Often, the most consequential decisions are those we make only once or twice in a lifetime. But decision – making itself is a skill that takes practice. That means we can get better at it. Even with practice though, it's almost impossible to forecast whether our decisions will work out. Often there are hidden factors at play, influencing our decisions, of which we may not even be aware. Learning about how our minds could be sabotaged, and how we could be nudged in wrong direction, can help us improve our decisions. One of these nudges is called the "anchor effect." .Thus beneficiaries will continue to be hit with steep costs when they fall into the coverage gap in the foreseeable future. To keep prices as low as possible in the doughnut hole, beneficiaries can look into using mail-order pharmacies, which require 90-day prescriptions and are often cheaper per dose than a 30-day supply. People with limited incomes may also qualify for Extra Help or other pharmaceutical assistance programs. TSCL also recommends that Part D beneficiaries talk to their doctors at each visit to discuss potential alternatives to their high-cost prescriptions. .Medicare has three Parts: A (hospital), B (doctors and hospital outpatient) and D (prescription drugs). Each has a deductible and each increases every year. In 2007 the Medicare deductibles (annually) are: .You don't need to be a doctor to understand that Medicare-for-all would mean access to quality health care for none. So, as presidential candidates continue their road trip to ruin for rural America, remember that the hollow promises of a trillion government-run proposal would disproportionately affect the families who work every single day to feed and clothe you and your families. .TSCL has filed three lawsuits under the Freedom of Information Act requesting copies of the agreement and other information and has placed ads in The Washington Times in opposition to the proposed agreement. We will continue to closely monitor the totalization matter. .Your mail order pharmacy may require that your doctor fax the prescription and you will also mail in the original as well as other required forms, your check, or credit or debit card information. Be sure to find out when medications requiring refrigeration are shipped so you can be expecting them. In general, you can order refills after 60 days or so. .Let's consider what the I.O.U.s held by Social Security represent. The I.O.U.s are bookkeeping entries, a lot like entries in checking accounts, but are not represented by real cash sitting in a strong box anywhere. The U.S Treasury collects Social Security payroll taxes from employers. In turn, the U.S. Treasury issues I.O.U.s to the Social Security trust fund. In the meantime, those payroll taxes are immediately used for other federal budget operations. When more payroll taxes were collected than needed to pay benefits, that reduced the amount of borrowing from the public that was needed for the general revenues, and lowered taxes. Now, however, the situation has reversed, and the Treasury must increase borrowing from the public to redeem the I.O.U.s held by the trust fund in order to pay benefits. Increased borrowing, and the cost of interest on the debt, further drives up our federal spending. According to many economists, that can weaken our economy, and our nation's ability to respond to a crisis. .Using statistical data from the Social Security Administration, TSCL estimates about 88 percent of Social Security beneficiaries have received benefits during the 2009 – 2015 period and have been impacted the hardest. "With 64 percent of older Americans depending on Social Security for over half of their income, going without a COLA is a loss of income that most beneficiaries simply can't be expected to bear," Cates says. Spiking medical costs are causing retirees to go into debt, and run through their savings," he adds. .The following Members of Congress, among many others, will be holding town hall meetings in the final days of this week's recess: Sen. Charles Grassley (IA), Rep. Lynn Jenkins (KS-2), Rep. Tom MacArthur (NJ-3), Rep. Mark Pocan (WI-2), Rep. Bruce Westerman (AR-4), Rep. Will Hurd (TX-23), Rep. Suzanne Bonamici (OR-1), Rep. Jim Langevin (RI-2), and Rep. Jim Sensenbrenner (WI-5).