Medicare
Information
Survey
Finds People With Medicare More Negative Than Positive Toward New
Drug Law, But Want It Fixed, Not Repealed
Most
People On Medicare Do Not Believe The New Drug Benefit Will Help
Them Personally; Few Currently Plan To Enroll But Most Don't Know
Enough To Say
Press
Release WASHINGTON, DC-(August 10, 2004)- Many more people on Medicare
have an unfavorable than a favorable impression of the new law that
adds a drug benefit to the program, but most want Congress to fix
rather than repeal it, according to a new survey of the opinions
of people on Medicare released today. The survey found that, as
of July 2004, nearly twice as many people on Medicare have an unfavorable
view of the law (47%) as have a favorable view (26%), and one in
four (25%) say that they don't know enough to offer an opinion.
Overall,
two out of three people on Medicare (66%) say that lawmakers in
Washington should work to fix problems in the law. Much smaller
numbers favor repealing the law (10%) or leaving the law as is (13%),
according to a national survey of 1,223 seniors and people with
disabilities who receive Medicare conducted from June 16 to July
21. The survey, Views of the New Medicare Drug Law: A Survey of
People On Medicare, was conducted jointly by the Kaiser Family Foundation
and the Harvard School of Public Health to provide insight into
the opinions of the 41 million Americans on Medicare, including
the 6 million people on Medicare under age 65 who have permanent
disabilities.
"Fifteen
months from implementation, seniors are mostly negative and very
confused, but there is little evidence of a large scale backlash,"
said Drew Altman, President and CEO of the Kaiser Family Foundation.
"This survey suggests that there will be big debates in the
future about the prescription drug law, but they will be about improving
it, not repealing it."
Will
I Benefit?
The
majority of people on Medicare think the new law will be helpful
for most people on Medicare, but most don't think the law will be
helpful to them personally. About three in 10 view the new law as
very (9%) or somewhat (19%) helpful to them personally.
The
groups most likely to be helped by the new law - those with low
incomes and those low who currently have no drug coverage - are
not significantly more likely than others to think the law will
help them personally.
A
third (33%) of people on Medicare with incomes under $20,000 annually,
and three in 10 people on Medicare with no drug coverage (31%),
say the new law will be very or somewhat helpful for them personally.
With
the full Medicare drug benefit set to take effect in January 2006,
most people on Medicare (62%) say they haven't yet heard enough
to decide whether they will enroll in a Medicare drug plan when
the benefit becomes available in 2006, while 16% say they will enroll,
and 21% say they will not enroll. More of those who currently have
no prescription drug coverage (23%) say they will enroll in the
benefit in 2006, but 11% say they will not enroll, and nearly two
thirds (65%) say they haven't yet heard enough to decide.
Among
the 47% of people on Medicare who have an unfavorable impression
of the law, the most frequently cited reason is that it does not
provide enough help with drug costs for people on Medicare (81%
of those with an unfavorable impression, or 39% of people on Medicare
overall, say this is a major reason). Other major reasons include
that the law is too complicated for people on Medicare to understand
(34% overall) and that it will benefit private health plans and
pharmaceutical companies too much (33% overall). Fewer people on
Medicare cite the long-term cost of the law to government as a major
reason for their unfavorable view (16% overall).
The
26% of people on Medicare who say they have a favorable impression
of the law cite several major reasons for their view, including
that the law will help pay many of the drug bills for people on
Medicare (78% of those with a favorable impression, or 20% overall,
say this is a major reason), that it the law will help low-income
people on Medicare (20% overall), that it will be helpful for people
with high drug bills (20% overall), that it allows people on Medicare
to choose a drug plan that best meets their needs (17% overall),
and that it is a good start and can be improved over time (15% overall).
Whether
positive or negative, however, views about the law are moderate
in tone. Just 2% say they are "enthusiastic" about the
law, and 10% say they are angry; 31% say they are "satisfied,
but not enthusiastic," and 41% say they are "dissatisfied,
but not angry."
The
negative views toward the new Medicare law are in sharp contrast
to how seniors and disabled people view the Medicare program itself.
The survey found that three out of four people on Medicare (73%)
say they have a favorable opinion of Medicare, compared with one
in four (26%) who say they have a favorable opinion of the new Medicare
law.
Impact
On Elections
When
asked about November's elections, nearly three in 10 seniors and
people with disabilities on Medicare (28%) say the passage of the
new law will have an effect on their vote for president. A significantly
larger number - nearly four in 10 (38%) -- say it will have an effect
on their vote for Congress.
The
issue appears to favor Democrats in the Congressional elections
at this point in time. Among those who say that the law will impact
their vote in Congressional races, more than twice as many say it
will make them more likely to vote for a Democrat (53% of those
who say law will impact their vote, or 20% overall) than say it
will make them more likely to vote for a Republican (21% of those
who say law will impact vote, or 8% overall).
"The
Medicare issue could be a decisive factor in a close Presidential
election and in some House races," said Robert J. Blendon,
Sc.D. Professor of Health Policy at the Harvard School of Public
Health.
Among
those who say that the law will impact their vote for President,
more than twice as many say that it makes them more likely to vote
for Democratic challenger John F. Kerry (44% of those who say they
law will impact their vote, or 12% overall) than say it makes them
more likely to vote for President George W. Bush (18% of those who
say law will impact vote, or 5% overall). People on Medicare are
nearly evenly divided on whether they trust Sen. Kerry (39%) or
President Bush (34%) more when it comes to handling prescription
drug benefits for people on Medicare.
The
poll shows that to date the law has not been a political plus for
Republicans, but the number of seniors likely to switch their vote
from one candidate to another because of the law is modest, with
any benefit likely going to the Democrats.
Medicare-approved
drug discount cards
More
than half of all people on Medicare (53 percent) say that the Medicare-approved
drug discount cards "aren't worth the trouble because they
don't do enough to help people with their drug costs, and they are
too confusing to use," while about a third (34 percent) say
they are "worthwhile because they give people on Medicare immediate
help before the full prescription drug benefit is available in 2006,
and they provide another way to cut their drug costs."
The
survey found that 9% of people on Medicare say they have signed
up for a Medicare-approved drug discount card, and another 17% say
they plan to sign up for a card this year.
Six
in 10 people on Medicare (60%) say they don't have a card and don't
plan to sign up for one. Many of those who don't plan to sign up
say that they already have other drug discount cards or coverage
(63%) and that they do not think the card will save them money (41%).
Fewer say they won't sign up because they were worried about how
the cards would affect other prescription drug coverage they have
(21%) or because it was too difficult to choose among the variety
of cards offered (14%). About one in eight (13%) who did not sign
up say the reason was that they did not know about the cards.
Reimportation
and negotiation
People
on Medicare also overwhelmingly support two legislative changes
that have been debated in Washington.
Eight
in 10 (79%) say they favor changing the law to allow Americans to
buy prescription drugs from Canada if they think they can get a
lower price. Two thirds (66%) agree that the change will make medicines
more affordable without sacrificing safety or quality. Large majorities
disagree with arguments put forward by the opponents of reimportation.
About seven in 10 (71%) disagree that this will lead U.S. drug companies
to do less research and development, and about six in 10 (62%) disagree
that it will expose Americans to unsafe medicines from other countries.
Similarly,
eight in 10 people on Medicare (80%) say they favor changing the
law to allow the federal government to use its buying power to negotiate
with drug companies to try to get a lower price for prescription
drugs for people on Medicare. Large majorities agree with arguments
for government negotiation, including that it makes sense because
other governments currently negotiate drug prices (80% agree), it
will make medicines more affordable for people on Medicare (76%
agree), and it makes sense because the government already negotiates
lower prices for the Defense Department and Veterans Administration
(69% agree). When it comes to arguments against government negotiation,
six in 10 (61%) disagree that it will lead U.S. drug companies to
do less research and development. Half (53%) agree that it will
mean government price controls on prescription drugs.
Outreach
efforts
People
on Medicare say that they get information about Medicare and prescription
drugs from various sources. Four in 10 (42%) say they saw any television
advertisements about the Medicare law in the previous month, and
a similar number (41%) say they saw news coverage about the new
Medicare law in the previous month. Among those who have seen TV
ads, more say the ads were positive (34%) than negative (9%) towards
the new law, while nearly half (47%) say they were mixed.
Six
in 10 (60%) say they have gotten information in the mail about the
new Medicare-Approved Drug Discount Card Program. They say that
this information comes from a variety of sources, including the
government and private companies selling discount cards.
Six
in 10 people on Medicare (60%) say they have heard of 1-800-MEDICARE,
and 16% of these (10% overall) say they have called the toll-free
number. More than one in eight (14%) say they have heard of the
Medicare.gov web site, though only 4% overall say they have visited
the site. A quarter of people on Medicare (25%) say they have ever
been online to use the Internet or e-mail.
The
survey showed that disabled people under age 65 who receive Medicare
are more likely to use these resources than seniors. Disabled people
under age 65 who are on Medicare are significantly more likely than
seniors to be online (33% vs. 24%), to have visited Medicare.gov
(10% vs. 4%), and to have called 1-800-MEDICARE (16% vs. 9%).
METHODOLOGY
The
Kaiser Family Foundation/Harvard School of Public Health Views of
the New Medicare Drug Law: A Survey of People on Medicare was designed
and analyzed by researchers at the Kaiser Family Foundation and
Harvard School of Public Health. The Kaiser/Harvard survey research
team included Mollyann Brodie, Ph.D., Tricia Neuman, Ph.D., Elizabeth
Hamel, and Michelle Kitchman from the Kaiser Family Foundation;
and Professor Robert Blendon, Sc.D., and John Benson, M.A., of the
Harvard School of Public Health.
Fieldwork
was conducted by telephone by ICR/International Communications Research
between June 16 and July 21, 2004, among a sample of 1,223 total
respondents. The survey included a nationally representative random
sample of 973 respondents 65 years of age and older, including an
oversample of African American respondents in this age group (a
total of 203 African American respondents ages 65 and older were
interviewed). A separate sample of 250 respondents ages 18-64 with
physical and/or mental disabilities who receive Medicare was also
interviewed. The disabled sample was drawn from a nationally representative
survey of households contacted between June 2002 and January 2003
that was screened to identify households with an adult, aged 18-64,
who receives disability payments through the SSI or SSDI program
and/or considers him or herself disabled. This sample was then re-screened
to include those people with disabilities who are covered by Medicare.
Results for all groups have been weighted to reflect the actual
distribution in the nation.
The
margin of sampling error for the survey is plus or minus four percentage
points for total respondents; for respondents age 65 and older it
is plus or minus four percentage points; and for non-elderly respondents
with disabilities it is plus or minus 10 percentage points. For
results based on subsets of respondents the margin of error is higher.
Note that sampling error is only one of many potential sources of
error in this or any other public opinion poll.
The
topline results and the survey report are available online at www.kff.org.
The
Kaiser Family Foundation is a non-profit, private operating
foundation dedicated to providing information and analysis on health
care issues to policymakers, the media, the health care community,
and the general public. The foundation is not associated with Kaiser
Permanente or Kaiser Industries.
Harvard
School of Public Health is dedicated to advancing the public's health
through learning, discovery, and communication. More than 300 faculty
members are engaged in teaching and training more than 800 students
in a broad spectrum of disciplines crucial to the health and well
being of individuals and populations around the world.
