As our nation goes through the process of getting vaccinated for COVID-19 and getting our lives back on track, TSCL is working on a number of long-term issues that await Congressional attention. We expect policy makers in Congress will be turning their attention to the question of boosting benefits and restoring the long-term solvency of the Medicare and Social Security Trust Funds. .Last year a premium support plan that passed in the House prompted a firestorm of opposition from seniors and critics concerned that the plan cut federal spending too much — shifting too great a portion of costs -- and would make Medicare unaffordable for beneficiaries. But premium support itself is nothing new, nor would it "end Medicare as we know it." To the contrary, seniors already know it, and like it. Medicare operates two premium support programs — Medicare Part D, and Medicare Advantage. .The Post story said that labs struggled to ramp up coronavirus testing, and hospitals and nursing homes ran short of personal protective equipment over the spring. These failures hampered the national and state responses to the pandemic, leaving the United States with far more infections and deaths than any other country. Even now, shortages of protective medical gear are looming as outbreaks grow in the South. One big reason is because these supplies often come from other countries, which were also dealing with outbreaks. .To date, no government agency has released any complete estimate of the potential cost of illegal earnings to the Social Security Trust Fund. The best indication of the potential cost is contained in the Social Security Administration's "earnings suspense file" (ESF). .The Neal bill was passed by the Ways and Means Committee on Wednesday of this week. It would ban surprise billing using an arbitration process favored by hospitals and specialty physician groups but opposed by insurers, employers and labor unions. Neal's legislation would send all the disputes that can't be settled between the parties to arbitration but require mediators to consider median contracted rates used by health plans, with the mediators prohibited from considering "usual and customary charges," also known as "billed charges." .Get an annual check up. Case in point: I recently helped a senior who hadn't seen a doctor in years, despite being a smoker. It took some urging, but she finally got a physical. She was shocked to learn that her blood pressure was high — dangerously so — and wound up driving straight to the pharmacy with a prescription for blood pressure medication. Visits to the doctor are far less expensive when you get there under your own steam rather than via an ambulance gurney. Starting this year, Medicare covers a yearly annual "wellness" exam and you pay nothing, if your doctor "accepts assignment" or the amount Medicare pays for the service. Do this before I have to nag you, too. .Co-pays and coinsurance: This refers to the portion of the cost of services that you pay out-of-pocket. Co-pays are a fixed amount that you will pay for each service. For example, in a Medicare Advantage plan, you may be billed a co-pay of to see a primary care physician and to see a specialist. On the other hand, coinsurance is a variable amount. It is a percentage of the cost of the service. Theoretically if the total cost of the service is ,000 and you pay 20% coinsurance, your cost could be about 0. Under Medicare Advantage your health plan negotiates the cost of service, thus you would want to call your plan to get an idea what your total out-of-pocket costs would be, and whether your provider is a preferred provider. Under most Medigap policies, the Part B co-insurance cost is covered in large part, but there still could be some "excess charges" that you pay out of pocket. .This week, the Social Security Fairness Act (H.R.1205, S.915) gained one new cosponsor in Congressman Steve Stivers (OH-15), bringing the new cosponsor total up to 16In the Senate, the bill gained six new cosponsors in Senator Bill Nelson (FL), Senator Sheldon Whitehouse (RI), Senator Elizabeth Warren (MA), Senator Mazie Hirono (HI), Senator Jack Reed (RI), and Senator Patrick Leahy (VT). If signed into law, the Social Security Fairness Act would repeal the Government Pension Offset (GPO) and Windfall Elimination Provision (WEP) – two Social Security provisions that unfairly reduce the earned benefits of millions of public employees each year. .The Social Security cost-of-living adjustment (COLA) is provided to protect the buying power of Social Security benefits from rising prices. Yet for almost a decade, retirees have had to manage their household budgets despite COLAs that have been at unprecedented lows. During this period, typical retiree costs have continued to rise several times faster than overall inflation and, consequently, Social Security benefits have lost one-third of their buying power since 2000.