1.  The recession has caused Social Security surpluses to decline, with ominous implications for the federal budget.

The Washington Post reported:

"The Treasury Department has for decades borrowed money from the Social Security Trust Fund to finance government operations. If it is no longer able to do so, it could be forced to borrow an additional $700 billion over the next decade from China, Japan, and other investors.

"And at some point, perhaps as early as 2017, according to the Congressional Budget Office (CBO), the Treasury would have to start repaying the billions it has borrowed from the trust fund over the past 25 years, driving the nation further into debt or forcing Congress to raise taxes."

As recently as last summer, the Social Security surplus for fiscal year 2009 was expected to be $158 billion.  This money is spent on other federal programs with the trust fund getting non-negotiable IOUs.  In total, the amount owed to Social Security is over $2.435 trillion.

CBO now expects the Social Security surplus to be only $16 billion this year and $3 billion next year.

That means that the federal government will no longer be able to depend on Social Security to finance Non-Social Security spending.  In fact, a big portion of the federal budget will soon have to be devoted to paying back the money that was borrowed from the trust fund.

In light of the other serious economic problems facing the government, that will be extremely difficult.

2.  More doctors are not accepting Medicare patients.

The New York Times reported that an increasing number of doctors have opted out of Medicare because the reimbursement rates are too low and federal paperwork too complicated.  The newspaper wrote:

"In a June 2008 report, the Medicare Payment Advisory Commission said that 29% of the Medicare beneficiaries it surveyed had a problem finding a primary care doctor or specialist to treat them, up from 24% the year before. Those looking for a primary care doctor had more difficulty. A 2008 survey by the Texas Medical Association found that while 58% of the state's doctors took new Medicare patients, only 38% of primary care doctors did."

If seniors are unable to find a primary care physician who takes Medicare, the Times suggested looking into one of the 18,000 urgent care centers in the U.S.

3.  Many Medicare hospital patients are readmitted within a month.

The Associated Press reported that 20% of Medicare patients who are discharged from a hospital end up back in the hospital within a month.  About 33% were back in the hospital within three months.

The estimated cost of unplanned return visits is $17.4 billion a year.

Dr. Eric Coleman, of the University of Colorado in Denver and one of the study's authors, said, "Hospitals put more effort into the admission process than they do into the discharge process."

President Obama's budget proposes reduced spending on Medicare readmissions to hospitals.