THURSDAY, April 26 (HealthDay News) -- Medicare, the federal
health insurance program for older and disabled Americans, may be
hurtling toward the critical list, but most people don't want to
pay for needed reforms from their own wallets, a new
Harris Interactive/HealthDay poll finds.
Eighty-three percent of those polled believe changes are needed
to keep Medicare affordable and sustainable, and 51 percent think
that "a great deal of change" is necessary. But they'd rather not
make any personal sacrifices, according to the poll.
"There's a clear majority who think there is a problem that needs to be addressed, but (people also believe) if the changes are going to cost me money in terms of higher co-pays, higher deductibles or higher taxes, no thank you," said Humphrey Taylor, chairman of The Harris Poll.
When people were presented with nine proposals for slowing the
rate of Medicare spending, the poll revealed strong approval (72
percent) for cutting the price Medicare pays for prescription drugs
to pharmaceutical companies, and modest support for trimming fees
to hospitals (47 percent favor, 28 percent oppose) and doctors (41
percent to 35 percent).
Few favor higher taxes and out-of-pocket contributions, such as
increased co-pays and deductibles. Fifty-three percent and 60
percent, respectively, oppose those options. But a majority said
people with higher incomes should pay more for Medicare benefits
than lower-income individuals (57 percent favor, 21 percent
Medicare, which serves 49 million older and disabled Americans,
is under severe financial strain. More than 15 percent of the
federal budget goes toward Medicare, and that's projected to
increase to 17.5 percent by 2020 -- the third largest government
expenditure after Social Security and defense, government
Experts say rising prices, new technologies, beneficiaries'
increasing use of services and the aging of the population are
fueling the growth in Medicare spending.
"You've got a situation now where health care is somewhere around 18 percent of GDP (gross domestic product), and it's going to go to 20 percent in a few years," said Nathan Goldstein, chief executive officer of Gorman Health Group, a Washington, D.C.-based consulting firm. "It's like a dragon eating the economy from the inside."
The situation will only worsen in the coming years as more and
more baby boomers become eligible for the program, swelling
Medicare enrollment to more than 80 million people by 2030.
Because of these trends, the board of trustees that oversees
Medicare's financial operations predicts that the hospital
insurance trust fund, known as Medicare Part A and a key component
of the program, will be depleted by 2024.
To put the program back on stable footing, policymakers are
considering a variety of cost-cutting and revenue-raising
One proposal being advanced by House of Representatives Budget
Committee Chairman Paul Ryan (R-Wis.) and Sen. Ron Wyden (D-Ore.)
would give seniors a voucher to shop for their own private health
insurance. Under their so-called "premium support" plan, Medicare
would no longer provide a "defined benefit." Instead, beneficiaries
would receive a "defined contribution" toward the cost of health
But support for such a plan depends on political affiliation,
the poll found.
When described as "one proposal to change the Medicare program,"
a small plurality (32 percent to 27 percent) of those polled said
they favor a voucher plan. When described as a House Republican
plan, Republican support increases to 47 percent from 35 percent
while Democratic opposition rises to 48 percent from 31
At a press briefing on Friday to unveil recommendations for
Medicare reform, the American College of Physicians (ACP) said it
could not endorse such a "premium support" plan without pilot
testing and strong protections for beneficiaries. However, the
college said it does support policies to improve the delivery of
care, reduce the government's cost of prescription drugs and pay
providers based on the value of services provided.
"Difficult choices must be made to ensure (Medicare's) solvency, but not at the expense of patient health," Robert Doherty, ACP's senior vice president of governmental affairs and public policy, said during the briefing.
A majority of adults (54 percent to 18 percent) polled agree
that doctors and hospitals should be paid based on quality and
results, rather than the volume of care provided. Even in
Washington, D.C., Taylor noted, "there is an acceptance . . . that
the traditional fee-for-service way of paying for things is a kind
of toxic incentive and needs to be changed."
The poll also found that people like having a choice between
traditional fee-for-service Medicare and Medicare Advantage plans.
Only small percentages would like to see the program run
exclusively by the federal government (12 percent) or by private
health plans (13 percent).
The online survey of 2,229 adults aged 18 and older was
conducted April 5 to 9. Figures for age, sex, race/ethnicity,
education, geographic region and household income were weighted,
where necessary, to make them representative of actual proportions
in the population. Weighting was also used to adjust for
respondents' likelihood to be online.
The Kaiser Family Foundation has a primer on
Medicare spending and financing.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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