Experts and Public Disagree on Need to Cut Medicare Spending

While many experts feel future Medicare spending should be reduced in order to lower the federal budget deficit, only one third of Americans agree, according to a special report in the New England Journal of Medicine.

In fact, a majority of the public says they will vote against candidates who favor the reductions.

According to the results of seven existing national polls, the majority of Americans feel that Medicare recipients pay or have prepaid the cost of their healthcare. According to data, Medicare beneficiaries on average pay about $1 for every $3 in benefits they receive. In addition, about two-thirds of the public believe that most Medicare recipients get benefits worth about the same (27 percent) or less (41 percent) than what they have paid in payroll taxes during their working lives and in premiums for their current coverage.

The public also doesn’t feel that overuse of medical care and the cost of new medical technologies are responsible for rising Medicare costs. According to survey results, only one in six Americans believe that ‘people receiving drugs and medical treatments they don’t need is one of the most important reasons why Medicare care costs are rising,’ and only 6 percent see ‘new drugs, tests and treatments being offered to the elderly’ as one of the most important reasons.

The three reasons cited most often by the public are poor management of Medicare by government (30 percent), fraud and abuse in the health sector (24 percent), and excessive charges by hospitals (23 percent).

Many experts believe that one of the most important reasons for rising Medicare costs is unnecessary care provided to patients. The public, however, sees the bigger problem for people on Medicare as not getting the healthcare they need (61 percent), rather than receiving unnecessary care (21 percent). Many experts see capitated payments (doctors getting paid a fixed amount of money so they can manage all of a patient’s healthcare for the year) as a preferred way of reducing future Medicare spending. However, a majority of the public favors continuing fee-for-service (FFS) payments (65 percent) rather than changing to capitated health care arrangements (30 percent). This resistance to change may be related to the fact that a majority of the public sees Medicare in some cases already withholding treatments and prescription drugs to save money, including 63 percent who believe this happens very or somewhat often.

The public’s hostility to reducing Medicare spending could play an important role in future elections. The poll findings show that regardless of the potential seriousness of the problem, candidates who favor major cuts in Medicare spending to reduce the federal budget deficit could face negative electoral consequences. Few registered voters (12 percent) say that they would be more likely to vote for a congressional candidate taking this stand, while many more (58 percent) say it would make them less likely. This is especially true for registered voters age 50 and over, about two-thirds (66 percent) of whom say they would be less likely to vote for such a candidate.

You can view charts here and topline here.

Source: Harvard School of Public Health , September 11, 2013

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