The generational divide on Medicare could have enormous political implications, according to the sponsors of a public opinion poll on Medicare, released today.
People who are retired are very supportive of Medicare and say it works for them, while those younger than 65 years of age are not so sure, says Robert Blendon, professor of health policy at the Harvard School of Public Health.
According to a survey of 1,424 adults age 18 and older conducted in May by Harvard and the Kaiser Family Foundation, 77% of seniors have a favorable opinion of Medicare, and 62% say it is well run. If given a choice between Medicare or a private plan for their health benefits, 63% of seniors would choose the current government Medicare program.
"There is a blinking red light from seniors," says Drew Altman, president and CEO of the Kaiser Family Foundation. "'Tread lightly on moving us to private plans,' seems to be where seniors are."
In contrast, 45% of adults age 18 to 64 say their view of Medicare is favorable, 23% say it is unfavorable, and 33% say they do not know. Those between 50 and 64 years of age responded more similarly to seniors, with 41% saying they would choose traditional Medicare over private plans upon retirement. Just 27% of those between 18 and 49 years said they had a personal preference for Medicare, with 60% leaning toward a private health plan, such as a PPO or HMO.
Similar Medicare reform bills that would provide a new prescription drug benefit through private insurance companies are being debated this week in two House committees and on the Senate floor.
"If a Medicare prescription drug law passes, it won't be fully implemented until 2006," Altman says. "It will be years before seniors see the details, have to make real choices, pay real bills and we see a real public verdict on this plan."
Younger adults are generally less familiar with Medicare and what it actually covers, the survey shows. More than half of adults age 18 to 64 incorrectly say Medicare already covers prescription drugs, as opposed to 16% of seniors who believe that. And 28% of younger adults know people on Medicare can choose any doctor or hospital they want, vs. 73% of seniors.
Regarding that choice in healthcare, what is most important to people is having a choice of physicians and hospitals, while a demand for choice of health plans comes second, Blendon says. When asked what matter most to them personally, 62% of the public and 68% of seniors say greater choice among doctors and hospitals, compared to 29% of the public and 19% of seniors who say greater choice among health plans.
Yet plan choice remains the dominant topic among legislators, Blendon says.
Democrats have a slight advantage over Republicans on the Medicare issue, but not over President Bush, the survey finds. In general, the public is not aware of basic differences between the parties on where Medicare should move in the future, with 33% saying there are small differences or no differences and 30% saying they don?t know if there are differences at all.
"Legislators can talk about Medicare's aches and pains, and about the merits of competition and private plans, but seniors clearly prefer to build on the Medicare they know and trust," Blendon says. "Younger people may be an entirely different matter."
The complete findings of the National Survey of the Public's Views on Medicare are available online.