says he s already feeling the, quote, dysfunctional effects of the health care overhaul. dr. marc siegl, member of our medical a team, with me now. good morning to you and thank you for coming back. what do you mean dysfunctional? good morning, bill. already in the doctor s office, one of the biggest concerns i have is that this was not planned in the doctor s office, doctors were not part of the cook that is made this stew and i m concerned about what s going on. bill: you see patients every day. give me an example. you wrote about one, right? the 63-year-old patient. i wrote about many, the 63-year-old patient, somebody that has a nod you ll on his chest x-ray, i ordered a cat scan and it showed there s a nod you ll that i need to follow this, year the insurance company is saying i can t approve that, next year he ll be 65 and have medicare, he was going to get medicare advantage, but i don t think he ll be able to because medicare advantage is being cut by $140 billion. i m worr