Traveling through the beautiful farmlands of early primary states, you can find the self-proclaimed champions of socialized medicine amid the flashes of cameras on the campaign trail. If you keep driving through, you'll see the harsh reality beyond presidential candidate photo-ops. You'll see the more than 100 rural hospitals that have closed in the United States since 2010, including two in my district in the last year alone. .According to the National Council on Aging, 34% of older households hold credit card balances, and another 29% still owe money on a mortgage, home equity line of credit, or both. Digging out requires work and making changes. Reducing debt requires increasing income, restructuring your budget, and other changes. Here are some things to consider: .According to MedPAC, the Medicare fee schedule undervalues the important services that primary care physicians provide. This creates disparities in compensation between the primary care and specialty fields, and it deters medical students from choosing to enter primary care. To address the issue, MedPAC recommended an extension of a primary care bonus program that is set to expire in the near future. However, instead of offering bonus payments for each service that is provided, the Commission suggested that physicians be rewarded on a per beneficiary basis, which will help the Medicare program improve the coordination of care. .The President ordered a payroll tax deferral, not a cut, meaning the taxes will not be collected for a while but they will still be due at a later date. However, some observers have suggested that rather than give employees the additional money and then try to collect it back from them at the end of the year, employers will simply hold onto the money so that the employees would never see it in their paychecks. .The report continues, "Two House panels last week approved legislation adding vision, hearing and dental coverage to Medicare. Dental is by far the most expensive and complicated of the three to roll out: the nonpartisan Congressional Budget Office previously estimated that such coverage would cost 8 billion over 10 years, compared with billion for vision and billion for hearing coverage. .The changes closed two claiming tactics known as "file and suspend" and "restricted application for spousal benefits." The claiming strategies have made it possible for both members of a couple who are 66 or older to delay claiming Social Security based on their own earnings records, in order to increase payments, while at the same time one spouse receives a spousal benefit. Alicia Munnell of The Center for Retirement Research at Boston College estimates the changes would save .5 billion per year — a potential cost that would grow over time. .What is a surviving beneficiary spouse? .TSCL enthusiastically supports the bills mentioned above, and we look forward to helping build support for them in the coming months. .The good news is that there was progress last week in moving the needed legislation forward. The Senate passed its own version of H.R.1868, which would postpone the cuts for another nine months.