Our Medicare Trust Fund system is in serious trouble, and there will be no practical way for the government to continue to provide the level of benefits that current Medicare recipients receive. If you wish to maintain your medical freedom, and have access to a high level of medical service, you must be prepared to pay for it yourself. The best strategy is to take good care of your health, and to build up your medical retirement fund as large as possible by using a Health Savings Account.

The Coming Medicare Insolvency

The total federal debt is now over $10 trillion. But if you also include the current unfunded liabilities of social security, Medicare, and other programs, the total federal debt is at least $54 trillion. This number has been confirmed in three separate studies - by the American Enterprise Institute, the NCPA, and the Brookings Institution.

It is difficult to get a grasp of a number that big. That's $180,000 per person currently living in the United States. It is four times the U.S. Gross Domestic Product, the measure of the final value of all goods and services produced in this country in the course of a year.

As the program is currently structured it is unsustainable, and the fund is expected to be depleted by 2018. That is a mere 11 years from now. The shortfall in Social Security and Medicare revenues will continue to increase as the years go by - it will exceed $2 trillion by 2030. At that point, half of all tax dollars will have to go to Social Security and Medicare.

That clearly can't happen. Instead, the system will face massive cuts in benefits, probably in addition to large tax increases.

Who Will Pay Your Medical Expenses During Retirement?

So can you count on Medicare? It depends on how old you are. Unless you are retiring in the next couple years, I certainly wouldn't count on it, particularly if you want to insure that you have access to high quality medical care during your retirement years.

Last year a Fidelity Investments study reported that an average couple retiring in 2006 would need $200,000 just to cover medical expenses during retirement. This estimate does not include the cost of over-the-counter medications, most dental services or, long-term care. And it did not include the charges that are currently paid by Medicare.

If we cannot depend on Medicare to be there for us, the only smart solution is to save as much money as possible. This will ensure that you can obtain the quality care you need. If you are not currently putting as much money as possible aside to pay for these expenses yourself, you are making a serious mistake.

What Is Your Solution?

As most readers already know, the very best tool for accumulating funds for future medical expenses is a Health Savings Account. An HSA is the only investment that provides a tax deduction when you deposit the money, yet never taxes the money if it is used to pay for qualified medical expenses.

Therefore, you should invest as much money as possible into your Health Savings Account, and withdraw as little as possible. The contribution limit for 2007 is $2,850 for an individual, and $5,650 for families. Those over 55 can also contribute an $800 catch-up contribution. Making the maximum contribution each year will help you build a medical retirement fund that can be used to pay future medical expenses, tax-free.

Rather than withdrawing money from your account to pay for medical expenses as they occur, you should pay for medical expenses that are not covered by your health insurance, out of your own pocket. Save your receipts (for doctor visits, eye glasses, aspirin, etc), and leave your money in the account to grow tax-deferred. There is no time limit before you have to reimburse yourself, so you can make the most of this tax-free investment.

You should also transfer some of the money into mutual funds. While some HSA administrators are paying interest rates as high as 5%, the only way to really grow the account is to get a much higher return on your money. Many HSA administrators offer a discount brokerage option where you can place your funds in a variety of stock or mutual fund.

For a family that contributes the maximum contribution each year, it is quite reasonable to assume an HSA account value well over $1 million after 25 or 30 years. Medicare may be broke, but at least you won't be.

"Medicare HSAs?"

The solution to the pending Medicare meltdown is very complicated, but it is clear that government-run medical programs don't work. The dismal results can be seen everywhere, from the former Soviet-bloc countries, to the broken down national healthcare systems of Canada and Europe. Medicare must be transformed into a program where seniors have an ownership interest in the money they are spending.

Replacing the government's obligation to provide benefits with a voucher that seniors could use to purchase health insurance from competing private insurers, and/or deposit into a "Medicare Health Savings Account," would bring market efficiencies and competition into the picture. This idea is endorsed by both the American Medical Association and the American Hospital Association.

Retirement HSAs may or may not ever come to fruition. But fortunately, HSA plans are available to those under age 65. If you do not yet have an HSA, get signed up for one now. You will lower your health insurance premiums, and can begin putting money aside for medical expenses you will almost inevitably incur during your older years.