Karen Davis, Stuart Guterman, Kristof Stremikis, Michelle M. Doty
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.
In a national Commonwealth Fund survey, elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans. The findings bolster the argument that offering a public insurance plan similar to Medicare to the under-65 population has the potential to improve access and reduce costs.
Much of the current health reform debate revolves around whether a public plan similar to Medicare should be made available to employers and individuals under age 65. The primary advantage of a Medicare-like plan is the cost reduction made possible by such a plan’s vast purchasing power and efficient public administration. Private coverage, on the other hand, can offer a greater variety of benefits, more flexibility in managing care, and more selective provider networks. In this study, the researchers sought to compare individuals with employer-sponsored plans and elderly individuals with Medicare to find out if a public plan could potentially improve access to necessary services and reduce the burden of medical bills for individuals under age 65.
A Medicare-sponsored public plan with benefits similar to those available in private employer and federal employee plans could build on Medicare’s broad provider network to offer employers and individuals under age 65 both improved access to care and lower costs. It could also encourage more coordinated, more organized health care delivery.
The authors used data from the Commonwealth Fund 2007 Biennial Health Insurance Survey to compare how patients felt about access and cost under Medicare and employer-sponsored plans. Princeton Survey Research Associates International conducted the survey by telephone with adults in the United States over age 19. The survey response rate was 47 percent. The 25-minute phone interview included questions about health care access, out-of-pocket spending, benefit information, and demographic characteristics.
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.
Full-text article available at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.4.w521?ijkey=DKzEhhsrWBjEo&keytype=ref&siteid=healthaff