Medicare Enrollees Report Better Care, Fewer Problems than People with Employer-sponsored Insurance

Elderly people whose health care is covered by Medicare report fewer problems and higher satisfaction with their care than younger patients whose health insurance is provided by their employers. Although the older Medicare beneficiaries have lower incomes and poorer health than the employer-covered group, they reported less difficulty paying their bills, fewer problems finding medical care, and higher overall satisfaction with that care.

Information comes from an analysis of the Commonwealth Fund 2007 Biennial Health Insurance Survey, a nationally representative telephone survey of 3,501 adults age nineteen and older living in United States.   Even counting those who refused to participate and those who could not be reached by phone, the survey’s response rate was almost 50 percent.

While 37 percent of Medicare patients said their overall medical care in the past year was “excellent”, only 20 percent of people with employer insurance said the same.  On the other hand, 18 percent of those employer-covered people said that their care was “fair to poor” while only 8 percent of Medicare-covered patients felt that their care was fair or poor.The survey found poorer health among elderly Medicare patients.

Compared to people with employer sponsored insurance:

• More than twice as many rated their health fair to poor (28 percent vs 14 percent)
• Almost four times as many had multiple health problem (38 percent vs 11 percent)
• More than half had incomes below 200 percent of poverty compared to about a quarter of those with insurance.
• One in four (25 percent) had annual income less than $20,000 compared to one in ten (9 percent) of people with insurance.

Medicare enrollees reported better access to care and fewer problems with that care:

• 32 percent said they had one or more negative experiences with coverage for care compared to 44 percent of employer-covered patients.
• 10 percent said that a doctor refused to take them as a patient compared to 17 percent of those employer-covered.
• 14 percent of Medicare patients had a problem paying a bill or with bill collection compared to 35 percent of employer-covered insured.

Since a similar study in 2001, Medicare patients do report more problems with access to care and paying bills, but the gap between their concerns and the greater problems experienced by patients with employer-coverage has grown.