Senior Americans prefer Medicare to Private Programs

Older Americans are uncomfortable with the idea of private insurance companies delivering them prescription drugs, and happier with the Medicare system as it is, according to a survey released last week by the Kaiser Family Foundation. Legislation currently before Congress aims to attract more people into privately run prescription drug programs.

Although the findings among senior Americans may give politicians food for thought, younger citizens have different views - half of them would prefer a system in which most seniors get insurance from private plans.

According to the research 80% of seniors have a favourable impression of Medicare and more than 6 in ten (62%) say the program is well-run. About 7 in 10 of those aged 65+ feel seniors should continue to get their insurance through Medicare. 45% of those aged 18-64 have a favourable view of Medicare and 36% say it is well-run.

Last Thursday the White House said that it supports the Senate bill, but expressed concerns about some of the details. The White House statement said the bill was 'an important first step', which would 'provide beneficiaries with more options and better benefits'. On the same day the Senate voted by 94-1 to give consumers faster access to low-cost generic alternatives for the treatment of illnesses ranging from allergies to arthritis.

One of the key questions addressed by the Kaiser poll is how generous the new prescription drug benefit should be. The majority of those questioned favoured a more generous program even if it meant giving up tax cuts

According to Kaiser, the findings are to an extent a matter of people being comfortable with what they know: older people have got used to open-ended insurance, having grown up with it, whereas most younger workers use private health insurance - typically managed care. This was backed up by questions checking familiarity with the actual coverage of Medicare - more than half of adults aged 18-64 wrongly said Medicare covers prescription drugs and less than 3 in 10 knew that people on Medicare can choose any doctor or hospital they want.

'In the very long run, a greater switch to private plans will see its day', said Drew Altman, president of the Kaiser Family Foundation, which conducted the survey with the Harvard School of Public Health.

Respondents were also asked about the main parties' record on dealing with Medicare, and a comparison with a similar question asked in December 1999 shows the Democrats sliding. The proportion of people saying the Democrats did a better job dealing with Medicare has fallen from 37% to only 26%. Satisfaction with both parties' performance on the issue has fallen.

Interviews were conducted by telephone between April 25 and June 1 with 1,424 people aged 18+, including 441 people over 65. More information can be found at www.kff.org/content/2003/20030619a/

All articles 2006-23 written and edited by Mel Crowther and/or Nick Thomas unless otherwise stated.