George R. Fisher, III, M.D.

Obituary

George R. Fisher, III, M.D.

Age: 97 of Philadelphia, formerly of Haddonfield Dr George Fisher III

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.

Books by Philadelphians or about Philadelphia

The Sound on the page

The Sound on the Page by Ben Yagoda (HarperCollins, $23.95).

Over the course of his career, acclaimed author, teacher, and critic Ben Yagoda has uncovered one certain truth about writing: "Style matters." Indeed, it is frequently the case that our favorite writers entertain, move, and inspire us less by what they say than by how they say it.

Most books, including Strunk and White's classic The Elements of Style, take a narrow view of style, suggesting that the only proper one is of plainness, simplicity, and transparency. But tell that to David Foster Wallace, Dave Eggers, Don DeLillo, and other stylistic risk takers!

While not a "how-to" manual, The Sound on the Page offers practical and incisive help for writers on identifying and developing a distinctive style and voice. Drawing on interviews with more than forty authors -- Tobias Wolff, Elmore Leonard, Michael Chabon, Cristina Garc'a, Dave Barry, Camille Paglia, Junot D'az, Margaret Drabble, and Bill Bryson among them Yagoda discusses:

Conscious and unconscious ways writers approach to style, from Bebe Moore Campbell on her pointed use of Black English to Christopher Hitchens's penchant for adverbs
The influence of writers on writers, including Susan Orlean on Ian Frazier, James Wolcott on Manny Farber, and Frank Kermode on William Empson
The impact of tools on style, featuring Cynthia Ozick and Harold Bloom grumbling in harmony about the word processor and its discontents

Filled with insights from outstanding writers and close readings of their works, The Sound on the Page is an essential book for all aspiring and experienced writers, as well as for readers who are interested in learning how their favorite writers approach the craft.

Freedom Just around the corner

Freedom Just Around the Corner: A New American History, 1528-1828 by Walter A. McDougall (HarperCollins, $34.95).

A powerful reinterpretation of the founding of America, by a Pulitzer Prize-winning historian "The creation of the United States of America is the central event of the past four hundred years," declares Walter McDougall in his preface to Freedom Just Around the Corner. With this statement begins McDougall's most ambitious, original, and uncompromising of histories. McDougall marshals the latest scholarship and writes in a style redolent of passion, pathos, and humor in pursuit of truths often obscured in books burdened with political slants.

From the origins of English expansion under Henry VIII to the founding of the United States to the rollicking election of President Andrew Jackson, McDougall rescues from myth or oblivion the brave, brilliant, and flawed people who made America great: women and men, native-born and immigrant; German, Latin, African, and British; as well as farmers, engineers, planters, merchants; Protestants, Freemasons, Catholics, and Jews; and -- last but not least -- the American scofflaws, speculators, rogues, and demagogues.

With an insightful approach to the nearly 250 years spanning America's beginnings, McDougall offers his readers an understanding of the uniqueness of the "American character" and how it has shaped the wide-ranging course of historical events. McDougall explains that Americans have always been in a unique position of enjoying "more opportunity to pursue their ambitions...than any other people in history." Throughout Freedom Just Around the Corner the character of the American people shines, a character built out of freedom to indulge in the whole panoply of human behavior. The genius behind the success of the The United States is founded on the complex, irrepressible American spirit.

A grand narrative rich with new details and insights about colonial and early national history, Freedom Just Around the Corner is the first installment of a trilogy that will eventually bring the story of America up to the present day -- a story as epic, bemusing, and brooding as Bob Dylan's "Jokerman," the ballad that inspires its titles.

All I Did Was Ask

All I Did Was Ask by Terry Gross (Hyperion, $24.95).

A fascinating collection of revealing and entertaining interviews by the award-winning host of National Public Radio's premier interview program Fresh Air.

Over the last twenty years, Terry Gross has interviewed many of our most celebrated writers, actors, musicians, comics, and visual artists. Her show, Fresh Air with Terry Gross, a weekday magazine of contemporary arts and issues produced by WHYY in Philadelphia, is one of National Public Radio's most popular programs. More than four million people tune in to the show, which is broadcast on over 400 NPR stations across the country.

Gross is known for her thoughtful, probing interviewing style. In her trusted company, even the most reticent guest relaxes and opens up. But Gross doesn't shy away from controversy, and her questions can be tough -- too tough, apparently, for Bill O'Reilly, who abruptly terminated his conversation with her. Her interview with Gene Simmons of Kiss, which is included in the book, prompted Entertainment Weekly to name Simmons its male "Crackpot of the Year."

For All I Did Was Ask, Gross has selected more than three dozen of her best interviews -- ones of lasting relevance that are as lively on the page as they were on the air. Each is preceded by a personal introduction in which she reveals why a particular guest was on the show and the thinking behind some of her questions. And in an introductory chapter, the normally self-effacing Gross does something you're unlikely ever to hear her do on Fresh Air -- she discusses her approach to interviewing, revealing a thing or two about herself in the bargain.

The collection focuses on luminaries from the art and entertainment world, including actors, comedians, writers, visual artists, and musicians, such as:

Conan O'Brien
Chris Rock
Michael Caine
Dennis Hopper
Dustin Hoffman
Jodie Foster
John Updike
Mary Karr
Mario Puzo
Nick Hornby
Chuck Close
Eric Clapton
George Clinton
Sonny Rollins
Samuel L. Jackson
Johnny Cash
Isabella Rossellini
Divine
Uta Hagen
Carol Shields

Old Stock

Becoming Old Stock: The Paradox of German-American Identity By Russell A. Kazal (Princeton, $35).

More Americans trace their ancestry to Germany than to any other country. Arguably, German Americans form America's largest ethnic group. Yet they have a remarkably low profile today, reflecting a dramatic, twentieth-century retreat from German-American identity. In this age of multiculturalism, why have German Americans have gone into ethnic eclipse--and where have they ended up? Becoming Old Stock represents the first in-depth exploration of that question. The book describes how German Philadelphians reinvented themselves in the early twentieth century, especially after World War I brought a nationwide anti-German backlash.

Using quantitative methods, oral history, and cultural analysis of written sources, the book explores how, by the 1920s, many middle-class and Lutheran residents had redefined themselves in "old-stock" terms--as "American" in opposition to southeastern European "new immigrants." It also examines working-class and Catholic Germans, who came to share a common identity with other European immigrants, but not with newly arrived black Southerners.

Becoming Old Stock sheds light on the way German Americans used to race, American nationalism, and mass culture to fashion new identities in place of ethnic ones. It is also an important contribution to the growing literature on racial identity among European Americans. In tracing the fate of one of America's largest ethnic groups, Becoming Old Stock challenges historians to rethink the phenomenon of ethnic assimilation and to explore its complex relationship to American pluralism.

Human-Built the world

Human-Built World by Thomas P. Hughes (University of Chicago, $22.50).

To most people, technology has been reduced to computers, consumer goods, and military weapons; we speak of "technological progress" in terms of RAM and CD-ROMs and the flatness of our television screens. In Human-Built World, thankfully, Thomas Hughes, a professor emeritus at Penn, restores to technology the conceptual richness and depth it deserves by chronicling the ideas about technology expressed by influential Western thinkers who not only understood its multifaceted character but who also explored its creative potential.

Hughes draws on an enormous range of literature, art, and architecture to explore what technology has brought to society and culture and to explain how we might begin to develop an "ecotechnology" that works with, not against, ecological systems. From the "Creator" model of development of the sixteenth century to the "big science" of the 1940s and 1950s to the architecture of Frank Gehry, Hughes nimbly charts the myriad ways that technology has been woven into the social and cultural fabric of different eras and the promises and problems it has offered. Thomas Jefferson, for instance, optimistically hoped that technology could be combined with nature to create an Edenic environment; Lewis Mumford, two centuries later, warned of the increasing mechanization of American life.

Such divergent views, Hughes shows, have existed side by side, demonstrating the fundamental the idea that "in its variety, technology is full of contradictions, laden with human folly, saved by occasional benign deeds, and rich with unintended consequences." In Human-Built World, he offers the highly engaging history of these contradictions, follies, and consequences, a history that resurrects technology, rightfully, as more than gadgetry; it is in fact no less than an embodiment of human values.

Three Mile Island

Three Mile Island by J. Samuel Walker (California, $24.95)

Twenty-five years ago, Hollywood released The China Syndrome, featuring Jane Fonda and Michael Douglas as a TVnews crew who witness what appears to be a serious accident at a nuclear power plant. In a spectacular coincidence, on March 28, 1979, less than two weeks after the movie came out, the worst accident in the history of commercial nuclear power in the United States occurred at Three Mile Island. For five days, the citizens of central Pennsylvania and the entire world, amid growing alarm, followed the efforts of authorities to prevent the crippled plant from spewing dangerous quantities of radiation into the environment. This book is the first comprehensive account of the causes, context, and consequences of the Three Mile Island crisis. In gripping prose, J. Samuel Walker, the historian of the U.S. Nuclear Regulatory Commission, captures the high human drama surrounding the accident, sets it in the context of the heated debate over nuclear power in the seventies, and analyzes the social, technical, and political issues it raised. His superb account of those frightening and confusing days will clear up misconceptions held to this day about Three Mile Island.

The heart of Walker's suspenseful narrative is a moment-by-moment account of the accident itself, in which he brings to life the players who dealt with the emergency: the Nuclear Regulatory Commission, the state of Pennsylvania, the White House, and a cast of scientists and reporters. He also looks at the the aftermath of the accident on the surrounding area, including studies of its long-term health effects on the population, providing a fascinating window onto the politics of nuclear power and an authoritative the account of a critical event in recent American history.

Runway America

Runaway America: Benjamin Franklin, Slavery and the American Revolution by David Waldstreicher (Hill & Wang, $25).

Scientist, abolitionist, revolutionary: that is the Benjamin Franklin we know and celebrate. To this description, the talented young historian David Waldstreicher shows we must add runaway, slave master, and empire builder. But Runaway America does much more than revise our image of a beloved founding father. Finding slavery at the center of Franklin's life, Waldstreicher proves it was likewise central to the Revolution, America's founding, and the very notion of freedom we associated with both.

Franklin was the sole Founding Father who was once owned by someone else and was among the few to derive his fortune from slavery. As an indentured servant, Franklin fled his master before his term was complete; as a struggling printer, he built a financial empire selling newspapers that not only advertised the goods of a slave economy (not to mention slaves) but also ran the notices that led to the recapture of runaway servants. Perhaps Waldstreicher's greatest achievement is in showing that this was not an ironic outcome but a calculated one. America's freedom, no less than Franklin's, demanded that others forgo liberty.

Through the life of Franklin, Runaway America provides an original explanation to the paradox of American slavery and freedom.

How to Create Your Own African American Library

African America

by Dorothy L. Ferebee (Ballantine, $13.95).

Here is the first book ever written to help African Americans build a home library that celebrates the diversity of their culture and heritage. How to Create Your Own African American Library truly does unlock the door to knowledge and power.

With warm and expert commentary, experienced book reviewer and avid reader Dorothy Ferebee reviews and recommends books that will help you to build your own home library. Inside you'll discover:

Nonfiction From autobiography to history, including Resistance and Rebellion Against Slavery and the Civil Right Movement.
Fiction: Literature that explores the many facets of the African American life.
Culture and Anthropology Books that will open doors to new insights on the African American experience.
Children's books From picture books to teenage fiction books that empower children and make them proud of who they are.
Health Guides that teach you how to take the very best care of yourself, with attention to health issues that affect African Americans.

Plus books on Travel, Music, Poetry, and Special Collections!

Here's all you need to know to create a mini-university in your own home, one that is open every day to support the highest aspirations of yourself, your children, and their children.

Boardwalk of Dreams

Boardwalk of Dreams by Bryant Simon (Oxford, $35).

No one can deny that casinos have brought money and crowds back to Atlantic City. Since the first casino opened in 1978, gambling corporations have invested six billion dollars in the old resort town and, during the 1990s, more tourists visited Atlantic City than any other place in the United States including Las Vegas and Disneyworld. Perhaps the finest book ever written about Atlantic City, The complete review of this book by a Temple University scholar is available on Amazon.com at the link above.

Wilt

Wilt by Robert Cherry (Triumph, $24.95).

Authoritative, informative, and entertaining, Wilt is the first standard biography about this American legend the unique and unforgettable Wilt Chamberlain. One of the 20th century's greatest and most controversial athletes, Wilt also had an intensely private side that the author uncovers through years of interviews with the people closest to Wilt up until the time of his death in 1999. This groundbreaking work successfully captures Wilt Chamberlain the man, while also closely examining the better-known myths that surrounded him throughout his life.

REFERENCES

Runaway America: Benjamin Franklin, Slavery, and the American Revolution, David Waldstreicher ISBN-13: 978-0809083152

Amazon

REFERENCES

Freedom Just Around the Corner: A New American History: 1585-1828: Walter A. McDougall ISBN-13: 978-0060197896

Amazon

Google Earth Tour of Franklin Locations

On the front page of Philadelphia Reflections is found a button which will download Google Earth, and if you follow instructions on the left column, will give you a satellite tour of every blog let on the site. At least, it will when we get it finished; it's only about half complete at present. If you are unfamiliar with this approach, we suggest you download the Earth program from the Google site and get acquainted by locating your own house, or Independence Hall, or the Vatican.

In addition, every Topic (listed in the left-hand column of the front page of Philadelphia Reflections) will contain a button which generates a tour of the geoTags of that particular Topic, providing there are three or more such tags. You will generally get the best results from tours developed by unknown authors if you turn off ALL of the layers provided in the lower section of the left-hand panel of Google Earth, although you might turn them on, one at a time if you want to enhance the effects. Generally speaking, the route of Interstate 95 seems a little out of place among the local wanderings of Ben Franklin.

Take a satellite tour of nearly
every place Ben Franklin ever visited.

You should also become familiar with KMZ files and KML files. Keyhole markup language gives instructions to Google Earth, allowing authors like Bob Florig to organize tours of a particular subject. KML files are quite large, so they get compressed to make them easier to send over the Internet. Compressed files of KML are designated KMZ, referring to Winzip the decompressor. Other decompressors will often work, too, especially Stuffit for Apple users. The extra step of decompression is a nuisance, and it is possible to have the file do things itself, to become known as a self-extracting file. Self-extracting files are often, but not always, designated as EXE files.

You are here invited to take a tour of every site Benjamin Franklin is known to have visited as if you were an interplanetary alien riding a flying saucer. Double-click the blue link to download a copy of Google Earth if you don't already have one, followed by a self-extracting KMZ file constructed by Bob Florig and used with his kind permission.

There's one other feature you should know about, called overlays. Bob took an 18th Century map of Philadelphia and substituted it for the satellite map of contemporary central Philadelphia. That lets you see Philadelphia as Franklin saw it, and by changing overlays, also allows you to see the little red-brick buildings which remain standing among the skyscrapers. Both he and I are uncertain about the copyright status of the old maps and may have to remove them if the author identifies himself and protests.

Robert Morris and the Lee Brothers

* * *

Morris was a monarchist, announcing he liked the king and did not want to change him. The Lees, one surmises, though they might make pretty good kings, themselves.

But we get far ahead of the story. The immediate mystery is Morris' behavior in July, 1776.

Robert Morris

The dominant feeling during 1775 had been that Americans needed to prepare for war while doing everything possible to avert it. If England prevented both the manufacture and importation of gunpowder in the colonies, there was no way to be prepared for war except to smuggle gunpowder. Not to smuggle it would leave the colonies weak, almost inviting abuse from London. In several elections, before then Morris had been the nominee of both the radicals and the conservatives. The radicals could see he was an energetic, efficient and close-mouthed international shipowner; when a Secret Committee was proposed, he obviously would be an effective member of it. But he was loudly opposed to war with England and was formidable in a debate. The conservatives might have felt he would keep the hotheads on the committee from wandering from or expanding its narrow charge. He explained his dual position as seeking "Constitutional Liberty" rather than independence, but that was shrugged off as just so much blather. It would be twelve years before people did understand what he wanted, and that he was entirely serious about it. That the Lee brothers didn't ever understand, didn't bother Morris at all. That the Lee brothers couldn't comprehend his unwillingness to charge headlong into battle, unarmed and unprepared, was equally mysterious to Morris. The Lee brothers would well have understood Napoleon's remark that victory was 10% based on surprise. But what Napoleon is thought to have said was that victory was 90% based on supplies.

Arthur Lee

The later appointment of Arthur Lee to the Secret Committee can be similarly explained as a counterbalance to Morris. There were no Southerners on the initial committee, so a hothead like Arthur Lee could be counted on to resist the influence of conservative merchants and perhaps Arthur, outnumbered, was even urged to overplay his hand. From the moment he was appointed, he was demanding that Benjamin Franklin be removed from the committee. Not only does this help us understand his disruptive behavior when he later joined Franklin at the Paris negotiations, but such misjudgment of Franklin's patriotism illustrates how extreme Lee's suspicions really were. Since the original motion for independence had been introduced in Congress as the Virginia Resolution by his brother Richard Henry Lee, we sense this family was perpetually anxious to slay dragons. And finally, we can sense the likelihood that Robert Morris and Arthur Lee probably provoked each other.

Richard Henery Lee

To tolerate for the moment the rather extreme Lee brothers, it must be said there was every reason to suppose Morris hoped to enrich himself from gun running. But that is an entirely different accusation with a different defense. The ambivalent behavior of Morris and Dickinson at the Congress is admittedly puzzling, but in the end, defensible and honorable. The accusation of graft and self-dealing was plausible for uncomprehending people but seems legitimate today only because American standards of leadership ethics have gravitated toward the Virginia viewpoint. That viewpoint can be summarized by George Washington refusing to accept a cent for his years of public service. Very few politicians will today tell you this is a practical position, but nevertheless, many Americans wish it could be. Lacking any insight into what Morris was talking about with "Constitutional Liberty", the Lees were perhaps understandably driven to invent plausible explanations. These seldom proved to be fair. Morris certainly had the sympathy of the commercial world at the time for what was to them quite normal behavior. However, the rural population, especially Cavalier Tidewater Virginians, will probably never yield the point.

Morris repeatedly advised his partners he was serving his nation, while of course engaging in private profit. Even using present standards about self-dealing, it must be admitted the need for secrecy at the time necessitated hiding the smuggling within legitimate businesses. Nowadays we throw people out of a public office on suspicion of enriching themselves and throw them into jail on clear proof of it. There is also a curious feature of extreme mindsets, which seems to justify making false accusations. The underlying theory is that behind every great fortune is a great crime, so you might as well hang him for it without further proof. Morris would have been astonished at the thought of taking such risks without hope of restitution: "Do you want me to smuggle this stuff or don't you?" might well have been his answer.

And then there were those two aristocratic Frenchmen, Penet and Pliage, appearing in Providence RI in a boat loaded with gunpowder, looking for George Washington to sell it to. Everyone at the time assumed they were just adventurers, out for the money. After the passage of two centuries, it may be within bounds to ask the French to look into their records to see if maybe P&P were sent here to stir up a little trouble? There proves to be quite a literature about them, linked to that glamorous Renaissance Man, Beaumarchais.

Ben's Little Legacy

Benjamin Franklin and George Washington

ONE of the many compromises of the Constitutional Convention was to allow equal-sized blocs of people to choose their Representatives, but the State Legislatures of any size to appoint two Senators, in a bicameral Congress requiring affirmative votes from both bodies, for action. This was the first step in a separation of powers. After separation came apportionment: every state still got two Senators, but varying numbers of Representative districts would reflect population changes. The effect of this second step was to confer greater Senate power to small states because otherwise, a few states with large populations would probably always dominate the voting. (Shorthand for Constitutional scholars: favoring the House of Representatives means favoring big states.) When Franklin proposed a bargain to give the South time to solve its slavery problem, he needed to maintain balance. The small states were truculent about losing Senate power, so he had to give something else to the big states. The three big states of Massachusetts, Pennsylvania, and Virginia were very mindful that England had primarily targeted Boston, Philadelphia, and Yorktown for attack during the Revolution. Big states are paradoxically more anxious to unify with allies, to gain military strength, because enemy commanders seem to favor them as military objectives. Franklin's proposal was to allow the big states to control tax legislation, through the device of mandating that tax laws must originate in the House of Representatives. He may have known that eight states already had similar laws, but may not have realized such laws were regularly flouted. It's hard to be sure what Franklin knew because although he had once been Speaker of the Pennsylvania House, it was during a time it was a unicameral Legislature.

ARTICLE 1, Section 7. All bills for raising revenue shall originate in the House of Representatives, but the Senate may propose or concur with amendments as on other Bills. {bottom quote}

Washington's Gift to Franklin

Experienced politicians in the Convention snorted with disgust. There were a dozen ways to get around such a provision, and nowadays the traditional one is for the Senate to attach a tax amendment to some bill which had originated in the House. Any House bill will suffice, and thus we have Senate-originated Medicare Amendments attached to House-originated bills whose first page purports to be legislation about highway construction. Medicare, don't you see, is an amendment to Social Security, which itself began as tax legislation. Any politician of standing could see his way through that. And even in 1787, the delegates could immediately think of ways to circumvent this little trick. When Chairman Rutledge of South Carolina returned his report from the Committee on Detail, it included Franklin's gift to the big states. His fellow delegate from South Carolina Charles Pinckney immediately proposed a friendly motion to delete the rule. Edmund Randolph of Virginia however, felt the big states "should at least get what they had been promised", thereby upsetting others who felt Randolph was being indelicate. So George Washington stepped out of the shadows and supported Randolph, his long-term neighbor, and friend in the Virginia caucus. The matter was then referred to the Committee on Postponed Parts. After a decent interval, it was reported out of the second committee and adopted. After all, with Washington and Franklin as supporters, it would be embarrassing not to pass an inconsequential motion.

Paying for the Healthcare of Children

It has been said by others that eventually healthcare will shrink down to paying for the first year of life, and the last one. Right up to that final moment, medical payments must somehow evolve in two opposite directions. We might just as well imagine two complimentary payment systems immediately because the two persisting methodologies could eventually conflict unless planned for. Paying in advance is fundamentally cheaper than paying after the service is rendered because there is no potential for default in payment.

The two methods even result in different aggregate prices; in one case you pay to borrow, while in the other you get paid to loan the money. Dual systems are a fair amount of trouble; remember how long it took gasoline filling stations to adjust to credit cards versus cash. When gas prices eventually got high enough, they just charged everybody a single price, again. This isn't just lower middle-class stubbornness. Dual payment systems slow you down, and profit is generated from repeated rapid transactions. The buyer wants the goods and the seller wants the money. The profit comes from doing exchanges as fast and often as you can manage them.

In a well designed lifetime scheme, with balances successively transferred from one pidgeon-hole to another, it becomes possible to maintain a positive balance for years at a time (thereby reducing final prices, because the income from compound interest keeps rising toward its far end). That was a discovery of the ancient Greeks, but sometimes Benjamin Franklin seems like the only person to have noticed.

The last year of life is more expensive, But the first year of life may cause more financial pain. {bottom quote}

However, In real-life health costs, there is one intractable exception. Because obstetrics can be costly, particularly the high costs of prematurity and congenital abnormalities, the first year of life averages $10,500, or 3% of present total health costs. It, therefore, results in pricing which many young parents cannot afford, in spite of insurance overcharges to catch up later. And thereby a multi-year stretch of interest income is jumbled up, often lost entirely. It gets worse: childhood costs from birth to age 21 average 8% of lifetime healthcare. Please notice: Single-year term insurance premiums always rise to a much higher level than a lifetime, or whole-life, premium costs, because of internal float compounds in whole-life. Modern medicine has also resulted in rising lifetime costs, with only this obstetrical exception. Someone surely would have figured this out, except excessive taxation of corporations created a motive not to notice the effect on tax exempted expenditures.

This problem obviously could be approached by borrowing or subsidizing. Someone might even envision a complicated process of transferring obstetrical costs to the grandparents for thirty-five years, then transferring the costs back to the parent generation. Since we are describing a cradle-to-grave scheme, it seems much better to imagine a single person's costs eventually becoming unified. Grandparents do in fact share continuous protoplasm with grandchildren, but before that was recognized, the courts had decided a new life begins when a baby's ears reach the sunlight. Stare decisis beats biology, almost every time. A society which already has a high divorce rate and plenty of other family upheavals probably feel better suited to the principle of "Every ship on its own bottom." -- except for this financing issue. For childless couples and parentless children, some kind of pooling is possibly more appealing, and the complexities of modern life may eventually lead that way.

In the meantime, lawyers, who see a great deal of human weakness, are probably better suited to suggest a methodology for transferring average birth costs between generations, and back, although a voluntary process seems more flexible. It would seem grandparents are often most likely to be in a position to leave a few thousand dollars to grandchildren in their wills, and age thirty-five to forty seems the time when competing costs are at a lifetime low, making that the best time to pay it back.

Some grandparents are destitute, however, and some parents are basketball stars. There are surely generalizations with many exceptions. The process is happily simplified by a birth rate of 2.1 children per couple, which is also 1:1 at the grandparent/grandchild level and our Society has an unspoken wish to increase the birth rate if it could afford it. For legal default purposes, matrilineal rather than patrilineal descent may be more workable. But -- if every grandparent willed an appropriate amount to some grandchild's account, it would work out (with a small balancing pool), creating a small incentive for the intermediate generation to have more children.

The answer to this dilemma probably lies in revising the estate-resolution process, making HSA-to-HSA transfers largely automatic within families, devising a common law of special exceptions and adjustments, and creating a pooling system for special cases which defy simple-minded equity. A large proportion of grandparents have an indisputable defined obligation, and a large proportion of grandchildren have an indisputable entitlement. The difficult problems reside in the exceptions and require a Court of Equity to decide them. We leave it to others to fill in the details because there could be many ways to accomplish this, and some people have strong preferences. The basics of this situation are the grandparents with surplus funds are likely to die later, but they are still likely to die, close to the age when newborns are appearing on the scene.

When you get down to it, the problem isn't hard if you want to solve it. By arranging lifetime deposits in advance, a large number of grandparents could die with an HSA surplus of appropriate size. A large number of children will be born without a standard-issue family and need the money. After the standard-issue cases have been automatically settled, these outliers can be referred to a Court of Equity charged with doing their best. After a few years of this, the results can be referred back to a Committee of Congress to revise the rules.

A basic fact stands out: most newborn children create a healthcare deficit averaging 8% of $350,000, or $29,000, by the time they reach age 21. Most young parents have difficulty funding so much, and so all lifetime schemes face failure unless something unconventional is done to help it. A dozen more or less legitimate objections can be imagined, but seem worth sacrificing to make lifetime healthcare supportable. The main alternative is to pour enormous sums into the government pool, and then redistribute them. I am uneasy about letting the government get deeply mixed into something so personal. So, speaking as a great-grandfather myself, about all that leaves as a potential source of funds, is grandpa, and even grandpas sometimes have an aversion to long hair and rock music.