At the hearing, the witnesses explained the intricacies of the prescription drug price-setting process and the drivers of rising costs. Doctor Anderson told the committee members, "Drug pricing is extremely complex … When a company has a monopoly, it sets the price that maximizes its profit and that's not the price that allows all people to get access to the drug." Doctor Howard urged Congress to "create incentives that reward providers who use medicines and technology to deliver care as efficiently as possible, while also empowering patients with the information they need to identify high-quality providers." .Social Security is a promise our country must keep. If you work and pay into the system, you should have the opportunity to retire with dignity and respect. This promise is part of what makes America exceptional — the idea that after a lifetime of work, Americans deserve security in retirement. .The latest report from the Congressional Budget Office says that after passage of recent massive tax and budget legislation, over the next decade the federal deficit is now expected to be .7 trillion higher than estimated in June of 201"To put that in context, that's close to the total amount of money that the federal government would need to cover the reserves held by the Social Security Trust Fund over the next 13 years," Johnson points out. .Have you calculated how much you might need? How much income would be lost if you or your spouse were to pass away? There's a loss of retirement income, particularly when the higher benefit spouse dies. The couple's Social Security benefit is cut by one-third to one-half, and a couple's private pension benefit (if any) is either cut in half, or disappears completely if you have not opted for a joint-and survivor annuity. If you have a large estate, thriving business, valuable real estate and savings, would there be estate taxes to pay? Some families choose to keep life insurance because the death benefits are tax free to heirs, and can give the surviving spouse a financial cushion. .TSCL is concerned that illegal immigrants who gain temporary work permits and Social Security numbers would become permanently eligible for Social Security and Medicare among other federal benefits. Here are several areas of concern: .There are two types of U.S. debt: debt held by the public, like U.S. savings bonds, and debt held by government accounts. The Social Security Trust Fund is the single biggest government account holding U.S. debt, with the federal government owing the Trust Fund about .8 trillion. Since 2010, the program has paid out more in benefits than it receives in cash revenues, requiring the U.S. treasury to borrow to pay the interest due on the non-marketable bonds or I.O.U.s held by the Trust Funds — money that is needed to pay the benefits of current beneficiaries. According to a recent TSCL poll, 95 percent of older voters say that money owed to the Social Security Trust Fund should be repaid in full. .Increasing the payroll tax rate. Social Security is currently financed by a 12.4 percent payroll tax, split evenly between employers and employees. Gradually increasing the tax rate to 14.4 percent – just one percent more for both workers and employers – would extend the solvency of the Social Security program for decades to come and would amount to just an extra 50 cents per week for the average worker. .The Congressional Budget Office recently estimated in their September budget outlook that Medicare outlays for 2020 would rise about 12 percent — roughly double the rate forecast by the Medicare Trustees in their April 2020 report. This suggests that the Medicare Part B premium increase for 2021 could be about .40 per month higher in 2021, rising from 4.60 to 2.00. But even this estimate does not include the impact of cost shifting due to protecting people with low Social Security benefits from reductions due to the high Medicare Part B increase. .TSCL believes the increased use of observation stays is denying Medicare beneficiaries access to medically necessary skilled nursing care. All days spent in a hospital should count toward Medicare's three-day hospital stay requirement. TSCL supports the Improving Access to Medicare Coverage Act (H.R. 1179) introduced by Representatives Joseph Courtney (CT-2) and Tom Latham (IA-3), and (S. 569) introduced by Senators Sherrod Brown, (OH) and Susan Collins (ME). The legislation would deem time an individual spends under observation status eligible towards satisfying Medicare's three-day requirement.