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November Is National Diabetes Month – This Year We Need to Pay Attention

November is diabetes month, and the COVID-19 pandemic should encourage us to pay attention . . . our lives may depend on it!

In 2019 there were over 48 million Americans 65 or older. Of that population around 28% had diabetes or prediabetes. Just think about it — when you get together with your friends (back when there wasn’t a pandemic and you could get together), almost 3 out of 10 people in the room had diabetes or prediabetes. That’s a lot of your friends, it may even be you. As with most diseases early detection is key to maintaining an active lifestyle and avoiding complications. There are 34 million people in America with diabetes and 1 in 5 of the 34 million are unaware they have it. The bottom line is there are a lot of older Americans with diabetes and the preliminary data indicates that people with diabetes are much more likely to have complications if they catch COVID-19.

So, either you or, most likely, someone you care for or know has diabetes. The question is, what can you do? If we’ve heard it once we’ve heard it a hundred times — wear a mask, social distance, and stay away from large groups indoors. Those are the added steps over and above what we should be doing as diabetics. In fact, some of the COVID-19 restrictions may make it harder for a diabetic to stay healthy. For instance, the CDC highlights the 3 common mistakes diabetics make in controlling their disease.

  1. Not testing enough – Each individual is different. Their testing regime is designed for them and the intervals are important. Testing is critical.
  2. Not moving enough – Here is where the pandemic could cause problems. Self-isolating is a great way to avoid getting the COVID-19 virus. It’s also a great way to turn into couch potatoes. Here’s my catch phrase, find a way to isolate and invigorate. Get up and move, exercise, walking outside is OK and the fresh air will help. Find a way to move every day.
  3. Not checking up – You may think that everything is going well with your diabetes and you don’t need to keep your regular appointment with your doctor, especially with the virus running rampant. Don’t skip your appointment. Follow all of the safety rules but go to the doctor. It’s your best defense against problems.

There’s another important step you can take to keep you healthy, get your flu shot. Now’s the time, if you haven’t had your shot yet, get it this week. This link takes you to a great article on flu and people with diabetes. A couple of important things from the article, for those of us over 50, we should get the shot rather than the nasal spray vaccine. Also, when you go to get your flu shot see if you’re up-to-date on your pneumonia vaccination. Both the flu and pneumonia can be devastating for diabetics or people with prediabetes and is really harmful for those that don’t even know they have diabetes.

This year especially, if you have diabetes, you need to pay attention to the effects the pandemic, flu and pneumonia can have on you. If you are a caregiver to someone with diabetes, or have a friend or loved one with the disease, help them understand how important it is this year to pay attention to your doctor’s directions and observe the recommendations concerning the COVID-19 pandemic. It truly can be a matter of life or death.

Finally, today we will select who will be our President for the next 4 years. I hope you voted. It is the loudest and most effective way seniors can speak out. There are, however, other more frequent ways we can speak out about how we feel on issues that affect us. We only vote for federal offices every two years but we can advocate and speak out as many times as necessary to let those in Washington know how we feel. Just recently, in the diabetes arena, the price of insulin was reduced for many who suffered from diabetes. I feel that our representatives heard loud and clear about how we felt about insulin prices and it had an effect. I urge you to vote and then to stay involved, it’s the only way we can have a say in how our healthcare is administered.

So, pay attention, follow the suggestions on staying healthy with diabetes, including following the guidelines concerning the pandemic and getting your flu and pneumonia vaccinations. And finally, stay involved — you really can make a difference.

Stay healthy, Thair

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Vote – But Be Safe

You’re probably sick of hearing people say – Don’t forget to vote! I’ve joined that chorus in encouraging you to vote in almost all of my recent blogs. It is a fact that a higher percentage of older Americans vote than any other age group. Given that statistic it makes us a powerful voting bloc, even more reason to make our voices heard.

I know many of the reasons that people don’t vote, I’ll list some of them here and include my rebuttal:

  • My state always goes to the Democrats or the Republicans, so my vote doesn’t make a difference.
    1) The percentage of the vote that the dominant party gets makes a difference. You hear all the time about how many percentage points a candidate won by in a previous election. That percentage means something.
    2) What about all those state and local races, amendments, propositions, bonds, etc. that are on your ballot? Those races and changes may have more impact on you personally than the national elections.
  • I don’t feel like I know all I should about the issues to make an educated vote.
    1) There are non-partisan web sites and educational information available that helps you understand where the candidates stand and the estimated impact of the different propositions, etc.
    2) Talk with someone who you trust and who has the same beliefs and political stance as you and ask them how they are voting and why.
  • I’m not sure if I’m registered, or where to vote, or how to vote without going to the actual polls.
    1) have a great link that will answer the questions above. It’s a New York Times link that covers every state, since each state often has different rules. Click here to make sure you’re registered or, if you’re not registered, how you still can register, the different methods you can use to vote and where, depending on your address, the nearest polling and ballot drop boxes are located.

The last reason that people may not vote this year is the COVID-19 pandemic. It is a valid fear, given the spike in the number of people testing positive for the virus. I’ve got some advice on how to stay safe while exercising one of the greatest freedoms we have.

The safest way is to vote without leaving your house. Most states have already mailed ballots out that can be filled out and mailed. Mail them early just to make sure they arrive in time. There’s been a lot of political posturing about the Post Office being overwhelmed or delaying the delivery of your mail. Don’t let it keep you from mailing in your ballot, the Postal Service says it can handle the expected volume.

The next safest approach is to drop your ballot into one of the ballot collection stations. The link above will give the location of those stations. It is easy and reduces the number of hands that your ballot passes through before it gets counted.

If you go to vote on November 3rd there are some steps you can take to keep you safe. First wear a mask . . . not under your chin, not under your nose. Wear a mask that covers your nose and mouth and seals around your face. Multiple layers and N95 materials make the most efficient masks. When you go to the polls:

  • go at off-peak times, like midmorning.
  • monitor the voter line from your car and join when the line is short.
  • fill out any needed registration forms ahead of time.
  • review a sample ballot at home to cut down on time spent at the polling location.
  • take your own black ink pen, or stylus to use on touchscreen voting machines.

Many have said this may be the most important election for decades. I think our founding fathers would say that every election is the most important. It seems like lately there are a lot of things that are out of our control, the pandemic, the negative divisive tone of our politicians, the magnifying of our differences rather than the unity of our common hopes and dreams. Voicing our personal opinions by voting is something we can control, it’s a way we can participate and become involved.

So, for probably not the last time you’ll hear it, be sure and vote. Hopefully, I’ve suggested some tools that will help you to vote efficiently and, most importantly, safely.

Best, Thair

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Bone and Joint Action Week

We all have bones and joints but most of us didn’t pay much attention to them when we were young, we might sprain an ankle or wrench a knee, but it didn’t keep us down too long. Well . . . it’s different now, most of us have joint aches and a lot of us have different degrees of arthritis. As many of you already know these types of aches and pains can have a big effect on our quality of life. Bone and Joint Action week, was last week, October 12th to October 20th. This special week’s goal is to raise the awareness of how bone and joint problems affect a huge number of us and highlights the need for more research and focus on this area of our health.

We’re living longer and that brings these types of bone and joint conditions into play at a steadily increasing rate. Did you know that 54% of Americans over 18 have musculoskeletal (bone and joint) conditions and a 33% went to the doctor or hospital to be treated? There has been an almost 20% increase in the last 10 years in these types of conditions. These bone and joint conditions effect a lot of people and cost our healthcare system a lot (to say nothing about the out-of-pocket costs we pay)  and yet these musculoskeletal conditions make up only 2% of the research budget of the National Institute of Health, and it’s shrinking! This action week is a great way to shine a much-needed light on these conditions that affect so many of us.

There are a number of special days in the Bone and Joint action week, I would like to focus on two of these days, October 12th, World Arthritis Day and October 20th, World Osteoporosis Day.

World Arthritis Day – One of the resources offered during this day is The United States Bone and Joint Initiative (USBJI). They provide Experts in Arthritis, an educational program for people with arthritis. There are sessions by rheumatologist, physical therapists, orthopedic surgeons, nurses, and occupational therapists, offering information and help for both the patient and the caregiver. Another resource is, which offers videos with tips on how patients can control their arthritis.

World Osteoporosis Day – This day, with the theme “That’s Osteoporosis,” will seek to improve the understanding of osteoporosis and its outcome, with the focus on the link between osteoporosis and broken bones and the human and socio-economic costs of fractures. They encourage the public to check their personal risk for osteoporosis through the use of the new IOF Osteoporosis Risk Check. You can learn more at

The other special days in the Bone and Joint Action Week are, October 15th, World Spine Day, October 17th, World Trauma Day and October 19th, World Pediatric Bone and Joint (PB&J) Day.

I have one other piece of advice that I feel is important. I’ve been part of panels, listened to presentations and conferences and moderated panels on numerous healthcare subjects and the pain that results from different diseases. Through all of these different forums I have noticed a common piece of advice that has almost always been offered – – – keep a journal of your symptoms and pain. When we get old our memory isn’t as good as it once was. Write down things like, when did a symptom present itself, in the morning or the evening? Was it after a good night’s sleep or a poor one? When the pain got worse what was I doing, was it better or worse than the last time the pain hit? Etc., Etc. These are the things that we can bring to our doctor, information that can help in our diagnosis. It is a powerful tool we can bring to bear as we seek to be our own best advocate.

I have seen the impact of arthritis on my wife’s mother and grandmother as they were forced to give up their lifelong passion of quilting and needlepoint due to the ravages of arthritis. We’ve all seen the impact of osteoporosis as older people fall and break their hips with often life taking results. When so many of us are impacted by these diseases why is so little research being funded? Let’s be active advocates, both of our own health and the health of our loved ones, by encouraging our government to focus on bone and joint health, something that would help a large number of older Americans.

Stay healthy and safe, Thair

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Medicare Open Enrollment – Important Options to Consider

Medicare open enrollment time is fast approaching, it starts on October 15th and goes through December 7th. This year especially, we should make sure we are prepared to make smart decisions concerning our healthcare. It can make a difference in our access to the care and how much we pay for that care.

First, some background – we really have two choices in selecting our healthcare –  standard Medicare and Medicare Advantage (MA). Standard Medicare is based on the old fee for service model. People often add supplemental insurance to standard Medicare to reduce or eliminate out-of-pocket costs. The MA model is based on the insurance company getting one fee for each Medicare enrollee, which encourages the insurance company to emphasize preventative care and offer programs to keep us healthy. With MA there are often no premiums and there are often more benefits, such as prescription drug coverage, dental, hearing and health clubs, etc. The tradeoff is higher out-of-pocket (OOP) costs for many services and some limits on choices of doctors. If your situation enables you to take advantage of the added benefits that MA offers and the doctors you use are part of the MA network, then MA may be a good choice for you. I changed from standard Medicare to Medicare Advantage last year and found that I saved money, even with a battery of tests I had done.

Part D, the prescription drug program, is another place where careful consideration can be very beneficial. Part D is often included in a MA plan but you should pay special attention to your choice of your Part D provider no matter which Medicare plan you choose.

While I can’t tell you which type of Medicare you should choose, I can give you some things to consider as you get ready for open enrollment. They are, in no particular order:

  • While historically less than 10% of us change our Medicare plans, statistics show that the average person can save $300 or more when they review their coverage.
  • Your options for Medicare plans have increased 20%. You will have an average of 47 different health plans to choose from.
  • There are two main areas to consider when you are evaluating different plans, can I get easy access to the care and products I need and what will my OOP costs be? For Part D, for instance, you first need to make sure the plan you are considering offers the medicine you take and then determine what it will cost.
  • Evaluate how your current plan did, were you happy?
  • Your insurance companies are required to send you an explanation of any coverage changes that will affect your plan. These changes can have a big impact on next year’s access and cost. They may have dropped your doctor or the medicine you take, they may have increased OOP costs.
  • Research if you qualify for Medicare assistance under the Social Security Disability Insurance (SSDI) benefit or the Patient Assistance Program.
  • Pay attention to the Medicare Star ratings on Part D and MA plans.
  • If you plan on traveling next year, especially if it’s out of the U.S., review what your plan will cover when you are traveling.
  • Research what your maximum yearly OOP maximums will be. For MA plans the maximum OOP costs for 2020 was $6,700, some plans are less.
  • It is often to your benefit to get a separate Part D plan than your spouse. Your medicines may be available and cost less under a different plan than your spouse’s.
  • There are situations when you can change or apply for Medicare outside of the open enrollment period:
    • Loss of health coverage: The loss of a job or qualification for Medicare or Medicaid services, or aging out of your parents’ plan.
    • Changes in household: A birth, adoption, death, marriage, or divorce in the family.
    • Changes in residence: Moving to a new region outside of your current insurer’s coverage.
    • Other qualifying events: Becoming a U.S. citizen, leaving incarceration, joining or leaving the AmeriCorps.

These are a few things to consider as you evaluate your coverage. You do have places you can go to get help with choosing your coverage. Here are four great places to get help:

1.Contact your local SHIP office.

The State Health Insurance Assistance Programs (SHIPs) give free, in depth, one-on-one insurance counseling and help. A SHIP counselor, who understands Medicare and Medicaid can guide you to smart options for your personal situation. You can trust them because SHIPs are government programs funded by the federal U.S. Department of Health and Human Services. Find your state’s SHIP office .Contact your local Area Agency on Aging. The local Area Agency on Aging has programs that help with Medicare Open Enrollment. Find your local Area Agency on Aging

2.Use Medicare’s online plan finder.
Medicare has an online plan finder and comparison tool. Answer a few quick questions and the tool will show available plan options for 2021.

3.Use Medicare’s online plan finder. There’s a separate place to find supplemental insurance: Medigap Policy plan finder

4.Call 1-800-MEDICARE (1-800-633-4227).
You could also call the Medicare office and ask a representative to run a search for plan options and mail you the results. This takes extra time, so call ASAP if you want to use this method.

I hope this helps you as you consider your healthcare options during this open enrollment period.

Don’t forget to register to vote!

Stay healthy, Thair

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A Questionable Way to Change Medicare

With so many significant changes to the Medicare program being discussed right now, I thought it would be a good idea to take a step back and examine the way changes in Medicare policy get made. It would be good to understand, for example, what tools are used to make it possible for any president’s administration to unilaterally change the program.

As you know, there is a defined process that allows our government to spend money and to change programs that have been legislated into law. A tool that presidents are using more frequently to get around these conventional processes involves the Center for Medicare and Medicaid Innovation (CMMI).

CMMI was created within the Affordable Care Act (Obamacare) as a testing ground for new ways to implement and pay for healthcare in our country. It was a great idea, have providers or payers or academia propose new ways to increase the efficiency and lower the cost of healthcare. Let them get a small number of representative healthcare providers signed up and test a new concept outside of current regulations and restrictions. If there is a positive result from the small test, then the changes to the existing laws can be proposed and the normal legislative processes are followed to implement the changes. What a great idea, test ideas to find the best way to administer healthcare before you change the existing laws. Unfortunately, this great idea began to be used instead as a way to circumvent the usual process and change Medicare policy, by both the Obama and the Trump administrations.

This misuse began with the administration proposing ideas directly to the CMMI that were so large in scale they were similar to an actual policy change. These proposed tests were not limited; they were designed to include virtually all the providers in America. And the test mandated participation, no provider could opt out. There is no legislative input and no judicial review. This is not how the CMMI has usually done business, it ignores the checks and balances that historically have been part of the CMMI process. Whether you believe the changes proposed by a president are good or not, this is not the way we should be changing programs that have been voted into law by the legislative process.

Misusing designed testing programs is not limited to the CMMI. The $200 card that the President proposed to send to 33 million Medicare beneficiaries to help pay for prescription drugs uses a program in the Social Security Act that allows Medicare to test out new money saving programs. These tests are usually proposed by state governments, Congress or the private sector and go through a rigorous, methodical approval process. Again, it isn’t for implementing a payment to 33 million Americans within a few weeks. This program is primarily for saving money so it must be at least budget neutral. The proposed source of funds to offset the cost of this $6.6 billion program is the savings from the “most favored nation” Executive Order, a program that hasn’t been implemented and any proposed savings are suspect. This onetime payment does nothing to lower the long-term costs of our healthcare. A yearly cap on the out-of-pocket payments on Medicare Part D would be a much more effective long-term solution to those who really need help with the tens of thousands they pay each year for their prescription drugs.

Somehow, we must put safeguards around these various testing programs. They should be transparent, have continued congressional oversight, have clear goals and published updates, be available to testify at congressional hearings, and have committee hearings before a rule is finalized. Unilaterally changing Medicare is not the way we should be operating. The checks and balances inherent in our government have worked for over 200 years. As you communicate with those who represent you, either directly or through your vote, remember how important it is to make sure that any changes to Medicare go through the same approval process that brought us this great benefit.

Get your flu shot and stay healthy, Thair

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The President Releases a Hurtful and Ill-timed Executive Order

As we all feared the President released an Executive Order (EO) last week that imports foreign drug pricing, an ill-advised and shortsighted method to lower drug costs. This EO is even worse than the proposed order that was released in July in that it also includes Medicare Part D drugs. It expanded from targeting drugs administered at the hospital or doctor’s office to those Part D prescriptions you get at your local pharmacy. This is a dangerous escalation.

This EO uses the term favored nation as a way to identify the foreign nations used for setting American drug prices. What it really does is import the socialistic, government dictated, access-controlled, pricing schemes of these so called “favored nations”, nations we have historically condemned for these very practices. I have said it before and will say it again, price controls don’t work, no matter what foreign country we seek to emulate.

It amazes me that the President has decided to release this innovation-limiting EO at the very time that we need all the innovation we can get to battle the COVID-19 pandemic. Even worse, it will depress innovation long term, meaning the new cures and vaccines we will need for the next pandemic-causing virus may not be available when we need them.

I don’t like the fact that Americans have been footing most of the bill for innovation but there are many other tools that can be used to accomplish this goal. This hurtful and ill-timed EO capitulates to the heavy-handed schemes used by foreign countries rather than using other tools, like proven free market policies and trade agreements, to level the playing field.

I’m asking you to speak out. Use whatever communication method you feel most comfortable with to tell your Senators and your Representative that this Executive Order is ill-timed and hurtful to older Americans. I like the fact that America is the center for new drug discovery, and we are often the first to get access to these lifesaving and life changing treatments. This Executive Order threatens the very foundation of this innovation that has changed our lives. Washington needs to know now how you feel. I urge you to make your voices heard.


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Upcoming Webinar/Tele Town Hall

Latest Survey Results, Medicare Part D, Prescription Drug Program
This Wednesday, September 16th, at 4:00 p.m. ET, Medicare Today’s Seniors Speak Out will conduct another webinar town hall. This virtual town hall will discuss the results of our yearly survey on Part D, the Medicare prescription drug program. We have always thought it was important, through a survey each year, to take the pulse of seniors concerning their feelings about Part D, a program that continues to have a huge impact on the wellbeing of older Americans.

Those of us that were around in 2002 and 2003, when this new program was hotly debated, remember the doubters who predicted that the new program wouldn’t offer enough choices in rural areas and that the costs would balloon out of control. Today, in one of our most rural of states, Montana, there are 17 different plans to choose from. As for the cost, Part D is the only government program, that I know of, that not only came in under its initial estimate but 30% below that estimate.

There have been, over the years, changes to Part D, some good and some bad, but it remains a success in improving the health and well being of seniors. There continues to be proposed changes . . . we have worked hard to keep you informed about the impact on you of these proposed changes. We also know that we need to continually let you speak out, through seminars, surveys, tele town halls, etc. so we can monitor your feelings about Part D. We don’t want to become complacent in safeguarding this life saving and life changing program.

Our tele town hall this Wednesday, September 16th, will discuss our latest Part D survey. We’ll cover the results, especially as they relate to the current crazy times we are living in. It will also give you a chance to ask questions about the survey and the program itself. It will give you a chance to speak out and tell us how you feel about how Part D is working for you.

I will be one of the presenters at the tele town hall along with Jennifer MacDonald, a Director at Morning Consult, a data intelligence company. It will start at 4:00 p.m. ET on Wednesday, September 16, 2020. We hope you can attend. You can register by clicking the link below:
After registering, you will receive a confirmation email containing information on joining the webinar.

Don’t miss out on this chance to speak out about this important prescription drug program.

Best, Thair

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This month is Healthy Aging Month

This focus on healthy aging started over 20 years ago as the baby boomers began to turn 50 and it became evident that getting old had a bad reputation. The ornery, bent over, lap blanket, picture of anyone over 50 needed to be changed. Everyone’s attitude toward getting old needed to be updated. I’ve had the patch below hanging in my office for a long time.

I’ve always looked at it as a testament to a great plane, one that I happen to have over 2,000 hours in as an Air Force bombardier, but it’s also an indication of the understood distrust most people had in people over 50. It was this type of attitude that needed to be changed. President Reagan’s age, he was 69, became quite a discussion item during his campaign for President. The average age of the two candidates running for President right now is 75.5. Hopefully, America’s attitude about age is becoming more positive but the most important attitude about getting older is our own. Healthy aging is much more than our physical health, it’s how we look at each day when we rise in the morning and how we evaluate our day as we go to sleep at night.

I always enjoy getting tips about how to play better golf and I found these great 10 tips on the healthy aging website. I liked the straightforward way they presented the 10 ways we can change to live a more positive, healthy life. So, here are 10 tips for reinventing yourself:

1. Do Not Act Your Age

Do not act your age or at least what you think your current age should act like. What was your best year so far? 28? 40? Now? Picture yourself at that age and be it. Some people may say this is denial, but we say it’s positive thinking and goes a long way toward feeling better about yourself. (Tip: Don’t keep looking in the mirror, just FEEL IT!)

2. Be Positive

Be positive in your conversations and your actions every day. When you catch yourself complaining, check yourself right there and change the conversation to something positive. (Tip: Stop watching the police reports on the local news).

3.  Ditch the Negativity

Have negative friends who complain all of the time and constantly talk about how awful everything is? Drop them. As cruel as that may sound, distance yourself from people who do not have a positive outlook on life. They will only depress you and stop you from moving forward. Surround yourself with energetic, happy, positive people of all ages and you will be happier too. (Tip: Smile often. It’s contagious and wards off naysayers.)

4. Walk Tall

Walk like a vibrant, healthy person. Come on. You can probably do it. Analyze your gait. Do you walk slowly because you have just become lazy or, perhaps, have a fear of falling? (Tip: Make a conscious effort to take big strides, walk with your heel first, and wear comfortable shoes.)

5.  Stand Tall

Stand up straight! You can knock off the appearance of a few extra years with this trick your mother kept trying to tell you. Look at yourself in the mirror. Are you holding your stomach in, have your shoulders back, chin up? Check out how much better your neck looks! Fix your stance and practice it every day, all day until it is natural. You will look great and feel better. (Tip: Your waistline will look trimmer if you follow this advice.)

6. How Are Your Pearly Whites?

How’s your smile? Research shows people who smile more often are happier. Your teeth are just as important to your good health as the rest of your body. Not only is it the first thing people notice, but good oral health is a gateway to your overall well-being. (Tip: Go to the dentist regularly and look into teeth whitening. Nothing says old more than yellowing teeth!)

7. Lonely?

Stop brooding and complaining about having no friends or family. Do something about it now. Right this minute. Pick up the phone, landline, or cell and make a call to do one or more of the following: Volunteer your time; take a class; invite someone to meet for lunch, brunch, dinner, or coffee. (Tip: Volunteer at the local public school to stay in touch with younger people and to keep current on trends, take a computer class or a tutorial session at your cell phone store to keep up with technology, choose a new person every week for your dining out.) [You may have to be creative during these times of COVID-19 but there are many safe ways we can volunteer and touch other people’s lives.]

8. Walk 10,000 Steps A Day

Start walking not only for your health but to see the neighbors. Have a dog? You’ll be amazed how the dog can be a conversation starter. (Tip: If you don’t have time for a dog, go to your local animal shelter and volunteer. You will be thrilled by the puppy love!) Make it a goal to walk 10,000 steps a day. Want to lose some weight or belly fat? Make it 15,000. You can do it!

9. Get Those Annual Check-Ups

Make this month the time to set up your annual physical and other health screenings. Go to the appointments and then, hopefully, you can stop worrying about ailments for a while. [Also, make sure you get your needed vaccinations.]

10. Find your inner artist.

Who says taking music lessons is for young school children? You may have an artist lurking inside you just waiting to be tapped. Have you always wanted to play the piano, violin, or tuba? Have you ever wondered if you could paint a portrait or scenic in oil? What about working in wood? (Tip: Sign up now for fall art or music classes and discover your inner artist!)

I think these are great ways to reinvent ourselves. It’s a good time to disprove the negative saying, “you can’t teach an old dog new tricks.” It’s a good time to show everyone that your lifetime of experience is a good reason that they can trust someone over 50, over 60, over 70, etc. Fall is the time that the kids go back to school, it’s a good time for us to get busy and reinvent ourselves.

Best, Thair

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A Birthday Check List

It’s the end of the summer and for me that means another birthday. In fact, my birthday is today. As I was musing about how old I’ve become I thought there had to be something productive I could do other than wish I was younger. And, as you might have guessed, I thought that maybe a birthday was a good time to do some things that will help us stay healthy and happy and might make a for a helpful blog. We all know to change the batteries in our smoke detectors when we change the clock to, or back from, Daylight Saving Time. It’s a great way to keep our houses safe. So why not use our birthday as a reminder to do some other things that not only keeps us safe and healthy but also maybe a little bit richer. You might have some more things to add to the list, I’m always open to comments with suggestions. Here’s my list . . .

Get your yearly physical – This reminder is almost as common as the smoke detector batteries, but I think it might be the most important item on the list. Many of us have been self-quarantining, which has kept us away from the doctor’s office. I just got my physical and our care givers are really good at keeping us safe. They take everyone’s temperature, we go through a check list to see if we might be a COVID-19 risk, and everyone wears a mask and makes sure we are wearing ours. They clean everything between patients. I felt safe wherever I went. Getting a yearly physical exam is the best thing we can do for our long-term health.

Review your immunization needs – Part of our yearly physical should include gathering and reviewing our immunization records and finding out what immunizations we might still need. Click here to go to my recent blog about immunizations. It has links to some great sites to help you determine what vaccines you need. If you don’t have your immunization records, request them when you visit the doctor. Many doctors’ offices have online portals that give you access to your health records. One way or another, get a copy and keep it in a safe place.

Review your Medicare Part D drug coverage – While your birthday may not coincide with the Part D annual enrollment period (October 15 to December 7), your birthday is not a bad time to get your prescription drug information together. It’s a good time to update your information with any changes you’ve had to your medications.

Actions required on important birthdays – As we get older there are some important birthdays that needs special scrutiny and possible important action. The important date for Medicare is 65, that’s when we need to sign up and register for Medicare and decide whether we want to use Medicare fee-for-service or Medicare Advantage. Even if we are still working and have private insurance there are still actions that we must take.  Go to to find out about your Medicare benefits. There are other important birthdates, 62, 66 and 8 months to 67 (depending on your birth year), and 70. These are birthdays when you can elect to begin receiving Social Security (SS). There are a lot of variables that go into when you should begin taking Social Security. Before your 62nd birthday make an appointment to talk with a SS representative. In these times of the COVID-19 virus, it might be difficult to meet in person but don’t put off finding out all about this important benefit.

Inventory your medicine cabinet – Your birthday is a great time to inventory your medicine cabinet. It’s a good time to get rid of old medicine, both prescriptions and over the counter medicines. Many pharmacies will help you dispose of old medicine. Don’t flush it down the toilet or throw it in the garbage. We want to safely remove it from the environment. Now, I need to talk about a touchy but important topic. Many people suffer from drug addictions. We have all heard of the alarming increase in opioid addiction in our country. Unfortunately, a common way these drugs are obtained are by friends and relatives stealing prescription drugs from someone’s medicine cabinet. Having a medicine cabinet lock helps prevent this problem while also keeping these medicines from unsuspecting children. At the very least, monitor who has access to your prescription medicines.

Review your financial health – Being financially secure helps both our physical and mental health. You should review your finances with a trusted advisor. It’s up to you who you deem trustworthy, but it is a place to be very careful. Unfortunately, there are people out there who prey on older people and find ways to rob them of their savings. It’s always a good idea to have a third party, unconnected with your trusted advisor, independently review any actions with your savings. Due to the COVID-19 impact on the economy and investments it is especially important to review your finances. It’s also a good time to go over your non liquid assets, like property, jewelry, etc. A balance sheet to identify your net worth helps you understand your financial standing.

Inventory your passwords – This might seem like a trivial item but many people’s identity and ultimately their money are stolen because a person used common passwords or made access to their passwords easy. Find a smart computer person to help you set up a secure password vault and, after it is set up, change all of your passwords. There are vaults that only require you to remember one password to get into the vault, and they have all of your other passwords.

I’m sure you can think of other things that should be done at least once a year. I suggest creating a check list. Unlike my keys or my cell phone, my birthday is one thing I don’t forget. Use that fact to help you remember some things that may be even more important than your birthday.

Be safe and register to vote, Thair

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Our Legislative Focus

As summer wanes and fall begins to come into focus, it’s time to look ahead to the healthcare legislative issues that could come into play. With campaigns heating up and the debates beginning, you can guarantee that promises will be made and accusations leveled concerning your healthcare. Some of the issues that will be brought up might have a small chance of actually being implemented, but this doesn’t mean that we shouldn’t pay attention. In the past, seemingly long shot proposals have become late night trading fodder when politicians make deals on far reaching legislation. Many of the issues I’ll talk about today were thought to be not-starters a few years ago and now they are political realities. What I will do is offer a simple explanation of each issue, give you an idea on how it could affect you and how likely I think it will be to be implemented. I’ve written an earlier blog about many of these issues. You can look through recent posts to get a more detailed explanation of some of the issues.

International Pricing Index/Favored Nation Pricing

Background – In an effort to lower drug costs some in Washington (most recently the President) have proposed that we fix the cost of a drug to the lowest price a “favored nation” paid. As I’ve explained before, price fixing has never been a long-term solution to any cost problem. There are better ways to have other nations share in the costly research and development that goes into discovering and manufacturing prescription drugs.

Impact – If this approach is implemented the supply line safety that we have enjoyed over the years will be jeopardized with no guarantee that any savings will make its way to you.

Chance of Implementation – While this idea has been around for at least a couple of years, its chances of becoming a reality have gone up. It would be difficult to implement and the chance of unintended consequences high. This makes its implementation politically unpopular but a great thing to talk about during debates.


Background – This issue has some of the same characteristics as the international pricing index. The goal is again to lower drug prices by allowing importation of these drugs from Canada. I talked about this proposal in my earlier blog explaining how it bypasses the safety net we now enjoy without any proof that the patient will see any savings while counting on Canada to implement a program that they have already said they can’t support.

Impact – While you or someone you know has gone across either our southern or northern boarders to purchase medicine at a lower price, this is not what this proposal is about. This importation proposal is at a much higher-level involving suppliers and transporters and large volumes. Some states have passed laws allowing importation but none of them have been implemented.

Chance of Implementation – This approach has been around for many years and no one yet has found a way to safely implement it. A pilot program of some sort may be started but it will take some real political will to make it happen.  Canadian officials have indicated they will not support it. However, the chances of it happening are much more likely than they were just a few years ago. This is one of those solutions that may gain some traction.

Changes to Medicare Part B

Background – The price of drugs administered and paid for under Medicare Part B have increased substantially. These are drugs that are often injected at a doctor’s office for serious diseases like cancer and many types of autoimmune diseases. A proposal to fix the cost of these medicines has been put forth. This approach would go against the market-based approach that is now in place. It would impact many of the doctors who perform these services and upend and regulate this vitally important portion of our healthcare. Again, fixing prices has never been and efficient, long range solution.

Impact – If implemented, this approach would change the economics of this vital service. Any savings to the patient has been hard to quantify but it would most certainly put pressure on already pressured neighborhood practices. Losing these close, more accessible, services would have serious consequences.

Chance of Implementation – Part B drug prices have become a focal point for people seeking solutions to increased costs. We need to correct the underlying parts of the system rather than using a sledgehammer to bludgeon one part of the business.

Part D Cap

Background – Almost all of us, either in private insurance or Medicare or Medicare supplemental insurance, have experienced caps on our healthcare out-of-pocket costs. It helped us budget our money, we even decided what type of insurance to buy based on the yearly cost caps. Medicare Part D has no such caps. Depending on what prescription drugs, we need we may have out-of-pocket costs that balloon to the tens of thousands a year.

Impact – While we have been against the other proposed changes, a Medicare Part D cap would have a huge impact on those of us who are already retired and everyone younger as they plan for their retirement. I’ve known people, maybe you have also, who were living comfortably until an illness struck and their drug costs forced them to tap into their retirement. The peace of mind that a cap on our drug costs would give all of us, whether planning for or already retired, would be immense. This a change that is worth fighting for.

Chance of Implementation – This change is gaining some traction. While it probably won’t be something that is done on its own, it is a change that could be incorporated in some larger legislation as a balance or concession to reach final approval on the bigger legislation. It would be a most welcome change.

It is guaranteed that there will be other changes to our healthcare put forth as we near election day. We will keep you up to date on each one, explaining in simple terms what the change is and its impact on you. There is one over all criteria that I would like you to consider. Making short term, knee jerk, politically popular, changes is not the answer. Trying to band aid or quick fix a broken process never ends well. We need to fix the underlying problem, simplify the process, and let the free market drive us to the most effective, cost efficient solution. I believe the reduction of administrative overhead and regulations is a big step toward this goal. Measure each change to see if it offers simplicity and transparency in its solution.

Let’s stay informed as we approach this critical election. Get involved, tell those in Washington how you feel. Also, get registered to vote and then vote! It’s one of the most powerful things we can do.