Philadelphia Reflections

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

1 Volumes

Chapter Twenty-Five Seventy years of Frankie and The Movie Stars

Chapter Twenty-Five Seventy years of Frankie and The Movie Stars

Making Money (5)


Every newly-rich country seems to experience at least one episode of adolescent giddiness, thinking there is no stopping them, their trees will all grow to the sky. America's comeuppance took place in 1929, Japan's in 1990. Sooner or later the Chinese and the Indians will learn that it is unwise to grow faster than human systems can readjust, overcapacity is certain to appear at some point, and the new bumpkin will then appreciate what it means to have a business cycle. After a variable time, deflation reaches the bottom, and it is past time to inflate back to normal. Lord Keynes (pronounced "Caine's") advised Franklin Roosevelt to promote government spending, even useless spending, but it didn't help as much as they hoped. The Japanese built bridges and tunnels to nowhere, and that didn't help much either, although encouraging residential construction worked better than they expected. Wars are good for deflation, too, but only if you win them.

America has devised three methods for combating deflation: cutting taxes when other nations maintain fixed currencies, cutting consumer prices at the expense of developing countries, and cutting costs by improving productivity. You could combine these three methods into one principle: if you can't increase the amount of money, you must increase virtual spending power by cutting prices. In a deflation, consumer prices have fallen because of overcapacity, so you must cut consumer costs in those areas which will not respond to overcapacity. Same money, more buying power. Other countries are apt to resort to gold as a way of preserving their buying power; it will be an interesting struggle.

Nevertheless, it will be important for America to spend its affluence on increasing productivity rather than trinkets and junkets; we, too, have our share of adolescents. Computers have helped us reduce transactional costs everywhere; transportation is in fair shape. Education is an expensive mess, simply begging for improvement. Housing is still using 19th Century methods. Entertainment is expendable. We have a huge supply of underutilized labor in the black male community, in the early retirees, and in our comfortable work habits. Fighting wars is a pretty expensive hobby. How well we withstand the next world recession will depend to a major degree on how well we solve the problems that obviously need solving.

The business cycle will continue to cycle, but it is possible to feel pretty good about American ingenuity in relating, globalizing and enhancing productivity. There is even a wicked satisfaction in reminding our British cousins of their little witticism which made the rounds after World War II:

In Washington, Lord Halifax
Once whispered across to Lord Keynes:
"It's true that they have big moneybags,
But we have all of the brains."

Democracy Turns Out To Be a Two-Party System

American two-party system

America's two-party system took fifty years to stumble into permanence. Regardless of the happenstances of their eventual emergence, political parties were clearly not designed into the original plan. Those few founding fathers who did think about political parties rejected them as "factionalism", something to be condemned. The true nature and advantages of a two-party system began to be truly venerated when other nations tried something quite different, which we now call Proportional Representation. PR is a fairly natural outgrowth of creating a large democracy from a collection of little tribes -- then creating surrogate political parties for them as part of the design. Guided by historical experience, it is now possible to ignore all minor differences between stable two-party democracy and multi-party democracy, except one. In a two-party system, the political dealing and vote-swapping takes place before the election, with all the players jockeying and sacrificing principle to answer a single candidate question, "Can he win?" By contrast, in a multi-party or proportionally-represented democracy, the election comes first, and only subsequently do vote-swapping and artful promises construct the ticket of candidates and the policy platform. The plain fact is the public doesn't know whom it is voting for and often is disagreeably surprised. Furthermore, important matters remain unsettled by a multi-party election. A cabinet member of a splinter party, potentially one with negligible public support, retains the threat of resigning if things don't go his way, and his resignation may trigger a whole new national election if it breaks up the political margin of the ruling coalition. At least, a two-party system settles things for a while and gives the public a relative rest from factional tensions.

The American system has evolved into a universal conviction, stronger than any Constitution, that two parties are quite enough. Third parties are of course tolerated because they aren't forbidden, but most offer a mechanism in case there is a serious wish to reconstitute one of the two major parties. The strength of third parties is to discipline the leadership of the major parties; the weakness is they threaten the unifying principle of compromise-in-order-to win. Nothing except religious fanaticism would likely induce any ambitious American politician to remain within a third party, fruitlessly frittering away his life's chances. Because of 18th Century history more than wisdom, an "established" religion is constitutionally prohibited in America; observation of the turmoils in other nations, and perhaps wisdom also, keep it that way.

If two parties are then quite enough, is it possible only one would be better? The quickest look abroad, the briefest exposure to history, shows a one-party system is synonymous with dictatorship. Communism and fascism had only this one feature in common; in fact, China seems to be morphing from one to the other, while resolutely retaining its single ruling-party system. The paradox of this situation is that it leads to the American realization that maintaining a two-party system means that neither party must ever achieve total victory. After each national election, the electorate settles back with relief that one side won, but neither side conquered. Even academics are muffled by the system; with much to criticize, there is nothing else worth substituting.

There is one thing left to mention about the two-party system, which is that the interests and affiliations which arouse the club-like loyalties of party members seldom perfectly match the party's current campaign policy issues, and depend in a high degree on habit and a formless sense of group comfort. Any schoolchild can notice, although the party candidates avoid mentioning, that policy issues move back and forth between the two parties. Whether it is tariffs, public schooling, the gold standard or a thousand other matters, the issues repeatedly shift to the other party when lack of progress or apparent betrayal offends them. The special interests seek to use the parties, and the parties regard each special interest as a bargaining chip; the gut feelings of the party membership adjust far more slowly. For maximum effectiveness, a two-party system needs the public to see itself as two warring affinity groups; for a while, polarization seemed to revolve around the rich and the poor. There would always be more poor people than rich ones, as the Founding Fathers feared and the anti-Federalists sought to exploit; but now Populism can only be sustained by continuous massive immigration. The times are growing stale for the Republicans to suggest that only they have an electoral incentive to eliminate poverty, while the Democrats would secretly like to increase it. Or for the Democrats to imply they have a monopoly of sympathy for the poor. Compared with the status of the rest of the world, permanent lifetime poverty in America is growing too infrequent to dominate elections, even supplemented by fear of poverty, a recollection of having once been poor, or guiltiness about never being poor. It is difficult to maintain the firmness of party members with such vague attitudes for abstruse legislative policies like banking reform or compulsory health insurance. Therefore, the search is on for large social affiliations which would more comfortably enlist loyalties for pressing specific legislative actions. At the present time, division of the working populace into the public and private sectors is being promoted as a bedrock political affiliation, but it is questionable whether that will be as successful as the public sector unions seem to hope for. Only twice in our history, during the administrations of George Washington and James Monroe, have Americans overwhelmingly agreed on core issues of religion, foreign policy, and prospects for the future. During both episodes, political parties virtually disappeared.

Let's Give the Supreme Court Some Help


Supreme Court, 2017

all the current wrangling about abortion, it continues to be implicit that the U. S. Supreme Court has a problem, which the Court needs to settle. But in fact, the Court didn't create the whole problem. The Court doesn't need to solve all of it.

First of all, privacy. That word doesn't appear in the Constitution, but surely no one is opposed to making privacy a right. Even

James Madison

James Madison wasn't opposed to the idea so much as he wanted to avoid cluttering the Bill of Rights with unnecessary detail. Unfortunately, circumstances have now changed enough to make it useful to be explicit about a strictly defined right to privacy. Since no one is truly opposed, what harm would there be in passing a bill in both the House and the Senate, and then having the required number of states ratify it? Once both sides got over the suspicion that somebody was trying to put something over on them, it should be possible to design simple clear language that creates and defines the right to privacy -- and avoids the temptation for somebody to insert some sly wording that does in fact put something over on somebody else. At the very least, creating a written right to privacy by following the prescribed path for amendment should dispel the idea that the abortion issue is part of an elaborate effort to undermine the Constitution.

By itself, this hypothetical amendment would seem like a rebuke to

Justice Blackmun

Justice Blackmun and the rest of the Supreme Court. It needs something else added in order to look like a compromise, which it is. So, what's proposed further is a declared presumption that state laws written before 1890 which forbid the performance of abortion were written with the intent of protecting the health of the mother.

That seems to be historical fact. There was a forty-year window of time between the invention of anesthesia, which made abortion easy to do, and Lister's invention of aseptic technique,


which make abortion safe. The anti-abortion crusade, led by the American Medical Association, took place during that window of time. The AMA was alarmed by the medical disasters it was witnessing and urged legal measures to curtail it. When the safety issue was resolved by Pasteur and his followers, the AMA greatly softened its position. It is now surely true that more mothers are protected by abortion than harmed by it. If the courts have a role in untangling this mess, it is to recognize that the original intent of the anti-abortion laws has become lost by ignoring the changed scientific situation.

Well, where would this leave us? It should get privacy out of the issue, by making it clear that the right to privacy in the new amendment is not to be stretched to legitimize

just anything that people want to keep private. Murder, for example, is something everyone might well wish to hide but could hardly be legitimized by a right to privacy. Nor is defecation, which everyone wishes to keep private, to be prohibited just for that reason. Abortion could be constitutionally established as something people have a right to keep private, but abortion -- other than to protect the health of the mother -- is not legitimized or de-legitimized by saying so.

Does teasing out the sophistries then settle the question of abortion? No, but it would reduce the problem to its essence. By the process of teasing away the irrelevance, abortion then becomes a process which is safe, easy to do, and legitimate whenever it protects the health of the mother. Whether to prohibit it when it lacks those features would be a decision for the individual state governments, so long as the threat of public exposure is not used as an enforcement weapon, as every reader of Hawthorne knows it has been.

Perhaps we can even imagine the day when stripped of emotional demons, abortion can be viewed as a rather cumbersome contraceptive method, currently resorted to far more frequently than is sensible.

Dinner With Hoffa

{Jimmy Hoffa}
Jimmy Hoffa

Although she lived for twenty more years, in 1975 my mother was eighty years old. Nevertheless, she did not display the slightest surprise, or hesitation in answering, "Sure", when asked if she would like to have dinner with Jimmy Hoffa. One of her constant pleasures was to be doing things that other women couldn't match.

The Philadelphia County Medical Society's Center City branch was having dinner, and the program chairman had the main goal in life of attracting speakers who would bring an overflow audience. Jimmy Hoffa, the former president of the Teamsters Union, recently released from prison, certainly filled that description; one of the members of the branch had a patient who was a teamster official who happened to know that Jimmy would love to speak to the doctors about medical care in prisons. Not only was he willing, but he also paid his own expenses to fly up from Florida to give the speech. As by far the oldest lady present, my mother was not to be denied when she demanded to be seated at the head table.

Hoffa was indeed a charming person and an able proponent of his cause. He had experienced medical care in a prison, he felt mistreated, and the doctors in the audience were sympathetic to what they suspected was quite true. They generally began that evening with conflicting opinions, because it is generally known that doctors in the prison environment are often threatened, and occasionally harmed. We know quite well how reluctant the Legislature is to spend one cent on a group of people they dislike, and how they all wish the problem would just go away. By the end of the evening, Hoffa held his audience in his hand. No wonder he rose to the top of his organization.

Well, the impact of the evening was certainly heightened, even in my mother's view, by the fact that two weeks later Hoffa just disappeared, and there have been hundreds of books and articles written about his probable grisly murder by the Mafia. The latest is called I Heard You Paint Houses, in which one Frank Sheeran is quoted as claiming, or even boasting, that he had been the hit man. I wouldn't know. The title, however, is reliably known to refer to all the blood which is found splattered about, following a mob rub-out. Calling them wise guys is quite apt.

The reawakening of this topic by the book does raise some other old questions of the highest rank. Reviewing the evidence, it is possible to believe Hoffa was not guilty of precisely what Bobby Kennedy was accusing him of. At least, the prosecution failed to convince one jury of it. The FBI records do seem to indicate that J. Edgar Hoover offered him evidence of the questionable Kennedy private lives, which Hoffa refused to use in his defense in the trial. And there seems to be little doubt that he worked hard to elect Richard Nixon, or that Nixon later commuted his sentence. Generally speaking, he was on the side of the angels concerning Mafia influence in the Teamsters Union. But his strange relationship to Nixon and the Kennedy family is quite another matter, although equally obscure.


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4 Blogs

Making Money (5)
The business cycle has not been repealed. Other countries are likely to drag us into the next world recession, and we had better be thinking ahead.

Democracy Turns Out To Be a Two-Party System
One is too few, four is too many. Third parties may be occasionally useful.

Let's Give the Supreme Court Some Help
It's getting to be time to have an up-or-down vote on the constitutional right to privacy.

Dinner With Hoffa
The author's mother decided she wanted to form her own opinion of the Teamster's Boss, a couple of weeks before he was disappeared.