only part of the health financing problem. At the beginning of life, medical expenses concentrate forward, toward the very first day, leaving absolutely no way for the child's own income to pre-pay his expenses. No matter how it is rearranged, someone must give children some money. Indeed, this second issue seems so unsolvable, everyone has stopped trying to notice it. It only makes people uncomfortable to suggest that adding children to a new HSA system might add twenty-some years to the compound interest in Health Savings Accounts if they only had some money. They don't, so be quiet.
But on the contrary, if someone always gives children the money for their healthcare, why not acknowledge it? Frank acknowledgment seems pre-destined if you aspire to serve lifetime financing. You require two systems, roughly the opposite of each other. One delivery system faces toward the beginning and the other faces toward the end of life. (Even this conception finds the working class in the middle, largely funded by employers who change frequently and have other concerns foremost in their minds.) If the realities of life will never change, then it is the payment system which must adjust, with the finances of each system facing in opposite ways. The reader is therefore urged to toy with the eventual outline of a circular system, far down the line. For now, existing programs would alter their interface to accommodate a new funds flow, while changing their program as little as possible. There's still a big gap left unfilled: Those working people aged 25-65 who largely support the whole system, unfortunately already have so many constraints on their financing it is not feasible even to discuss their needs until the politics subside a little. Connecting, yes; unifying, only as much as you can. Therefore, this book passes over single payer as fundamentally over-reaching and concentrates on lower-hanging fruit.
Essentially, it is proposed: The Health Savings Account to expand to be a unifying financial bridge between programs, one account per individual lifetime, serving many disparate programs. Designed to be implemented in phased-in pieces, it continues to aspire to minimize changes in the delivery system itself. The reader will probably be surprised at how simple some dilemmas are likely to become, once it is conceded the individual patient ought to decide what others now decide for him.
Extended retirement costs are a predictable outcome cost of Medicare.
Prepare yourself for one big rearrangement of thinking, however. Extended retirement costs are a direct consequence of superior healthcare. They could become five times as expensive as healthcare itself, and still be fairly described as a predictable outcome cost of Medicare. The only way budget shifts could be avoided is if science cures a few expensive diseases, quickly. That's not impossible, but it's unwise to depend on. It's also conceivable Medicare beneficiaries could be persuaded to allow HSAs to borrow from Medicare, but only after a titanic struggle, and only after Medicare revenues improve appreciably. New revenues for retirement must nevertheless be found, sooner rather than later, because of the ever-growing retirement crunch. It's a devastating realization, but the seed of solving the problem is contained in it. Where are the new revenues to come from?
The Right Angle Club was honored to have the wife of one of its members, Marjorie G. Jones wife of Jonathan Jones, as its speaker at a recent Friday lunch meeting. Both are Quakers, as you might expect from couples with those names. Marjorie told us of her interesting experiences with a typical Quaker concern, supplying college education to incarcerated prisoners.
Graterford Prison
In this case, she was not acting as a J.D., which she also is, but rather as a teacher, teaching college-level History at Graterford Prison to sure-enough felons, under the auspices of Villanova University, and before that, at Sing-Sing Prison. Pennsylvania comes out looking rather shabby by comparison with New York in these matters, an example of which is the Pennsylvania Law that no one may teach Social Science except with a Ph.D. degree, even though they have a J.D. as she does. Similarly, there are four thousand prisoners in Graterford, while the much more famous Sing-Sing has only seventeen hundred. Pennsylvania hates to blow its own horn, even when the subject is fairly non-glamorous. It even goes as far as spell-check, which never heard of Graterford, but has no trouble recognizing Sing-Sing, up alongside the Hudson River, in Ossining, NY -- which is only half as large.
Eastern Penitentiary
The Quakers of Pennsylvania conceived of Eastern Penitentiary, whose central theme was solitary confinement, hoping in the Quaker tradition for the calming effect of silence to soothe the prisoner into remorseful rehabilitation. Most Quakers would not see quiet reflection as a punishment, but the rest of the world under the leadership of Charles Dickens no less saw it as hideous torment, cruel and unusual punishment. Most Quakers will tell you they rather enjoy an hour of silence.
Ever since their own imprisonment in the 17th Century, the Quakers have had a particular interest in helping the plight of the incarcerated. The rest of the world may yet turn away from prison as a punishment, because prisons are so expensive, costing more than it costs to go to Harvard, and having an incidence of recidivism close to 65%, plus nearly universal drug use. The Quakers, seeing That of God in every man, specialize in giving college degrees to inmates, and have a recidivism rate of around 1%. Mrs. Jones frankly admits there are some people in stir who deserve to be there and would be a hazard to society if released. Pennsylvania has little sympathy with "visitation" rights, which are greatly enjoyed by New York prisoners, while Pennsylvania is more attracted to privately operated prisons, with their incentive for welcoming more prisoners the better.
HIV (AIDS) and Hepatitis B, Hep C
A week ago, a new development clouded the issue of what should be done about the punishment of crime. For twenty years, we have had a cheap simple test to demonstrate the existence of Hepatitis C, but no acceptable treatment. Like HIV (AIDS) and Hepatitis B, Hep C seems to have got its start in homosexual males, and gradually spread into the rest of the community by "dirty needles" in the intravenous drug world. The first two are coming under control with new drugs and vaccines, but Hep C just festers on, and eventually kills the victim with cirrhosis. But last week, the whole matter changed with the announcement of twenty new drugs with more than 95% cure rate in three months, and unfortunately a $65,000 price tag per patient. That's about $150 billion for the known cases clustered around penniless American prisoners, to say nothing of what might immigrate from abroad. There are about 30 million American residents intentionally excluded from those federal programs Congress is now wrangling about, including several million incarcerated prisoners. If even the Obama administration didn't know what to do with prisoners' health costs, it isn't easy to see a federal solution to it, and since the states are overwhelmed by health costs already, they won't likely be eager to add to them, either.
Because we had a test for Hepatitis C for twenty years before we had an effective treatment for it, patient identity is pretty well classified. It will become glaringly evident that the people who don't have the disease will be forced to pay for those who do, and those who do will already have all of the common characteristics for being discriminated against -- black, male, convicted homosexual criminals, to which must now be added the accusation of spreading disease. The prisoners are mostly destitute, and Hepatitis C is contagious to the rest of the population.
On the other hand, it is simply unthinkable to turn these patients loose untreated, no matter what other foreign nations may be bold enough to try. The "solution" is apt to revolve around forcing the drug companies to lower prices as a punishment for curing a disease, and the rest of the population to suffer more taxes. Unfortunately, this is apt to concentrate public ire on criminal violators, homosexuals, drug addicts, immigrants, and black people. It is also apt to stimulate a desire to eliminate prisons by constraining their budgets even further below humane standards. You can expect Congressional hearings about the failure of competition to lower prices, and indeed it really is unlikely that twenty drugs would spontaneously make an appearance overnight, achieving a 95% cure rate, all at the same time. More likely, the manufacturers hoped to recover their investments, before the disease disappeared. But somebody is likely to get flogged, perhaps ejecting prisoners from jail back toward the whipping post, perhaps by looking for deeper pockets within the pharmaceutical industry.
109 Volumes
Philadephia: America's Capital, 1774-1800 The Continental Congress met in Philadelphia from 1774 to 1788. Next, the new republic had its capital here from 1790 to 1800. Thoroughly Quaker Philadelphia was in the center of the founding twenty-five years when, and where, the enduring political institutions of America emerged.
Philadelphia: Decline and Fall (1900-2060) The world's richest industrial city in 1900, was defeated and dejected by 1950. Why? Digby Baltzell blamed it on the Quakers. Others blame the Erie Canal, and Andrew Jackson, or maybe Martin van Buren. Some say the city-county consolidation of 1858. Others blame the unions. We rather favor the decline of family business and the rise of the modern corporation in its place.
Originally the "lower counties" of Pennsylvania, and thus one of three Quaker colonies founded by William Penn, Delaware has developed its own set of traditions and history.
Start in Philadelphia, take two days to tour around Delaware Bay. Down the New Jersey side to Cape May, ferry over to Lewes, tour up to Dover and New Castle, visit Winterthur, Longwood Gardens, Brandywine Battlefield and art museum, then back to Philadelphia. Try it!
Millions of eye patients have been asked to read the passage from Franklin's autobiography, "I walked up Market Street, etc." which is commonly printed on eye-test cards. Here's your chance to do it.
In 1751, the Pennsylvania Hospital at 8th and Spruce was 'way out in the country. Now it is in the center of a city, but the area still remains dominated by medical institutions.
Grievances provoking the American Revolutionary War left many Philadelphians unprovoked. Loyalists often fled to Canada, especially Kingston, Ontario. Decades later the flow of dissidents reversed, Canadian anti-royalists taking refuge south of the border.
