PHILADELPHIA REFLECTIONS
Musings of a Philadelphia Physician who has served the community for six decades

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Medical Economics
Some Philadelphia physicians are contributors to current national debates on the financing of medical care.

Favorite Reflections
George Ross Fisher III M.D. In no particular order, here are the author's own favorites. filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler filler

Reminiscences
"The past is never dead. It's not even past." -- William Faulkner, Requiem for a Nun

Clinton Health Plan of 1993 - Part Two
William Penn Pennsylvania HospitalAfter the Clinton Plan was dropped, and then after fifteen years of aftermath, public dissatisfaction with the health financing system is no better, probably worse. Here are some fresh ideas.

Personal Passions
My own personal short list; eight decades in retrospect.

The Hospital That Ate Chicago (1)

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George Ross Fisher M.D III

One evening in 1979 my visiting son, puzzled by health financing, asked me to explain. A decade of asking myself the same question led to the prompt reply that there seemed to be two central problems, both of them man-made. It's axiomatic in our family that man-made problems can have man-made solutions.

I believed you adequately understood health care financing if you understood the price reduction which hospitals give to subscribers of Blue Cross but not to subscribers of their competitors, and if you also understood the income tax dodge which the Federal government gives to salaried, but not to self-employed people who buy health insurance.

He asked how in the world these two subsidies were defended, and I told him. He then asked how these monopoly-inducing subsidies related to other weird quirks of health finance, and I told him that, too. He listened quietly for thirty minutes, and then exclaimed, "Wow. That's really the Hospital that Ate Chicago!"

So he went to bed, while I stayed up and wrote a short fancy for the New England Journal of Medicine, called, "The Hospital That Ate Chicago". Next morning I polished it a little, and sent it off to the editor. Within a few days it was accepted. Six weeks later it was in print.

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Dear Dr. Fisher: I was walking today to our office when a long forgotten book title came to my mind: The hospital that ate Chicago. I remember a particular section of it very well, but could not remember where I had read it. So the re-emergence of the title was a terrific blessing. I had gone to medical school at SUNY Downstate and Kings County was clearly the hospital that ate Brooklyn. A remarkable institution that is too big to fail and should have been closed before World War I. One of your sections or chapters clearly outlined the absurdity of such a hospital. Today, SUNY Downstate is in dire financial straits as KCH continues to frighten medical students away to as far away as possible. I am working on a new paradigm of health care for Brooklyn for the 21st century. I would love to communicate with you since I am grateful for your written down observations which confirmed my own. Bohdan A Oryshkevich
Posted by: Bohdan A Oryshkevich, MD, MPH   |   Apr 11, 2013 4:03 PM
Dear Dr. Fisher: I was walking today to our office when a long forgotten book title came to my mind: The hospital that ate Chicago. I remember a particular section of it very well, but could not remember where I had read it. So the re-emergence of the title was a terrific blessing. I had gone to medical school at SUNY Downstate and Kings County was clearly the hospital that ate Brooklyn. A remarkable institution that is too big to fail and should have been closed before World War I. One of your sections or chapters clearly outlined the absurdity of such a hospital. Today, SUNY Downstate is in dire financial straits as KCH continues to frighten medical students away to as far away as possible. I am working on a new paradigm of health care for Brooklyn for the 21st century. I would love to communicate with you since I am grateful for your written down observations which confirmed my own. Bohdan A Oryshkevich
Posted by: Bohdan A Oryshkevich, MD, MPH   |   Apr 11, 2013 4:03 PM
Dr. Fisher,
It has been awhile but there isn't a week that goes by that I don't reflect on some of your wisdom.
Posted by: Jim Stevenson   |   Feb 13, 2012 8:38 AM
I certainly miss you, Dt. Fisher. You first treated me at the age of appox. 23 and I stayed with you until you retired. I am now 62 and living in south Jersey. I still have issues with my thyroid even though it's been gone since 1978. I truly believe that you and Dr. Leldon Pitt saved my life. God bless you and I think of you fondly, still.
Posted by: Kathleen McLaughlin   |   Jan 13, 2012 9:08 PM

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