The Institute of Medicine released a report Monday on the health care outlook for the 78 million baby boomers about to begin turning 65. It was not rosy. In short, there aren’t enough specialists in geriatric medicine; insufficient training is available; the specialists that do exist are underpaid; Medicare fails to provide for team care that many elderly patients need.

Medicare may even hinder seniors from getting the best care because of its low reimbursement rates, forcing physicians to cut back on the number of Medicare patients they treat.

And as we have been saying for a while, the health care system is not geared toward managing chronic conditions and is woeful at coordinating care with multiple providers.

Sens. Senators Barbara Boxer, D-Calif. and Susan Collins, R-Maine have introduced a bill to steer caregivers towards geriatric and long-term care roles, and create an advisory panel to analyze this critical sector and make recommendations to tackle its changing needs. The report also urges that all health care workers be trained in basic geriatric care and that schools increase training in the treatment of older patients.

OK, all well and good but let‰Ûªs face it, this will only happen over time and many of these boomers will be well within the throes of managing their health care. Sage advice coming ‰ÛÒ not really. So again what does it come down to? Self-responsibility. Plain and simple. We as a nation have to start taking better care of ourselves. Estimates show that every other boomer will have arthritis. Every third will be obese. Every fourth will have diabetes. Six out of ten will have multiple chronic conditions. Much of this is preventable. And then not only do you have the health problems, you are going to have to pay for more of the care you receive. Prepare yourselves.