Précis This!

Report: Medicare Enrollees More Satisfied Than Members of Private Employer Insurance Plans October 16, 2009

American Medicare patients are happier with their care, get medical care with fewer hassles and suffer less financial hardship than people in employer-provided insurance plans, according to a recent study reported in Health Affairs on the Web.

Abstract

One key issue in health reform concerns the relative roles of coverage offered through private insurance and public programs. This paper compares the experiences of aged Medicare beneficiaries with those of people under age sixty-five who have private employer coverage. Compared with the employer-coverage group, people in the Medicare group report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher overall satisfaction with their coverage. Although access and bill payment problems increased across the board from 2001 to 2007, the gap between Medicare and private employer coverage widened. [Health Affairs 28, no. 4 (2009): w521–w532 (published online 12 May 2009; 10.1377/hlthaff.28.4.w521)]

(Emphasis added.)

Implications

A Commonwealth Fund brief about the project concluded:

Offering the choice of a Medicare-sponsored public plan to those under age 65 would likely increase access to care, reduce administrative burden, and offer people security of coverage, and could possibly contribute to greater competition among both public and private insurers—thereby increasing responsiveness to consumers’ needs.

(Emphasis added.)

Key Research Findings

Medicare beneficiaries are more satisfied with their insurance coverage. Only 8 percent of elderly Medicare beneficiaries rated their insurance “fair or poor,” in contrast with 18 percent of individuals with employer-based insurance. Thirty-two percent of Medicare beneficiaries had at least one negative insurance experience, compared with 44 percent of those covered by an employer plan.

Chart: Health Affairs, 2009

Medicare beneficiaries report easier access to physicians. Ten percent of Medicare beneficiaries’ physicians did not accept their insurance, compared with 17 percent of respondents with employer-sponsored plans.

Medicare beneficiaries are less likely to report not getting needed services. Twelve percent of elderly Medicare beneficiaries reported going without care, such as prescribed medications or recommended tests, because of cost restraints. Of individuals with employer-based plans, 26 percent reported experiencing these cost/access issues.

Medicare beneficiaries are sicker and poorer but report fewer medical bill problems. Elderly Medicare beneficiaries were more likely to rate their health as fair or poor than the employer-coverage group (28% vs. 11%); more likely to have multiple chronic conditions (38% vs. 11%); and more likely to have incomes below 200 percent of the federal poverty level (51% vs. 27%). Yet, Medicare beneficiaries were less likely to report a medical bill problem than those covered by employer plans.

(Emphasis added.)

Patient Satisfaction Results in Canada

The U.S. study’s results appear similar to patient-satisfaction data for Canada’s single-payer medicare system, in which government pays private providers for goods and services but runs very few health care facilities.

Source: Statistics Canada

Sources

K. Davis, S. Guterman, M. M. Doty, and K. M. Stremikis, “Meeting Enrollees’ Needs: How Do Medicare and Employer Coverage Stack Up?” Health Affairs Web Exclusive, May 12, 2009, w521–w532. Web URL:

http://content.healthaffairs.org/cgi/reprint/28/4/w521?ijkey=DKzEhhsrWBjEo&keytype=ref&siteid=healthaff

Statistics Canada. “Patient satisfaction with any health care services received in past 12 months, by sex, household population aged 15 and over, Canada, provinces and territories, occasional” (CANSIM Table 105-4080). Ottawa, Statistics Canada, 2006. See data charts on the Web: “Indicators of Well-being in Canada; Health — Patient Satisfaction.”  Web URL: http://www4.hrsdc.gc.ca/.3ndic.1t.4r@-eng.jsp?iid=7).