Health insurance should be de-coupled from employment. At the moment only people on public aide or medicare can get health insurance without a job. If you don't work and have had any prior health issues you cannot buy private health insurance at any cost.

HSAs are a start, but a medicare plan for everyone would be a better solution. Recall, that accuarial risk spread over a popultion of 300million would lower everyones premiums dramatically.

morry, I would agree with you if you added ... "and government" to your first sentence. Let municipalities offer free clinics for those who can't afford to pay for private medical care. Neighborhood clinics provide care where it's most needed and don't waste a lot a money on administration.

Individuals can buy their own health insurance at whatever level of services they want. Many would opt only for what used to be called "Catastrophic Coverage" and pay other costs out of pocket.

Is the article referring to companies offering a 401K in lieu of a Pension plan? I thought almost all companies were offering a 401K as a retirement savings plan for quite awhile now. I've had a 401K at work for at least 10 years now.

I hope it is the former. I've had to deal with the Pension Benefit Guaranty Corp and anything that puts them out of business would be good.

erp:
I thought that municipalities are the local governments. Why should anyone get free care? Should there be a double standard for people of lesser means?
A basic medicare policy for everyone as well as individual gap insurance or none (practitioners and hospitals already accept whatever Medicare will pay if the person has no other coverage) is really the only way to proceed to solve this problem.

I can understand the coupling between employment & health care. It's worth it for most companies to keep their employees healthy--but forcing them to accept some of their money in the form of HSA's makes a lot more sense than never showing them that money and pouring it down a hole, which is, for many of us, what health insurance amounts to.

AWW: With a Roth 401(k), your initial contributions are taxable while the money you take out after reaching retirement age is tax free. With a regular 401(k), you get a tax deduction now, but you pay taxes when you take the money now. You should use a Roth if you expect to have a relatively large retirement income.

It's funny that the Roth 401(k) has only been available since January and the press is, in February, talking about how slowly it's taking off. If it is slow, one reason is that it is now scheduled to end in 2010 -- this is one of the famous dissappearing Bush tax breaks.

It should be untaxed at both ends and we want employers to force the savings.

Timothy:
Health care insurance became coupled to employment in the USA as a benefit offered to attract workers in WWII. I can assure you that GM would be more than happy to uncouple health insurance from employment now.
Health insurance doesn't keep people healthy, people keep themselves healthy through life style choices such as not smoking, not being fat, and etc.
Insurance in general is a sink hole, but when you need it to prevent a catastrophic financial loss or provide expensive care for you or a loved one then its critical.
Insurance pemiums can be kept under control if the actuarial risk pool is large. Because no single insurance company could or should have a monopoly covering all 300 million of us, it falls to the federal or state governments to offer such a plan. The private sector would still be there to offer gap coverage and HSAs certainly could be a part of the solution.

Timothy:
Health care insurance became coupled to employment in the USA as a benefit offered to attract workers in WWII. I can assure you that GM would be more than happy to uncouple health insurance from employment now.
Health insurance doesn't keep people healthy, people keep themselves healthy through life style choices such as not smoking, not being fat, and etc.
Insurance in general is a sink hole, but when you need it to prevent a catastrophic financial loss or provide expensive care for you or a loved one then its critical.
Insurance pemiums can be kept under control if the actuarial risk pool is large. Because no single insurance company could or should have a monopoly covering all 300 million of us, it falls to the federal or state governments to offer such a plan. The private sector would still be there to offer gap coverage and HSAs certainly could be a part of the solution.

By government, I, of course, should have made clear, I mean federal or state government.

To answer your question as to why those of lesser means should get free care. It's because it is our obligation to make sure that all our citizens receive medical attention no matter their ability to pay and free clinics would be far less expensive than across the board Medicare. Let the marketplace work. Insurance companies could offer different policies.

When we reached 65, we tried to opt out of Medicare and purchase catastrophic coverage. No such animal was available. So our free Medicare costs nearly $2,000, add $2,500 for the BC/BS supplement and another $2,000 for drugs and other health related costs for a total of over $6,500.

If we were all paying for our medical care on our own, costs would start going down as would the incidence of unnecessary procedures.

Erp:
The private sector has no incentive to take on the acturail risk that a 65yo would pose. That's why government sponsored medicare insurance is the only thing available if you don't work. You cannot buy flood insurance in a flood plain except that offered by the government because the risks of private insurance companies is too great.
If there was universal coverage your premiums would be much less. My current heath insurance covered by my employer is about$6000.00 for my wife and me. I don't think you're paying too much in comparison.

Insurance in general is a sink hole. . . . Because no single insurance company could or should have a monopoly covering all 300 million of us, it falls to the federal or state governments to offer such a plan.

Is there a word for a conclusion that is contradicted by its own argument?

A Roth IRA or Roth 401(k) is entirely a long-term bet on the ability of the Fed gov't to finance the Boomer retirement while resisting the enormous honeypot of tax-free retirement accounts.

It's not a gamble that I'd take.
IMO the history of Congressional looting of the SS "trust" fund tells the whole story.

Regular 401(k)s and IRAs are also vulnerable, but at least you get a premium up-front, with the tax deductions.

morry, Sorry, but you've been living in an only-the-guvmint-can-do-it society too long. As for building in the flood plain. You've got that backward. People keep on building there because of government insurance, not in spite of it. No guvmint insurance, no building where you're likely to lose your shirt.

Noam: There could be no looting of the trust fund because there was no trust fund.

David:

And do you believe that in twenty years there still won't be a tax on the gains in Roth 401(k) accounts (at a "lesser rate", of course) ?

Posted by: Michael Herdegen at February 28, 2006 8:16 AM

It's a democracy, the elderly majority aren't going to tax themselves.

Hey oj, If not the elderly, who do you think have been paying taxes since Hector was a pup?

The employed.

It is indeed a democracy, and the ranks of the retired and near-retired do not now constitute a majority of Americans, nor will they anytime in the 21st century.

That's the most obvious conclusion that one can draw from the position that you take about immigration to America and continued American fertility - are you now saying that you were mistaken about those issues ?

Further, only a small percentage of aged Americans are going to have Roth IRAs and 401(k)s, and the much larger number of people receiving taxable distributions from regular IRAs and 401(k)s aren't going to go to the mat for their tax-free comrades.

"Pocketbook issues" may constitute the greater part of political activity, but by no means the whole, and there are and will continue to be many people willing to vote against their base fiscal interests, in the service of some larger principle.
It's the same dynamic that confounds many on the Left today, those who think that most working-class Republicans are voting against their own interests.

In twenty years, there will be many retired and near-retired people who will be willing to support taxing private retirement accounts, especially since most retired people won't have one, and will be relying exclusively on SS at that time - which will have been operating with a deficit for ten years.

Posted by: Michael Herdegen at March 1, 2006 12:02 AM

Michael:

Non0citizens and under-18s don't get a vote. The elderly vote in the highest numbers. Those at or near retirement will be a majority of the electorate or near enough.

That may well be true, but there are many ways to split a bloc.

Also, I don't think that having a majority of the electorate be retirees changes the analysis that those with taxable retirement accounts won't be much disturbed if Roth accounts begin being taxed.
Many will forget or not care about the differing tax treatments of deposits twenty years prior.

Posted by: Michael Herdegen at March 1, 2006 2:38 PM

Michael:

Right, so the gains won't be taxed.

That's the exact opposite of what will actually occur.

Posted by: Michael Herdegen at March 2, 2006 3:06 AM

Uh-huh, in a democracy the majority will vote to tax themselves in order to relieve the minority.

The percentage of people with private retirement accounts will NOT be a majority, perhaps 40%, and the number with Roth IRAs and Roth 401(k)s will be MUCH smaller.

If you wish to analyze the situation based on simple majority/minority splits, we can see that tax-free Roth gains are doomed.

Posted by: Michael Herdegen at March 2, 2006 1:26 PM

It'll be 100%.