Just read some of the more obscure parts of these public documents; they are available free to anyone with an Internet connection. Appendix F tells us the net surplus in trust accounting for combining Social Security and Medicare is a mere $10.1 billion. The $23 billion loss for Medicare hospital insurance (HI) reduced that surplus. [...] did the $4.6 billion loss for Medicare supplementary medical insurance (SMI). Based on these figures, it appears we can take a lot of comfort in that gigantic $2.7 trillion Social Security trust fund. The problem here is that the Social Security trust fund is only an accounting device. The trust fund tracks excess taxes workers have paid into the most important social program our nation has. Medicare payments for inpatient hospital stays will decline to 40 percent of private health insurance payments if payments follow law. Page 205 of the Medicare report warns readers to be cautious due to the effect of scheduled "negative payment updates" to doctors. Footnote 91 notes "secondary effects could include substantially reduced beneficiary access to physicians."