MEDICARE: Public Wary Of Specific Reform Options
More than half of the American public (57%) believes "major changes" are needed to ensure that the Medicare program can "keep costs from rising too quickly when the baby boom generation retires," according to a new survey by the Kaiser-Harvard Program on the Public and Health/Social Policy. Sixty-three percent of respondents under the age of 65 believe major changes are needed, while only 34% of respondents age 65 and over share this view. Among the 65 and older respondents, 56% believe Medicare "is basically working well as is, and Congress should continue to make only gradual adjustments to preserve the program for future generations." The Kaiser-Harvard survey further found a "major division ... between seniors and those under 65 over perceptions of the success of the management of Medicare." Forty-one percent of seniors said the government is doing an "excellent" job managing Medicare, while 40% rated the government's management as "good." Those numbers compare to only 29% of respondents under age 65 who said "excellent" and 43% who said "good."
The Hard Questions
The survey found that a large majority of the public opposes key Medicare reform options:
- Only 37% favor gradually raising the age of eligibility for Medicare from 65 to 67 for future retirees.
- Only 17% favor requiring seniors to pay a larger share of Medicare costs out of their own pockets.
- Only 27% favor charging seniors who want to stay in traditional Medicare higher copays to encourage them to switch to Medicare HMOs.
- 56% of respondents said encouraging more seniors to enroll in privately-run managed care plans would be "a bad thing," because seniors "might not be able to continue using their regular doctors and would need permission to see specialists and get certain medical procedures."
- 47% oppose limiting the amount Medicare contributes toward health insurance for each person enrolled to a fixed amount per year that could be applied toward the cost of a health plan.
- 69% support the inclusion of long-term nursing home care coverage under Medicare.
- 68% favor covering prescription drugs under Medicare.
- 60% favor expanding Medicare so that people ages 62-64 can buy into the program.
- 59% said they favor cutting payments to doctors and hospitals for treating Medicare recipients.
Medicare Plus What?
An overwhelming majority of Americans -- seniors and those under 65 alike -- are unaware of the government's new Medicare+Choice program. Eighty-one percent of respondents under age 65 and 76% of seniors were not aware of Medicare+Choice, and only 9% of seniors were able to correctly describe what the program entails.
Implications For Policymakers
Only 39% of respondents were aware that a bipartisan Medicare commission has been convened to suggest changes to the program. That low level of awareness, along with the other responses, poses a serious problem for policymakers, according to Drew Altman, president of the Kaiser Family Foundation. "This process could end in a train wreck when the debate turns to specific proposals and their consequences if the public is not more informed about the problems facing Medicare and the options for reform," Altman said. Robert Blendon, professor of health policy and political analysis at Harvard, noted, "Overall, the public trusts Democrats -- 43% -- more than Republicans -- 27% -- to deal with the problems facing Medicare. As a result, if the Republicans remain the majority party in Congress, they will need bipartisan support in order to make any major reforms in the Medicare program." The Kaiser-Harvard survey of 1,909 adults was conducted between Aug. 14 and Sept. 20. The margin of error is +/- 3%.