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Consumers Favor Many Coverage Changes in a Medicare Overhaul

By Melanie Zanona, CQ Roll Call

September 19, 2014 -- Consumers would reshape Medicare benefits in all but two categories if asked to reallocate current funding levels, according to a study conducted by the Center for Healthcare Decisions (CHCD).

The report—which the American Enterprise Institute and the Brookings Institution highlighted in a recent panel discussion—suggested that participants would ultimately like to see a program design significantly different from current Medicare coverage.

"We're trying to understand what is most important to people when trade-offs are inherent," said Marge Ginsburg, founding director of the CHCD, at the event. "People think about health care very personally. But how do you get people to move from thinking solely in terms of what is in my best interest, to what would be in the best interest of all of us?"

Political leaders and health care groups have long agreed that it is crucial to address Medicare spending as baby boomers become senior citizens, but they have sparred over how to restructure the program. Meanwhile, the data illustrates that Medicare spending has slowed in recent years.

The CHCD study used a computer-based tool to simulate creating a Medicare benefits package by giving participants 100 "markers" that are equivalent to current program spending levels. In every category, participants were asked to pick from three tiers of coverage, each of which cost a certain number of markers based on its real world value, and one of which represented current Medicare coverage.

The results showed that participants were generally willing to reduce some low-value care coverage and restrict their freedom of choice in provider networks in order to gain greater long-term care and mental health coverage. They also did not believe that during end-of-life care, life-sustaining treatments should be offered when there is a high likelihood of failure. The only elements of the current Medicare program they did not want to see changed were routine and catastrophic care coverage.

Also noteworthy is that the majority of participants were willing to give up some of their markers in order to expand the solvency of the program.

Panelists at last week's event acknowledged the limitations of the study, such as the fact it only examined 800 Californians, but they maintained that the report is important for shaping policy debates in Washington and translating the results into meaningful proposals.

Robert Moffitt, senior fellow in domestic and economic policy studies at the Heritage Foundation, recognized the difficulty of reshaping Medicare in Congress. "It's nice that there was consensus" among participants in the study, he said. "If only that could happen here."

Publication Details

Publication Date: September 22, 2014