The vast majority of local governments in California, for one, and it's a $130 billion+
problem. The new report Reform before Revenue: How to Fix California's Retiree
Healthcare Problem, has all the details.
But if what was meant by the question "Who should care about retiree healthcare?," the answer is anyone concerned about state and local governments' pension problem. "OPEB" (those in the know pronounce it "Oh-peb") stands for "other post employment benefits," meaning other than pensions. As with defined benefit pensions, retiree healthcare benefits are increasingly rare in the private sector, still common in the public sector, and their costs are high and rising and squeezing out other, more vital government services.
The pension and retiree healthcare problems are not just similar, they're related.
From a certain perspective, it seems counterintuitive that an employer would deem it necessary to offer defined benefit pensions and retiree healthcare. In these times, both are precious commodities. Any worker should feel blessed to receive just one. Thus, you might think that it would be easy for an employer to offer just one.
But providing pensions actually creates pressure for retiree healthcare. Workers with no hope of "early" retirement, meaning before Medicare kicks in at 65, won't worry about how to replace employer-sponsored health care in retirement. But government employees still have pensions, so they can and do retire well before Medicare eligibility. So finding healthcare is an issue for them, particularly because they're older, more risk-prone and thus would face high costs were they forced to buy insurance on the open market.
Or maybe it works the other way, and providing retiree healthcare creates pressure for pensions. Either way, they tend to come together and their relatedness puts employers in a bind. An extremely expensive bind. Just think of how much governments could reduce their longterm liabilities if they could decouple the two. Here's another reason why governments should be rethinking both.
Decouple the two ? Hardly enough.
No, we (the Taxpayers) should insist on ending BOTH. Most studies show that Public Sector workers earn no less in cash pay than their Private Sector counterparts. This being the case, there is ZERO justification for Pensions and benefits multiples greater in value at retirement (than what Private Sector workers get) ... and with Taxpayers on the hook for all but the 10-20% of total Public Sector Pension Plan costs actually paid for by the workers' contributions (INCLUDING all the investment earnings thereon).