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Report: Public Often Clueless About Medicare

Survey respondents oppose cost containment (September 12)

In a special report published in the New England Journal of Medicine, researchers have found that a wide gap exists in beliefs between experts on the financial state of Medicare and the public at large.

The investigators analyzed data from six public opinion polls conducted in 2013 with approximately 1,000 to 2,000 U.S. adults, plus historical data. They also compared public-opinion data with published reports on the status of Medicare today.

Because of the public’s misunderstanding about Medicare’s financing, lawmakers in Congress are hesitant to enact changes to the program fearing voter backlash, the authors wrote.

For example, more than 6 of 10 survey respondents (62%) believe Medicare spending is rising faster than it was 5 years ago. Nevertheless, multiple polls show a low level of support (10% to 36%) for major reductions in Medicare spending to reduce the deficit. In the most recent poll, reductions were supported only by respondents 18 to 29 years old.

According to the authors, this lack of support may relate to beliefs that are not factually correct. Although Medicare is the third largest item in the federal budget, many Americans are unaware that it is one of the largest budget items (53% believe it is). In addition, most respondents do not see Medicare spending as a major contributor to the deficit today (only 31% believes it is a major cause of the deficit).

One reason that many people believe Medicare does not contribute to the deficit is that the majority think Medicare recipients pay or have prepaid the cost of their health care. Medicare beneficiaries, on average, pay approximately $1 for every $3 in benefits they receive. However, approximately two-thirds of respondents believe that most Medicare recipients get benefits worth about the same as (27%) or less than (41%) what they have paid in payroll taxes during their working lives and in premiums for their current coverage.

Overall, the authors found that the majority of Americans (72%), including nearly 9 of 10 seniors (88% of adults 65 years of age or older), have a favorable opinion of Medicare.

However, there are concerns about current cost-containment efforts. Most respondents see Medicare as already withholding treatments and prescription drugs to save money, including 63% who believe this happens very often or somewhat often. Also, the public sees the bigger problem for Medicare beneficiaries as not getting the health care they need (61%) rather than as receiving unnecessary care (21%).

Because of these beliefs, political candidates who favor major cuts in Medicare spending to reduce the federal budget deficit could face negative electoral consequences, the authors suggest. Few registered voters (12%) said that they would be more likely to vote for a congressional candidate taking this stand, whereas many more (58%) said it would make them less likely. This was especially true for registered voters 50 years of age or older, approximately two thirds (66%) of whom said they would be less likely to vote for such a candidate.

Source: NEJM; September 12, 2013.

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