In The Blogs

Who Loves Medicare?

| Wed Jul. 29, 2009 8:15 AM PDT

Matt Yglesias points out today that socialistic single-payer healthcare is actually quite popular in the United States. It's called Medicare. The chart below, from a Mark Blumenthal column last month, shows that Medicare users are far more satisfied with their healthcare than users of private insurance. So why is it so hard to persuade Americans to simply expand the program? Blumenthal explains:

The higher scores for Medicare are based on perceptions of better access to care. More than two thirds (70 percent) of traditional Medicare enrollees say they "always" get access to needed care (appointments with specialists or other necessary tests and treatment), compared with 63 percent in Medicare managed care plans and only 51 percent of those with private insurance.

....If the Medicare experience is so positive, why are people so easily talked out of expanding on it? First, younger Americans not enrolled in Medicare do not share the enthusiasm of seniors for the program. Six years ago, the Kaiser Foundation asked a national sample of adults to rate the Medicare program. Medicare was hugely popular among those aged 65 or greater....Those under 65, however, had very different views. Only 45 percent rated Medicare favorably. Only 36 percent considered it well run, as compared to 47 percent who said the same about private health plans. While 73 percent of those over 65 said Medicare allowed patients to choose any doctor, only 28 percent of those under 65 agreed.

There's a pretty obvious political dynamic that's responsible for this. Seniors, who actually use Medicare, know perfectly well that it's a good program. They can see any doctor they want, they get care when they need it, and the quality of service is high. So why do younger Americans have such a negative attitude toward Medicare?

Answer: because conservative politicians have been bellowing for years about what a terrible program it is. And since younger workers don't actually use it themselves, the bellowing works. They figure it must suck.

In reality, Medicare works fine. Not perfectly, but fine. It offers service at least as good as private insurance despite serving the highest-risk population there is, and it does at least as good a job of reining in costs — slightly better, in fact. Sure, it could be improved, but it's already probably better than the employer insurance that you have right now. I'd switch in a second if I could.

But I can't, and neither can you. And nothing like it will be offered to you anytime soon. After all, if you actually used it, you'd probably like it. Which is exactly what conservative politicians are afraid of.

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Kevin Drum is a political blogger for Mother Jones. For more of his stories, click here.

Comments

Another option we can't get

Submitted by Anonymous (not verified) on Wed Jul. 29, 2009 8:38 AM PDT.

Another option we can't get - the Congressional health care plans WE pay for. I don't understand why people aren't upset that Congress has wonderful healthcare, courtesy of the taxpayers. Pitchforks, anyone?

Wait...what?

Submitted by James2 (not verified) on Wed Jul. 29, 2009 8:39 AM PDT.

So it's still the conservatives fault, even though you've got 60 dems in the senate, a majority in the house, and one in the white house?

Erm, come again?

And why have those evil neocons been able to "bellow" and get most of the country to believe them? Couldn't those righteous dems do the same thing, preach the gospel of how great Medicare really is? Why haven't they been doing this for the last 20 years? Oh that's right, because it's not really so great. I guarantee you that if those interviewed were paying $4k a month for that same service, they'd be madder than all hell. But, since it appears to be free, it suddenly doesn't seem so bad, unless you ask the other 30%...

Suggested slogan: "Medicare

Submitted by Aris (not verified) on Wed Jul. 29, 2009 8:42 AM PDT.

Suggested slogan: "Medicare for All."
____________________________________________

Is medicare cheaper?

Submitted by BoringCommenter (not verified) on Wed Jul. 29, 2009 8:47 AM PDT.

Is not answered by the statistic you link to. You say it does a better job reining in costs, because it's rate of growth per capita is slower. Fine, but it has an entirely different population, and has put far more resources into fraud prevention than it used to. Just because the rate of money flowing out of the firehose hasn't increased as much as that of private insurance, doesn't say anything about the relative sizes of the firehoses.

(Similarly, the lower administrative costs don't say anything about how much of the money is stolen)

None of this is to say Medicare for all isn't a good idea. But overstating the case on shaky statistics doesn't help.

Well yes, James2, it IS the

Submitted by Dean Austin (not verified) on Wed Jul. 29, 2009 8:56 AM PDT.

Well yes, James2, it IS the conservatives fault. They have spent 30 plus years spewing demagoguery that the public and Democratic party have internalized. So absolutely, it’s their fault.

WHAT?!

Submitted by james2 (not verified) on Wed Jul. 29, 2009 10:26 AM PDT.

So the Democrats have "internalized" the neocons filthy rhetoric, and it's the fucking neocons fault? HOW FUCKING STUPID ARE DEMOCRATS? Seriously? This is your argument? They made us believe it? That's it?!!

Democratic legislators have been co-opted

Submitted by tpx on Wed Jul. 29, 2009 3:04 PM PDT.

Democratic legislators have been co-opted, not by rhetoric, but by graft. The stupid Democrats are the ones who vote for these corrupted cloth coat Republicans who run as Democrats.

health care

Submitted by john sherman (not verified) on Wed Jul. 29, 2009 9:09 AM PDT.

Medicare is a pretty good system; as a system to be under in the U.S. it's second only to the VA, which really is socialized medicine.

Not to mention, young people

Submitted by trotsky (not verified) on Wed Jul. 29, 2009 9:19 AM PDT.

Not to mention, young people pay for it and get no benefit.

our parents or grandparents are treated very well by Medicare

Submitted by tpx on Wed Jul. 29, 2009 9:20 AM PDT.

I was in America's heartland a couple of weeks ago and every Republican I met had bad things to say about government interference in any business, industry and health care. When I brought up how Medicare and how the folks using it are allocated hip transplants and heart procedures without too much trouble, the heartlanders had no rebuttal. All of them knew their parents or grandparents were treated very well by Medicare, yet they continued to parrot Limbaugh and Glenn.

That's quite an argument

Submitted by Got Change on Wed Jul. 29, 2009 9:20 AM PDT.

That's quite an argument Kevin but you forgot the 'working well but running up $35,000,000,000,000 in unfunded liabilities' argument. How's that for working well?

Exactly

Submitted by Mario on Wed Jul. 29, 2009 1:55 PM PDT.

Pointing to the popularity of Medicare without bringing up its financing problem is like touting the magical benefits of buying everything you want on credit. Since Medicare is about to receive substantial cuts in services, it would be better to wait and see how it fares in quality and customer satisfaction post-cut before we try to move everyone else into something similar.

Another reason younger

Submitted by Eagle (not verified) on Wed Jul. 29, 2009 9:31 AM PDT.

Another reason younger people are upset about medicare is that even as we care deeply about the seniors in our lives, we see them getting huge amounts of health care (often in the last years of their lives, following a diganosis that leaves little hope for a positive outcome) while we have no cost-effective access to the most basic care. Many of us have spent years of our lives without health coverage, even when we need care, only to watch our elders complain about how hard they have it, as they schedule endless appointments, have twelve MRI's, and have bottles and bottles of expensive medication around them that they often refuse to take. That DOES get wearisome.

Not saying that this has anything to do with the political debate, but it's part of the culture. To not recognize that is to misunderstand some of the anger people feel about health care in our country, at least, in my opinion.

You might also have

Submitted by Got Change on Wed Jul. 29, 2009 9:47 AM PDT.

You might also have considered the responsiveness of the elderly in the survey. Ask an 85 year old if they are happy with their Medicare and what are they going to say? No? I want something different? Of course not, they'd be afraid you were going to take it away. In fact without knowing the exact ages of the 'over 65' respondents calls the entire survey results into question.

Know anybody on Medicare, do you?

Submitted by gyrfalcon on Wed Jul. 29, 2009 10:04 AM PDT.

That's my age cohort, bud, and everybody I know who's gotten there is very, very happy with it, especially in comparison to the crappy private health insurance they were able to ditch once they became Medicare-eligible.

The only complaint I've ever heard about Medicare is the flood of unintelligible paperwork that comes in the mail after every check-up or test or procedure, but virtually all of it is labled in big letters "This is not a bill." And indeed, it isn't, it's just to tell you what you got and how much was paid for it.

Folks over 65 don't suddenly revert to terrified 5-year-olds. In fact, we get crankier and less inhibited about speaking our minds. The idea that we'd be too frightened of losing our health coverage to tell a survey taker our honest opnion is an insane and stunningly insulting fantasy running in your own head, not anything related to reality.

I was just going based on

Submitted by Got Change on Wed Jul. 29, 2009 10:50 AM PDT.

I was just going based on personal experience with two sets of parents in their mid 80's.

Why not expand existing programs?

Submitted by g. powell on Wed Jul. 29, 2009 9:55 AM PDT.

One aspect of the healthcare reform debate that I've never understood is why the govt just doesn't expand Medicare and Medicaid to include more people. This would have to be accompanied with finding new revenue and new cost containment measures, but it seems easier to me than designing a new system from scratch. It would also be easier to phase in the expansion of the programs.

And the arguments from the public-option/single-payer opponents would lose some of their sting. It's harder to argue against programs that already exisit and work reasonably well than to set up straw men and rail against those.

Medicare

Submitted by Kim (not verified) on Wed Jul. 29, 2009 10:17 AM PDT.

My father is on Medicare and is well taken care of. He is in a Nursing Home suffering from Dementia and my family would not be able to have him there if it were not for this program.

Medigap

Submitted by Cathy (not verified) on Wed Jul. 29, 2009 10:40 AM PDT.

It should be mentioned in all discussion of medicare that it only pays 80% of the cost that they determine. Seniors have "medigap" policies (through private insurers) to cover the remaining 20%.

My mother paid $245.00/month for her medigap and had 90 some dollars withheld from her SS check, and then some more for Part D so about $350.00/month even with medicare!

Also note to Kim medicare does not pay for long term care. Her father is most likely on medicaid which requires you to spend all of the patients assets including your house (unless the spouse is still alive) before it picks up the bill. YOu get an allowance out of your income of $60.00 month for toothpaste etc.

Medicare for all is a place to start, but it still leaves a lot of holes.

Medicare

Submitted by Bill Meyer (not verified) on Wed Jul. 29, 2009 1:05 PM PDT.

As A senior who has been enrolled in traditional Medicare for 8 years, and who also carries a Medigap policy, I couldn't be happier. I have 2 stents, treated high blood pressure, compromised kidneys and I get all the care I want. I currently see 3 specialists plus a GP. For 43 years I worked under a variety of emplyer-provided plans; some good, some not so good, but none of them can hold a candle to what Medicare provides.

Young/old divide

Submitted by EB (not verified) on Wed Jul. 29, 2009 1:52 PM PDT.

Could it be that seniors are so happy with Medicare because there is no other option that they can actually afford available to them? And could it be that younger folks have a negative view of it because they have to pay for it, but their future access to Medicare benefits is threatened by massive deficits and ever-increasing retirement age?

Republicans may have been

Submitted by JS (not verified) on Wed Jul. 29, 2009 1:56 PM PDT.

Republicans may have been bad-mouthing Medicare, but it is also true that Democrats have done a lousy job advertising its success and the degree of satisfaction of its participants.

In my experience, people who are not old enough to start thinking about Medicare about themselves know very little about the program. With the exception of those who are directly involved in the care and/or finances of elderly parents, the rest of the population is largely ignorant about what Medicare is, what it costs, and how much it's liked by those it covers.

The Democrats (from Obama on down) should be shouting this from the rooftops. But they haven't been, and the Republican negative message has been much more effective than it should have been.

Part of growing up is being

Submitted by Luther on Wed Jul. 29, 2009 4:16 PM PDT.

Part of growing up is being responsible and not putting things like Medicare on the credit card when you can't pay for them.