Wrestling With Medicare
I retired twelve years ago at age 67. Not by choice, mind you, but because my employer at the time, the College of Marin (Kentfield, CA), thought it was time for me to go. I was not entirely prepared for this particular transition. All of a sudden I had to thoroughly examine where I was in life, assess my finances, and make some highly consequential decisions.
One of my tasks involved trying to familiarize myself with the Medicare system. I had enrolled at age 65, but I was not relying on it because I was still employed and had a great employer-supplied health plan. Then, there I was: unemployed. I had to get my ducks in a row.
So, okay, the challenge was to figure out Medicare for real. It was not easy. I discovered an astonishingly complicated bureaucracy filled with unfamiliar terminology, competing plans, enrollment periods, coverage rules, and financial consequences. “Fuck. I don’t have time for this” (I thought). Of course, I had to make the time.
To understand the basic choices, I bought the 2014 edition of Medicare For Dummies. For I was truly a dummy. I learned there was Original Medicare, as well as Medigap, prescription-drug coverage, and Medicare Advantage plans. I ultimately went with Medicare Advantage. (These days, 55 percent of eligible Medicare beneficiaries do the same.) The choice offered some welcome familiarity because its premiums, provider networks, copayments, and other mechanics tended to resemble my employer-provided insurance.
I have remained with the same insurer ever since I started. For the most part, I have been satisfied with both the coverage and customer service. But satisfaction does not eliminate the need for vigilance. Every year during open enrollment, I have compared plans, confirmed that my doctors remain in network, reviewed prescription-drug coverage, and calculated the likely overall costs.
This year has been more frustrating than usual, though. I found that some of the Medicare Advantage providers are different than previous years. My plan is changing its name and increasing its monthly premium by 75%. My prescription coverage is also becoming less generous. A couple of generic meds I routinely take are being moved into a more expensive tier, now subject to a $600 annual deductible, something I have never faced before.
In addition, two more issues have arisen. In the last week, my insurer denied coverage for an epidural steroid injection in my spine, a routine procedure I have received before. It also denied reimbursement for my chiropractic visits, even though I have submitted receipts and received reimbursement for approximately the last four years. Today, I spent a stressful hour on the telephone trying to resolve these issues. That hour represents only the latest installment of the time and energy required to obtain benefits I believed were already included.
I pay attention. I read the annual notices of changes. I know how to work through a bureaucracy, and I am not afraid to ask questions or challenge a decision. Even so, this process is fucking exhausting.
This leaves me deeply concerned for other seniors who may struggle to understand complicated documents, make difficult telephone calls, use online comparison tools, or navigate an appeals process. Television commercials constantly remind us to “check our coverage,” as though it were a simple task. In reality, it takes time, confidence, persistence, and often outside help.
I don’t believe that Medicare beneficiaries, or indeed any person, should need to become insurance specialists merely to preserve access to familiar doctors, medications, and treatments. A plan can change its premiums, drug tiers, network, and benefits from one year to the next. Authorization and reimbursement decisions can arrive without warning, leaving the hapless patient to untangle every difference. This can be crazy-making!
What’s an old guy to do? Aging brings enough challenges on its own. Wrestling with Medicare should not be one of them.
Soundtrack Suggestion
You know that old trees just grow stronger
And old rivers grow wilder every day
Old people just grow lonesome
Waiting for someone to say, “Hello in there, hello”
(“Hello in There” — John Prine)
Is This How I Die?
I have walked almost every day for over forty years, including the past twelve on Eugene’s Ruth Bascom Riverbank Path System. I’m now retired and these walks remain essential to both my physical and emotional health, but the path no longer feels as safe as it once did. Several years ago, I began hugging the right side out of fear that a speeding cyclist might run me over. With e-bikes now racing along the same shared space, my concern has become even more urgent and I ask: Is this how I die?
That scenario seems even more plausible after the September 8 report in Lookout Eugene-Springfield about the planned overhaul of PeaceHealth Rides, our local bike-share program. Its operator hopes to replace the current fleet with 400 to 500 new bicycles by spring 2028, likely divided evenly between conventional bicycles and e-bikes. The e-bikes would have maximum speeds between 15 and 20 miles per hour. This could put 200 to 250 city-sanctioned e-bikes into circulation, including in the hands of first-time and inexperienced riders.
But let’s take a step back. Before Eugene embraces any such expansion, we should be clear about what an e-bike is. Oregon recognizes three classes, two of which stop providing electric assistance at 20 miles per hour. Class 3 provides pedal assistance up to 28. Then there are e-motos, powerful electric motorcycles often mistaken for e-bikes. Eugene says a throttle-powered vehicle without usable pedals is not legally an e-bike, even if its maximum speed is 28 miles per hour or less. E-motos are prohibited on Eugene paths, sidewalks, bike lanes and park trails.
On a shared path, Eugene says e-bike riders should travel no faster than 12 miles per hour when other people are present. Twenty miles per hour is allowed only when the rider is alone on the path. Cyclists must yield to walkers, pass on the left and give an audible warning. E-bikes are prohibited on sidewalks, and riders must be at least sixteen years old.
Despite the prevailing rules and laws regarding e-bikes, however, I don’t think concerns about my personal well-being are unreasonable. There are increasing numbers of reports surfacing that e-bikes are responsible for serious injuries to pedestrians. For example, earlier this year an 81-year-old Vietnam vet in Orange County, California, was killed by a 14-year-old driving recklessly on an electric motorcycle.
And then there is well-documented evidence about the negative consequences to e-bike riders themselves. An August 2026 NBC News report found that emergency-room visits involving e-bike and e-scooter injuries among children and teenagers had increased by more than 600 percent in three years. Head and neck injuries were among the most common. A Wisconsin pediatric emergency physician said accidents he once saw only occasionally had become a daily occurrence.
The local figures are equally sobering. As the Register-Guard reported in August, PeaceHealth Sacred Heart Medical Center treated 13 people for e-bike injuries in 2023 and 48 in 2025, an increase of roughly 250 percent. More than half of the injured riders in both years reportedly were not wearing helmets. Doctors are treating broken ribs, fractures, severe head injuries and facial trauma once associated mainly with motorcycles.
I recognize that many riders use e-bikes responsibly and that the technology can replace car trips or make cycling possible for older adults and people who are unable to ride conventional bicycles. A properly managed bike-share program might offer some advantages over privately-owned machines. But before adding hundreds of e-bikes, PeaceHealth Rides and its public partners should explain how they will verify riders’ ages, teach path rules, enforce the 12-mile-per-hour limit and respond when rented machines are used recklessly.
That Lookout report raises an even more alarming red flag. Brodie Hylton, executive director of Cascadia Mobility, said future options might include e-scooters or what he called a “pedalless e-bike.” Under Eugene’s own published definition, however, a throttle-only vehicle without usable pedals is not an e-bike. If officials are considering such vehicles, they must say precisely what they are proposing, where the vehicles could legally be ridden and how they would be kept off prohibited paths. A catchy new label cannot turn an electric motorcycle into a bicycle.
To keep both riders and pedestrians safe, Eugene needs more than a website, signs, educational campaigns and polite reminders. The city needs visible enforcement, including speed monitoring, citations for reckless riding and meaningful consequences for illegal e-moto use. Any PeaceHealth Rides expansion should include enforceable speed controls, clear identification of each vehicle and a system for suspending users who endanger others.
Rules that are not enforced are merely suggestions, and these suggestions offer little real protection to me as I walk beside the river. Eugene should address these issues before spending millions of dollars and placing hundreds of additional electric vehicles on our bike paths. It should not wait for me (or any other innocent bystander) to be killed before deciding that enforcement matters.
Editing Note: After posting a version of this essay on September 7, 2026, the very next day
Lookout Eugene-Springfield reported out on the developments with PeaceHealth Rides.
I subsequently revised the piece, and the final version is what you find above.
Update on September 15, 2026:
This essay, in a slightly-edited form, was published as a Guest Column in the Lookout Eugene-Springfield today.
Soundtrack Suggestion
How could I forget to mention
The bicycle is a good invention
Sitting there in a silent movie
Beside the only girl who really ever knew me
Happy days, but sad I’m facin’
Heaven knows I’m on the case, oh
How could I forget to mention the bicycle?
(“Bicycle Song” — Red Hot Chili Peppers)
Why Do Old Men Stop Trying?
I’m sitting in my usual spot at Starbucks this afternoon, looking at another old guy who is in my line of sight. He is wearing a frayed, ill-fitting, untucked flannel shirt over an untucked T-shirt, along with a pair of baggy jeans. His clothes may be clean (I can’t tell), but nothing fits, nothing coordinates, and nothing suggests that he gave his appearance a moment’s thought before leaving home.
I see versions of him everywhere. Obviously retired, senior-aged men appear at coffee shops, grocery stores, and doctors’ offices dressed as though they are spending Saturday afternoon cleaning the garage. Their hair grows past the point of intention, and their beards occupy some uneasy territory between five-o’clock shadow and pure neglect. Shirts droop, pants sag, and shoes appear to have been selected simply because they were near the door.
Of course, maybe I’m being unfair. I know that old age can make seemingly simple things difficult. From firsthand experience, I know that arthritis complicates buttons and shoelaces, while chronic pain drains energy once available for grooming. Our bodies change, familiar clothes stop fitting, and fixed incomes limit what can be replaced.
Depression and loneliness can also express themselves through one’s appearance. Sometimes a man who looks as though he has stopped caring has, in fact, stopped caring, but not without reason. Still, do those explanations account for all of what I am observing?
I suspect that many retired men simply decide they are finished making an effort. Who, after all, is going to call them out? The workplace once imposed minimum standards, and partnerhood may have supplied him with another person who noticed a stained shirt or suggested a haircut. Once those structures have gone away, some guys apparently decide that appearance no longer matters.
Me? I resist that conclusion. I get a haircut once a month. I shower and shave every day, wear clean clothes that fit, and try to look as though I knew I was going out in public when I got dressed. I even use body lotion in an attempt to smooth over some of my wrinkles.
Occasionally, finding clothes that fit requires more effort than simply taking something off the rack, though. Pants almost never come in precisely my size, so I buy the closest fit and have a seamstress alter them. I wear shorts, but not the voluminous old-guy (John Fetterman) kind that billow around the knees. I wear hoodies, too, provided they come in a size and cut that actually fit. My favorite, which I happen to be wearing today, says “HARVARD LAW (Just Kidding),” so clearly I am not arguing for formality. (My T-shirt, tucked in underneath, says “RESIST.”)
This is not vanity, or at least not entirely. I am not trying to look young, and I have no illusion that a well-fitting shirt or clean hoodie will disguise my age. (I am painfully aware that I am entirely invisible to younger women.) I simply want the clothes I wear to look chosen rather than surrendered to.
I am trying to look like a person who remains engaged with the world. Clothing is communication, even when we insist we are not communicating anything. Making some effort says that I expected to encounter other people today. It indicates that I recognize I am part of a shared environment and have not entirely withdrawn into my own private kingdom.
There may also be a question of dignity involved. Old age takes things from us without asking, including strength, balance, hair, smooth skin, and sometimes memory and the car keys. We cannot prevent every loss. Perhaps attending to my appearance is one small way of declining to decline.
I do not believe old men need expensive wardrobes, fashionable haircuts, or elaborate grooming rituals. A clean shirt that fits would accomplish quite a lot. So would shaving, or maintaining a beard as though one had deliberately chosen it.
The man across the room is entitled to dress however he pleases, and, as judgmental as this sounds, I am entitled to find the result dispiriting. What bothers me is not really his flannel shirt or baggy jeans. It is the possibility that they represent surrender, the idea that once a man retires and grows old, he no longer owes the visible world any sign that he is still participating in it.
This is where I come down: Even now at twelve years into retirement, I am not ready to give in. Tomorrow morning, I will shave, choose clothes that fit, and present myself to the world as someone who is still here. I encourage all you other old guys out there to give this some thought.
Soundtrack Suggestion
When I get older, losing my hair
Many years from now,
Will you still be sending me a valentine,
birthday greetings, bottle of wine?
(“When I’m Sixty Four” — Beatles)
The Weight of Books
I am in the process of getting rid of my book collection, and the experience has brought on a more profound sense of loss than I expected. I am not simply disposing of things I no longer need. As I remove the books from my shelves, I sometimes feel that I am losing pieces of myself.
Not long ago, I wrote about how my world is shrinking: fewer places to go, fewer things to do, fewer miles I can walk. I am even physically shorter. Now I am pondering another kind of shrinking as I continue to reduce the number of possessions I own.
I live in a 1,000-square-foot, two-bedroom upstairs apartment in Eugene, and everything I have, except my car, fits inside it. That was not true when I lived down in Marin County before I retired. In addition to all the things in my apartment, I rented a storage room for stuff I no longer used but was reluctant to discard. One summer, perhaps around 2011, I decided to empty it and lighten my load. I did not finish the project that summer, but I continued working on it during weekends and time off. By the summer of 2014, after many, many trips to Goodwill, the recycling center, and the dump, the storage room was empty. It was then that I moved back to Eugene, bringing only what would fit into my current apartment.
As I approach my eightieth year, I have come to truly appreciate the wisdom of this undertaking. I now practice downsizing as a lifestyle not a project; I try to dispose of one old item for every new one I bring home. This has worked reasonably well, except when it comes to books. I have been a reader and collector for most of my life, although I do not acquire rare books or valuable first editions. Whenever I wanted to read a book, or was just interested in one, I simply bought it. Eventually, it joined the steadily growing number in my bookcases.
As a preteen and teenager, I read a great deal of science fiction. I spent summer days reading indoors while my mother implored me to go outside and play. Most of those early books have disappeared, but I still own a few paperbacks from high school, including the copy of George Orwell’s 1984 that was assigned reading.
As just mentioned, not all my former collections have survived. During my early days in graduate school, I owned what amounted to a rather ambitious chemistry library, but those books also disappeared gradually over many moves. Giving them up was an earlier version of what I am doing now, although I do not remember experiencing quite the same sense of loss.
The books that remained reflect the changing interests and circumstances of my life. They included contemporary novels and biographies; and more books about photography, counseling, psychology, self-help, spirituality, travel, and health; and a collection about Watergate that began with All the President’s Men. My later doctoral work added books on higher education, qualitative research, American Studies, organizational culture, the history and philosophy of science, and epistemology.
Most of the physical weight I have lugged from city to city has been books. I have packed them, hauled them up and down stairs, and transported them from one home to another. For years, I accepted this as a routine part of life. Now I am considering a move into a senior residential community, where I will likely live in a one-bedroom or studio apartment. I cannot take all these books with me, and storing them makes little sense. The practical conclusion is clear, but carrying it out has been painful. I now buy books on Kindle, allowing me to continue reading without refilling the shelves I am trying to empty.
During the past few months, I have disposed of perhaps 300 to 400 books, still less than half my collection. I have sold roughly equal numbers to a local used bookstore and a buyer in Illinois. When I visit the bookstore, I take three banker’s boxes, each containing ten to twelve books. One box is about as much as I can safely carry down my stairs, so I take them down and lift them into and out of my car one at a time. I often have to bring some books back home.
The Illinois buyer has an app that lets me scan the barcodes on newer books and learn immediately whether it will accept them. Many older paperbacks have no barcodes, reminding me how long they have been with me. Each shipping box contains only ten to twelve books because I must carry it downstairs and into the FedEx store. Eventually, in the not too distant future, I will have sold everything anyone is willing to buy. I will have to donate them.
I understand the practical reasons for doing this. By disposing of them, it is my hope that at least some will find their way to new readers. Still, none of that eases my sense of loss. Together, these books form a record of my life: what I was curious about, what I studied, what work I did, what illnesses worried me, and what questions I hoped to answer. Some remind me of who I once was; others, of who I was trying to become.
That is why this feels so different from emptying a storage room. When I gave away unused household objects, I felt I was disposing of mere possessions. When I give away my books, I feel I am severing the physical and emotional attachments to different periods of my life.
For now, I plan to keep two shelves of books, about six linear feet. They are signed by their authors, written by people I know, or connected in some way to the core of my being. My will contains instructions for their eventual donation. I am not saving them forever, only admitting that I am not ready to part with them right now.
Perhaps that is all I can do. I can reduce the collection one manageable box at a time, knowing that every book will eventually leave my possession. (Or perhaps, more accurately, I will leave them.) For now, the only choice left is which pieces of my life I can let go of today and which I need to keep a little longer.
Soundtrack Suggestion
