Michelle M. Doty, Cathy Schoen, Karen Davis
"Medicare vs. Private Insurance: Rhetoric and Reality," Karen Davis, Cathy Schoen, Michelle Doty et al., Health Affairs Web Exclusive (October 9, 2002): W311324
Recent debates about the future of Medicare have included a range of proposals that would restructure the program to operate more like private insurance. Findings from The Commonwealth Fund 2001 Health Insurance Survey, however, show that Medicare outperforms private sector plans in terms of patients' satisfaction with quality of care, access to care, and overall insurance ratings.
In Medicare Versus Private Insurance: Rhetoric and Reality, Commonwealth Fund President Karen Davis and colleagues Cathy Schoen, Michelle Doty, and Katie Tenney present new evidence on how well Medicare works for beneficiaries compared with how well private insurance works for persons under age 65. Their analysis is based on data gathered by Princeton Survey Research Associates from April through July 2001. Interviews were conducted with a random national sample of 3,457 adults age 19 and older.
In their report, Davis and coauthors find that elderly Medicare beneficiaries are more likely than enrollees in employer-sponsored plans to rate their health insurance as excellent (32% vs. 20%) and less likely to report negative experiences with their insurance plans (43% vs. 61%). Medicare beneficiaries are also less likely than those with private insurance to go without needed care owing to costs (18% vs. 22%). The survey also finds that elderly Medicare beneficiaries are more likely to report being very satisfied with the care they received compared with those with private insurance (62% vs. 51%).
As the chart below illustrates, private insurance holders are actually less satisfied with health care and more concerned about costs than Medicare beneficiaries. The fact that Medicare was systematically more likely than employer coverage to be rated as excellent across income and health status categories challenges the received wisdom that Medicare is "out of date," and should "catch up" with the private insurance model. "Would-be Medicare reformers need to be cautious if they want to make the program more like the private sector," the authors conclude.