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On Aging: Getting help for health problems
Branch WEB
Dr. Roger Branch Sr.

"What?" you say. "Another column on health problems? Why?"

Seniors with health problems find that these issues dominate their lives, affecting much more than pain, even finances. But I am not a one-string fiddle. After one more, look for words in this space that "accentuate the positive," to borrow from a Bing Crosby song.

The United States leads the world in knowledge, technology and expertise about health. The issue is a delivery system that makes all parties happy. The elderly as a whole are among those who find it difficult to access these medical wonders.

One problem is age-related ignorance. We do not know how the system operates. We did not do anything wrong. It changed dramatically, but no one explained things. How does this world of third-party payees work? Why does everyone tell people who do not have a computer to do important things on-line? Are seniors who do not know these things somehow "bad" in their own world?

Forget age or mental state. Many people find it hard to make their way through the jungle of forms, rules, procedures and impersonal interactions that are normal in the third-party payee system. Explanations and instructions come in languages that fit the organization. Medicare and Medicaid are no worse than insurance companies or HMOs. Formal systems of all sorts - law, insurance, medicine - generate their own special languages that often are incomprehensible to outsiders. Because the health care delivery system is encased in such organizations, it is no wonder that seniors find it difficult to get the help they need.

This is a reminder from an earlier column: A few physicians do not accept any sort of third-party payment, even insurance. Some will not accept patients on Medicare, and more turn away Medicaid patients. But millions of people have no option; it is Medicaid or nothing. They are not "lazy all their lives" people but small farmers, farm laborers, domestic workers, pastors of small churches - the list is very long. If for some reason they did not catch the Social Security train - and many did not - they do not qualify for Medicare.

Another hurdle for seniors with health problems is mobility. Some do not have an automobile. Some never drove. Some once drove but do not now because they cannot see, are physically handicapped, can no longer get a driver's license. Many get along well as drivers in familiar places but will not try to negotiate city streets to see specialists. The small towns and small cities of southern Georgia do not have public transportation. Some have taxis, but these are not designed for handicapped people: "How can I climb down into this thing?" "Driver, can you help me get out of my wheelchair and into the car, and where will you put it until we can get there?"

Of course, many elders have family or friends to help them. Still, others do not, and we do not know how many because some never get anywhere to get counted.

The mobility problem is most acute in small towns and rural areas. Real people live miles north of Portal and down by Black Creek, far from the nearest physician or hospital. Even if they have adequate transportation and can drive, there is a good chance they will have to travel on dirt roads part of the way. The same is true of surrounding counties. A medical emergency requiring immediate help can be a death sentence or guarantee bad results from a stroke or heart attack. In passing, note that hospitals in smaller towns - the best hope and preferred place for treatment for rural people - are in economic jeopardy. Some will close soon or be absorbed by major for-profit systems.

It is also difficult for many seniors to access things that help them cope with health problems or ward them off entirely. Walking is great exercise - inexpensive and helps the whole body. But Statesboro has some terrible sidewalks, and in many places, none at all. It does have some nice walking trails, but most folks have to ride to get to them. That means drive or be driven; no car, no trail walk. And no senior should walk any of them alone, because a fall or other misadventure could be serious. Mill Creek Park is a wonder - an out-of-town wonder that some Statesboro seniors have never even seen. The pool there is great, including some features to aid the handicapped, great for those who can get there.

A recent Time magazine story reported on a study that concluded that seniors who exercise do better mentally. Sharp minds were associated with active bodies. The catch-it had to be vigorous exercise. Why do I suddenly think of fitness centers? In any case, this finding brings no comfort to those who cannot exercise vigorously for reasons too many to list. They cannot access this mind-saving activity.

The next column is about a coming crisis in health care for the entire nation and how it will affect seniors in a scramble for care and finance.

Roger G. Branch Sr. is professor emeritus of sociology at Georgia Southern University and is a retired pastor.



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