WASHINGTON — This week's settlement of a short strike by the United Auto Workers against General Motors underscores trends that affect all Americans and their health care.

The agreement to take $51 billion in promised health benefits off GM's balance sheets and transfer it to a UAW-managed trust may become a model for other large unionized employers. It accelerates a trend of businesses shifting health-care burdens onto employees.

Here's a closer look:

Q. Does the GM agreement directly affect my health plan?

A. Probably not, but it depends on where you work. GM and the UAW agreed to set up a Voluntary Employees' Beneficiary Association. That's a health-care trust fund that earns interest and puts responsibility for managing retiree health finance on the union.

News reports say GM will pay 70 cents into the fund for every dollar in promised health benefits to retirees; the rest will come from growth in investments. If other carmakers join the UAW-managed fund, it will contain tens of billions of dollars in assets.

Goodyear Tire & Rubber launched a VEBA last year. Many large employers with so-called legacy costs — retirement benefits guaranteed in past union settlements, often instead of higher wages — already have VEBA's.

But private-sector unions account for only about 7 percent of the work force, and only 13 percent of unionized companies still have retiree health obligations, according to the Employee Benefit Research Institute

Q. Are the health benefits of an employee or retiree safe under a VEBA?

A. History says not necessarily. A VEBA that the UAW ran on behalf of employees at Caterpillar Inc. went bust in 2005 and is the subject of a class-action lawsuit against Caterpillar by UAW workers. The VEBA's financial woes resulted in a near-doubling of health insurance premiums for employees and retirees, according to Labor Notes, a nonprofit labor-advocacy group. A similar VEBA with Detroit Diesel also went broke and is now in litigation, it said.

Q. Why does the GM-UAW deal reflect broader health-care trends?

A. Health-care costs are a top concern for employers and employees, and a top issue in the presidential race. Polls show that Americans tremble at the prospect of losing health-care coverage. Companies increasingly are passing on some of the escalating costs of coverage to employees. GM's shift of the management of health-care obligations to the UAW underscores how business is moving away from its traditional role as health care-benefits provider.

Q. Do statistics support this shift?

A. Yes. The Kaiser Family Foundation, a leading nonpartisan health-care research center, said this month that the percentage of employers who provided workers with health-care coverage had fallen from 69 percent in 2000 to 60 percent in 2006.

"Most of the loss of sponsorship has actually been among small employers," cautioned Gary Claxton, the vice president of the foundation.

Workers are paying more out of pocket even for employer-provided health insurance. In 2000, 14 percent of workers with employer-provided health plans had deductibles of $500 or more; that number swelled to 38 percent last year, the foundation said. Family premiums have risen 78 percent since 2001, while wages grew 19 percent.

Q. What political significance does the GM-UAW deal carry?

A. Regardless of which candidate or political party wins next year's presidential election, workers will be expected to be more active participants in their health care.

The three leading Democratic candidates are pushing health plans that give consumers more choices and options but require more direct participation.

Many Republicans favor what they call consumer-driven health care, with tax credits and IRA-like individual health savings accounts that allow workers to set aside tax-free money to be used to manage costs and pay for health care.

Both parties promise that the days of leaving health-care decisions to your employer are numbered.

Still, some health-care veterans warn that change tends to come slowly.

"The data is very frustrating about actual pickup and actual action by individuals," said Dallas Salisbury, who heads the Employee Benefit Research Institute. He cautioned that many of today's ideas of flexible health benefits date three decades and have progressed very slowly.