Get with the program.

Report on Medicare delayed, but consumers voice preferences

ADDING COVERAGE FOR LONG TERM CARE and prescription drugs are two modifications to Medicare that Americans appear to support, even as they agree on little else that should be changed about the 30-year-old program.

That's according to a new study based on the responses of some 6,500 people aged 25 to 77 who met in focus groups, community meetings, and public hearings. The study, a partnership of the Henry Kaiser Family Foundation and the League of Women Voters, was completed to help members of the National Bipartisan Commission on the Future of Medicare learn more about the public's view of Medicare. Commission members will receive a copy of the findings.

Fifty-eight percent of people at public meetings and groups supported adding a drug benefit, says Michael Perry, vice president of Lake Sosin Snell Perry & Associates, a report author.

But few Americans had strong opinions on any other options for changing the program, according to study authors, who gave two reasons for the indecision: Many people did not understand the program as it exists today, so they couldn't say how it should be changed, and up to 65 percent don't want to consider options for reforming the program until they are convinced that the government is doing enough to eliminate fraud and abuse.

Opinions also differed depending on the forum in which issues were discussed and were affected by how much knowledge study participants had. For example, up to 40 percent supported the idea of changing Medicare to a defined contribution program (similar to employer-sponsored health insurance) when it was discussed with them in focus groups, while in public meetings only 14 percent favored this idea.

Findings include the following: 47 percent favored raising Medicare premiums paid by the wealthy; approximately 33 percent of people polled favored raising the Medicare eligibility age from 65 to 67; only 18 percent supported reducing payments to providers, fearing that would serve to reduce their access to services; and 36 percent favored raising payroll taxes to bolster the program financially.

Members of the Medicare commission have not focused on adding long term care benefits to the program; whether the idea has support won't be known until the commission issues a report.

The commission faced a March 1 deadline to conclude its year-long effort to recommend program changes. Just four days before that deadline, however, the commission's co-chairs, Senator John Breaux (D-La.) and Representative Bill Thomas (R-Calif.), announced that they would need until March 31 to wrap up their recommendations.

Reaching consensus on any issue may be difficult for the commission. which must rally 11 of its 17 members behind any proposal offered as a formal recommendation. There has been much debate among the Medicare commission members about whether to add drug coverage and how to structure such a benefit.

The Medicare Trust Fund, which today pays for health care for 39 million elderly and disabled Americans, is expected to begin experiencing deficits by 2008.