At a recent meeting in Washington State an attender denounced the evils of The Affordable Care Act (ACA), or as it has become known “Obamacare.” He argued that requiring compulsory health insurance was a major restriction of personal liberty. When I asked what should happen to someone who becomes ill but does not have any money he replied that “There should be a safety net for such people.” As someone involved closely with state insurance systems this reply shows wishful, almost magical, thinking. more…

Doctors don’t strike about employee pensions in the USA. This is because many of them are not employees and few have defined pensions from the employers. Most doctors are in defined contribution schemes. Defined contribution means that the employer contributes to an investment fund (which will include some combination of bonds or equities with additional choices of investments such as small cap or foreign markets). Henceforth the doctors participate in the market. In the academic sector most doctors have their pensions held with TIAA_CREF. So after my only academic year my account was worth $13 000. After a turbulent 22 years this had compounded to $33 000. Additional to this contribution you can make personal contributions to programmes called IRAs and Roths, similar to SIPP’s and ISA’s. The mailman is pleasantly unworried when he delivers a letter marked “IRA statement.” more…