The last thing we need to happen to our healthcare system is to limit access to quality care. Already, 1-in-3 physicians are limiting the number of Medicare patients they see, and 1-in-8 physicians are refusing Medicare patients all together. Furthermore, the Affordable Care Act created the Independent Payment Advisory Board to control Medicare cost. This would place 15 bureaucrats, appointed by the president, in a position to control the future of Medicare and is another example of the Federal Government forcing themselves into your health care decisions. .Proponents of value-based healthcare say: .The Social Security Administration is required to withhold in benefits for each you earned above the limit until the year in which you reach full retirement age. The year in which you reach full retirement age, you are allowed to earn more. The amount you may earn is adjusted annually. In 2007 when you retired, it was ,960 (,080 per month) for retirees like you who were under full retirement age. .Prescription Drug Costs .Just how bad is it? We were stunned to learn just how big the disparity in drug prices can be. Recently I compared the highest and lowest prices of the top ten most-prescribed drugs in the U.S. using the Medicare drug plan finder. In my area, a monthly supply of diabetes drug Lantus Solostar for example, ranges from a high of 2.00 from the mail order pharmacy of First Health Part D Value Plus plan to a low of .75 from the network retail pharmacies for SilverScript Choice. In fact, the cost difference between the highest and lowest-cost plans for the ten drugs compared averaged 3 per month! .Premium support by itself is no shoo-in for cutting federal spending. In fact, the track record is pretty messy. The costs for Medicare Part D have been lower than originally projected. Competition between Part D drug plans seems to be working, for now, to keep costs down both for the government and for some seniors — particularly those who carefully shop and compare drug plans each year. ."This increase is due in large part to the effects of a zero and an excessively low cost of living adjustment (COLA) in 2016 and 2017, occurring when Medicare premiums and out-of-pocket costs like prescription drugs were climbing steeply," says Mary Johnson, a Social Security and Medicare policy analyst for The Senior Citizens League. .This week, the Social Security Administration announced the 2019 cost-of-living adjustment, and President Donald Trump signed into law legislation that will result in lower out-of-pocket prescription drug costs at pharmacies. In addition, The Senior Citizens League saw in Congress. .Unlike other types of health insurance, Part D plans do not have a fixed annual out-of-pocket maximum, and you could potentially continue to spend even more than ,100 this year. While that's a huge sum for just prescription drugs, the out-of-pocket threshold "re-sets" and it starts all over again next year. Unless Congress takes action, the out-of-pocket threshold is scheduled to make a steep increase in 2020 to ,250, due to an expiring provision of the 2010 Affordable Care Act.