Rather than working on bipartisan legislation to solve the rural healthcare crisis, many of my colleagues have instead chosen the fantasy of "free" healthcare for all. In reality, "Medicare-for-all," as they call it – would put more than 1,000 rural U.S. hospitals in 46 states "at high risk of closure" among other devastating consequences, according to experts. .Usually, your doctor's order is necessary. Before you need emergency care, put a plan into place, including someone to help take care of you should you become seriously ill. Often, doctors will order observation care when you are too sick to safely go home from the emergency room. Although this can still occur even with the best-laid plan, you may be able to reduce the length of an observation stay if you have someone who will take care of you once you are released. If you learn that your patient status was changed after your admission as an inpatient you have a right to appeal decisions about healthcare payment, coverage of services and prescription drug coverage. .What We Know and What We are Still Learning .This week, lawmakers returned to Capitol Hill and those in the House passed legislation that will reduce prescription drug costs at pharmacies. In addition, the House Ways and Means Social Security Subcommittee met to discuss information technology within the Social Security program, The Senior Citizens League (TSCL) saw two key bills gain support. .78% Of Older Voters Support Strengthening Social Security By Raising Payroll Taxes .Mandatory programs are those, like Medicare, that are automatically funded every year without passage of annual legislation to pay for them. Congress can, however, waive the PAYGO rules to avoid the payment cuts. .Spousal and survivor strategies also are important. One example is file-and-suspend, which allows a spouse to claim a spousal benefit while the individual defers claiming. Another is "claim now, claim more later," where the high earner in a married couple claims a spousal benefit based on the lower earning spouse's record, while delaying his or her own retired worker benefit. The idea is to generate higher benefits both for the individual as well as higher survivor benefits for widows. .Tests are underway in up to 26 states to move as many as 3 million "dual eligibles" — people who receive both Medicare and Medicaid — into managed-care health plans. .Nevertheless, Congress is considering ways to "redesign" Medicare. The Congressional Budget Office (CBO) estimates that changing the cost-sharing rules for Medicare and restricting Medigap coverage would save the federal government 4 billion over the next ten years.[1] Medicare supplements, better known as Medigap, cover Medicare's deductibles and other out-of-pocket costs. The plans are popular with seniors because they provide financial certainty by reducing unexpected out-of-pocket expenses.