<P> President Obama stated in May 2009: "But we know that our families, our economy, and our nation itself will not succeed in the 21st century if we continue to be held down by the weight of rapidly rising health care costs and a broken health care system...Our businesses will not be able to compete; our families will not be able to save or spend; our budgets will remain unsustainable unless we get health care costs under control ." </P> <P> The present value of unfunded obligations under all parts of Medicare during FY 2007 is approximately $34.1 trillion . In other words, this amount would have to be set aside today such that the principal and interest would cover the shortfall over the next 75 years . This is over six times as large as the Social Security unfunded obligation of $5.3 trillion, discussed below . </P> <P> Social Security is a social insurance program officially called "Old - Age, Survivors, and Disability Insurance" (OASDI), in reference to its three components . It is primarily funded through a dedicated payroll tax . During 2009, total benefits of $686 billion were paid out versus income (taxes and interest) of $807 billion, a $121 billion annual surplus . An estimated 156 million people paid into the program and 53 million received benefits, roughly 2.94 workers per beneficiary . During 2008, total benefits of $625 billion were paid out versus income (taxes and interest) of $805 billion, a $180 billion annual surplus . An estimated 162 million people paid into the program and 51 million received benefits, roughly 3.2 workers per beneficiary . </P> <P> There is significant confusion about the program, due in part to the accounting for surplus payroll tax receipts and the agendas of various political constituencies . A few key points to understand under current law, if no reforms are implemented: </P>

How much of the us budget is discretionary spending