"Whatever the reason, most Americans before they retire have paid little attention to the huge life transition that is coming. We don't have a good idea of how much we need to save for retirement," writes Mark Miller, journalist and author who writes about trends in retirement and aging. Mark, the author of The Hard Times Guide to Retirement Security: Practical Strategies for Money, Work and Living (John Wiley & Sons/Bloomberg Press, 2010) shares a few important tips with our readers. .Finally, one new cosponsor – Rep. Ted Yoho (FL-3) – signed on to the Social Security Fairness Act (H.R. 1795), bringing the total up to one hundred and seventeen. If signed into law, the bill would repeal the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP) – two federal provisions that unfairly reduce the earned Social Security benefits of millions of state and local government employees each year. .Healthcare would be more efficient and convenient for patients. Value-based payment systems provide incentives for health providers to make it easy for patients to get all the services related to managing their condition in one "medical home." Payments to providers are "bundled," covering the patients' full care cycle, or for chronic conditions covering longer periods of time like a year or more. .These laws affect state or local government workers in twenty-six states and teachers in fifteen states, because their employers do not withhold Social Security taxes from their salaries. The GPO affects public servants who are entitled to Social Security spousal or survivors benefits based on the work history of a husband or wife. Often, the benefits to which they are entitled are eliminated altogether. The WEP affects those public servants who have earned pensions from their state or local government, but have also paid into Social Security through previous employment. Their earned Social Security benefits are often unfairly reduced by one-half or more. .Rural Americans who face unique challenges would also experience unique struggles under a one-size-fits-all healthcare plan. For years, the farmers, ranchers, and everyone living in our nation's breadbasket have endured inequitable access to quality care and medical services compared to their urban and suburban counterparts. .The other big variable in health care is insuring against the risk of a big tab for long-term care. This is an area where we just don't have very good options right now. The market for private long-term care insurance doesn't function very well -- the cost of coverage has been soaring, and the number of insurance companies in the market has been shrinking. Medicaid is the country's biggest payer for nursing home bills, but you need to spend down to poverty levels to qualify and most often your care choices are limited. The other options are "self-insuring" paying out of pocket if you're very affluent, or if like many older senior Americans, you rely on family members for help. . Check to see if Eliquis is covered by your drug plan and the cost sharing for the tier in which it is listed. Many drug plans have five tiers covering preferred generics, generics, preferred brands, non-preferred brands and specialty drugs. Check to see where Eliquis fits in on these tiers (probably preferred or non-preferred brand). It's not uncommon for insurers to move a drug from preferred brand to non-preferred brand status, causing you to pay more out-of-pocket. For example, your plan in 2019 may have charged a co-pay of for preferred brands, but if Eliquis was moved into a non-preferred tier in 2020 you might have to pay 50% co-insurance or about 5.00. .Since people often move when they retire, under locality pay adjustment rates, the area they choose to live in during retirement could significantly impact the amount of Social Security they receive. Would retirees crowd into areas of the country with high locality pay adjustments? .We may not all agree on ways to reform the system, but at the very least it is time for our colleagues on the other side of the aisle to wake up and admit that we can't continue to defend the status quo. These new reports from the Medicare trustees make that much perfectly clear.