Philadelphia Reflections

The musings of a physician who has served the community for over six decades

Related Topics

Outlaws: Crime in Philadelphia
Even the criminals, the courts and the prisons of this town have a Philadelphia distinctiveness. The underworld has its own version of history.

Medical Malpractice
The medical system is on the point of abandoning the city to escape abusive lawsuits. A series of observations about shared blame, ultimately assigns responsibility to the mistake of allowing this matter to be covered by insurance, thus creating a financial target.

Philadelphia Medicine
The first hospital, the first medical school, the first medical society, and abundant Civil War casualties, all combined to establish the most important medical center in the country. It's still the second largest industry in the city.

Philadelphia Politics
Originally, politics had to do with the Proprietors, then the immigrants, then the King of England, then the establishment of the nation. Philadelphia first perfected the big-city political machine, which centers on bulk payments from utilities to the boss politician rather than small graft payments to individual office holders. More efficient that way.

Philadelphia Legal Scene
The American legal profession grew up in this town, creating institutions and traditions that set the style for everyone else. Boston, New York and Washington have lots of influential lawyers, but Philadelphia shapes the legal profession.

Philadelphia Economics
economics

Tammany Hall Origins
Is our court system getting better from the top down, or worse from the bottom up?

Corrupt and Contented

In 1904, first in McClure's Magazine and then in the book Shame of the Cities, Lincoln Steffens described the root cause of Philadelphia's bad local politics as failure of the people to turn out to vote.

The Philadelphia machine isn't the best. It isn't sound, and I doubt if it would stand in New York or Chicago. The enduring strength of the typical American political machines is that it is a natural growth -- a sucker, but deep-rooted in the people. The New Yorkers vote for Tammany Hall. The Philadelphians do not vote; they are disfranchised, and their disfranchisement is one anchor of the foundation of the Philadelphia organization."

Just exactly a century later, a Republican member of the Legislature coined a phrase:

"You show me a hundred thousand dollars, and I'll show you a Pennsylvania judge."

Asked to comment, two Democratic politicians on the inside (although one is dead and the other is in Federal prison for embezzlement) replied:

"That isn't precisely so. The precise way of stating it is that, to be elected a judge has two basic requirements. The first is the approval of a local ward leader. The second is the expenditure of between seventy and hundred-thirty-thousand dollars. With these two requirements fulfilled, just about anyone can be elected judge, regardless of legal qualification."

Is it a mystery why we have a malpractice crisis? Other explanations are offered, but this one, the system of "elected" judges, should be examined first. It's a slightly worse system than appointing them. Someday, someone will discover why state courts are much more corrupt than federal ones. Is the court system getting worse from the bottom up? Or getting better from the top down?

Originally published: Friday, June 23, 2006; most-recently modified: Sunday, July 21, 2019