The medical mess |

The medical mess

My professional take on the current medical mess is: Yikes!

As I write this column, reform is stalled in Congress and many people suspect that it may not be reform at all, but a disguised gift to insurance companies.

I wish I could know the truth here and also tell how each of us will end up a year from now under the new legislation, but I don’t have a clue. Really, even the experts have to guess the probable results. There is no previous model as to how it will all come out. Inventing new ways of health care is not measurable science – it’s more like a mud pit wrestling match.

Now, add to this mud pit a second related mess: As of March 1, Medicare reimbursements to physicians were cut 21 percent, which will mean that more docs won’t take Medicare patients and/or will pare back their practices to reduce the number of Medicared geezers on their roles. Some older people already find it hard to locate physicians who will take Medicare patients: docs say the reimbursement rates are so low, they lose money on older people. Currently one in four older people has trouble finding a primary care doc. Cutting rates will leave more of them out in the cold.

To fix the situation and keep seniors and their doctors from storming the halls of Congress, the House of Representatives passed recent stopgap legislation to delay those cuts, but the Senate went off for the weekend leaving the cuts in place. Meanwhile, back at the ranch – the Center for Medicare Services (where they pass out the Medicare money) – has told contractors to hold up on claims until the Senate also does a short-term fix, presumably within the next two weeks.

But note these are short-term solutions. We need to find a new physician reimbursement formula. On the other hand, we also have to find ways to contain medical costs or we will be in even deeper deficit doo-doo. One thing I am sure about: higher costs do not necessarily mean better medical care. Other countries spend less on care with better results.

Again, yikes! We’ve gone the wrong way here.

But is there a way to steer around these issues?


Each of us should do everything possible to stay out of the illness care system. Get healthy, stay healthy. Think of it as a system by-pass operation.

The fact is effective health care reform starts at home, not in Congress, not in an ER, not in a doctor’s office. If we still smoke, weigh 300 pounds, eat cookies for lunch, sit until our rears grow roots in the chair, then we will end up sick. Imagine diabetes and heart issues for starters. And if we don’t take care of ourselves, we lose all right to blame other taxpayers for not wanting to subsidize our care.

OK, it’s easier said than done, this get-healthy business, this using your own initiative stuff. I find it an everyday struggle against my Inner Slug and its cousin, the Inner Cookie Monster. On the other hand, going forward and depending only on an uncertain health care system to make things right for me seems clueless.

Yes, there are illnesses and accidents that are unavoidable, but we control the preventable medical conditions. Those are the ones we can work on to stay out of the mud pit.

Me, I’m starting my health system bypass today. Vegetable soup for lunch is my opening salvo.

I say it’s better to eat a carrot than to curse the darkness. Or the mud pit.

Mel Walsh is a gerontologist, author and columnist. Her book, “Hot Granny,” is available at The Book Seller in Grass Valley. Visit Mel at

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