* Respondents were asked: Thinking about paying for your healthcare in the future, would you be interested in having 1% of your (and/or your spouses) earnings.

71716869

0

25

50

75

100

Total Democrat Republican Independent

* Respondents were asked: “Thinking about paying for your healthcare in the future, would you be interested in having 1% of your (and/or your spouses’) earnings deducted from your paycheck(s), tax-free, and placed in your own Medicare account(s) to use for long-term care or other expenses not covered by Medicare?”

Source: The Commonwealth Fund Survey of Older Adults (2004).

Majorities of Adults Across Political AffiliationExpress Interest in Medicare Health Accounts*

Percent of adults ages 50–70 in working families interested in a Medicare Health Account

Figure ES-1

Percent of Adults Ages 50–64 Who Are Very/Somewhat Interested in Receiving Medicare Before Age 65, by

Insurance Status and Income

6450

4030

26 2231

3336

41 34

5870

34

24

32

0

25

50

75

100

Somewhat interested

Very interested

Percent of adults ages 50–64and not on Medicare

73

84

68

94


8681

7366

Figure ES-2

Total Employer Individual Uninsured Lessthan

$25,000

$25,000–$39,999

$40,000–$59,999

$60,000or more

Access Problems Because of Cost

32

57

24 21 2318

0

25

50

75

Total, Ages

50–70

Total

Insured

Medicare Employer Individual Uninsured

Percent of adults who had any of four access problems*in past year because of cost

* Did not fill a prescription; did not see a specialist when needed; skipped medical test, treatment, or follow-up; did not see doctor when sick.


Figure ES-3

More than One-Third of Older AdultsReport Medical Bill Problems

39

54

35 33 3530

0

25

50

75

Total, Ages

50–70

Total

Insured


Percent of adults ages 50–70 with any medical bill problemsor outstanding medical debt*

* Problems paying/not able to pay medical bills, contacted by a collection agency for medical bills, had to change way of life to pay bills, or has medical debt being paid off over time.


Figure ES-4

Older Adults Have High Ratesof Chronic Conditions*

6467

8070 67 75

8493

81

0

25

50

75

100

Percent of adults with a chronic condition*

Ages 50–64

* Includes hypertension/high blood pressure, heart disease/heart attack, cancer, diabetes, arthritis, or high cholesterol.


Ages 65–70Ages 50–70

Total 200% poverty or more<200% poverty

Figure 1

Insurance Instability Among Adults Ages 50–64Is Highest Among Those with Low Incomes

1023

125

7

14

77

8

14

12

6

312

0

25

50

75Insured all last year, time uninsured since age 50Insured now, time uninsured in past yearUninsured now

Percent of adults ages 50–64

6

25

51

31

18

Total Less than $25,000

$25,000–39,999

$40,000–$59,999

Note: Income groups based on 2003 household income.


$60,000or more

Figure 2

More than Half of Older Adults withIndividual Coverage Spend $3,600 or More

Annually on Premiums

6 28

114

10

6

26

20

25

50

75

Total Insured Medicare Employer Individual

Annual premium $6,000 or more

Annual premium $3,600–$5,999

Percent of insured adults ages 50–70

16

6

17

54


Figure 3

More than Two of Five Older Adults with Individual Coverage Have Annual Deductibles of $1,000 or More

7

1212710

8

42

2

0

25

50

75

Total insured Medicare Employer Individual

Annual deductible $1,000 or more

Annual deductible $500–$999


18

9

19

54


Figure 4

Annual Out-of-Pocket Medical Expenses,Including Prescription Drugs*

26

10

27201719

23

8

3

0

25

50

75

Total

insured


Annual out-of-pocket expenses $5,000 or more

Annual out-of-pocket expenses $1,000–$4,999


22 20 22

35

* Does not include premiums.


36

Figure 5

Percent of Insured Older AdultsWho Are “Underinsured”*

32

5

17

10

0

25

50

Total Insured Medicare Employer Individual

Percent of insured adults 50–70

* Defined as “underinsured” if: 1) medical expenses (excluding premiums) represent 10% or more of income; 2) medical expenses (excluding premiums) for low income (<200% FPL) represent 5% or more of income; or 3) deductible represents 5% or more of income. Based on C. Schoen et al., “Insured But Not Protected: How Many Adults Are Underinsured?” Health Affairs Web Exclusive (June 14, 2005): W5-289–W5-302.


Figure 6

Access Problems Because of Cost

32

57

24 21 2318

0

25

50

75

Total, Ages

50–70

Total

Insured


Percent of adults who had any of four access problems*in past year because of cost



Figure 7

Access Problems in Past Year,by Size of Deductible

21 18 21 22

35

0

25

50

75

Total None $1–$499 $500–$999 $1,000 or

more

Percent who had any of four access problems*in past year because of costs

Figure 8



More than One-Third of Older AdultsReport Medical Bill Problems

39

54

35 33 3530

0

25

50

75

Total, Ages

50–70

Total

insured


Percent of adults ages 50–70 with any medical bill problemsor outstanding medical debt*



Figure 9

Medical Bill or Debt Problems in Past Year,by Size of Deductible

3328

3442

47

0

25

50

75

Total None $1–$499 $500–$999 $1,000 or

more

Percent of insured adults ages 50–70 withany medical bill problem or outstanding debt*



Figure 10

Percent of Medicare BeneficiariesWho Were Uninsured Just Before Medicare

11

2418

41 38

0

25

50

75

All on

Medicare

Ages 65–70 Ages 50–64,

disabled

Less than

200% poverty

200% poverty

or more

Percent of Medicare beneficiaries ages 50–70


Figure 11

Importance of Becoming Eligible for Medicare

58

7166

84 85

0

25

50

75

100

All on

Medicare

Age 65–70 Age 50–64,

disabled

Less than

200% poverty

200% poverty

or more

Percent of Medicare beneficiaries ages 50–70 who saidit was “very important” to become eligible for Medicare


Figure 12

Ratings of Insurance Coverage

32 28 35

20

23 27 2212

0

25

50

75

All insured,

ages 50–70

Medicare Employer Individual

Very Good

Excellent

Percent of adults rating insurance coverage“excellent” or “very good”


55 55 57

32

Figure 13

Medicare Beneficiaries and Older Adultswith Employer Coverage Are Most Satisfied

with Health Care Quality

41

23

54 57 60 58

0

25

50

75

Total, Ages

50–70

Total

insured


Percent who said they were “very satisfied” with their health care


Figure 14

Medicare Beneficiaries and Older Adultswith Employer-Sponsored Coverage Are

Most Confident in Getting the Best Medical Care

45

18

49 5256

52

0

25

50

75

Total, Ages

50–70

Total

insured


Percent reporting they were “very confident”in getting the best medical care


Figure 15

Two of Five Older Adults Are Not Confidentin Their Retirement Security: Older Adultswith Low Incomes Are the Least Confident

15

50

29

69

4139

64

30 32

0

25

50

75

100

Ages 50–64


Ages 65–70Ages 50–70

Total 200% poverty or more<200% poverty

Percent of adults who are not too or not at all confident they’ll have enough income and savings to live comfortably in retirement

Figure 16

Total Bank or Stock Market Savings

Percent of adults ages 50–70 with savings of the following amounts

Less than $25,00038%

$50,000–$99,99911%

$25,000–$49,999 10%

$100,000 or more25%

Don’t know/Refused16%


Figure 17

Total Bank or Stock Market Savings, by Income, Adults Ages 50–70

Less than 200% Poverty 200% Poverty or More

$50,000–$99,999

5%

$100,000or more

2%

Less than $25,000

80%

$25,000–$49,999

6%


Don’t know/Refused7%

Less than $25,000

26%

$25,000–$49,999

13%

$50,000–$99,99914%

$100,000or more

37%

Don’t know/ Refused10%

Figure 18

The Quality of Retiree Health BenefitsIs Eroding

2827

48

0

25

50

75

Increases in amount

paid for benefits

Any cuts in benefits Heard of plans to

cut benefits

Percent of adults ages 50–70 with retiree health benefitsor who expect to have them


Figure 19

Majorities of Older Adults Are WorriedThey Won’t Be Able to Afford Needed Medical Care

30 23 26 3553

33 35

28 30

36

24

32 28

36

0

25

50

75

100

Total,

Ages

50–70

Total,

Ages

50–64

Total,

Ages

65–70


Somewhat worried

Very worried

51

67

56

77

Percent “very/somewhat worried” about affording medical care


63 6471

Figure 20

7273676969

0

25

50

75

100

Total Less than

$20,000

$20,000–

$34,999

$35,000–

59,999

$60,000 or

more

Interest in Medicare Health AccountsIs Strong Across Income Group*

Percent of adults ages 50–70 in working families interested in a Medicare Health Account

* Respondents were asked: “Thinking about paying for your healthcare in the future, would you be interested in having 1% of your (and/or your spouses’) earnings deducted from your paycheck(s), tax-free, and placed in your own Medicare account(s) to use for long-term care or other expenses not covered by Medicare?”


Figure 21

Percent of Adults Ages 50–64 Who Are Very/Somewhat Interested in Receiving Medicare Before Age 65, by

Insurance Status and Income

6450

4030

26 2231

3336

41 34

5870

34

24

32

0

25

50

75

100

Somewhat interested

Very interested

Percent of adults ages 50–64and not on Medicare

73

84

68

94


8681

7366

Figure 22

Total Employer Individual Uninsured Lessthan

$25,000

$25,000–$39,999

$40,000–$59,999

$60,000or more

Amount Willing to Pay to Buy into MedicareBefore Age 65

Total 50–64

Less than$40,000

$40,000or more

Percent of adults ages 50–64 and not on Medicare who are interested in buying into Medicare

73% 83% 68%

Willing to pay $200 26 21 30

Willing to pay $100,but not willing to pay $200

26 32 24

Willing to pay $50,but not willing to pay $100

11 17 8

Not willing to pay $50 5 10 3

Don’t know/refused to answer how much willing to pay

5 4 5

Note: Columns may not sum properly because of rounding.


Figure 23

How Interested Would You Be in Payingan Extra $100 per Month to Medicare to Have

All Your Health Services, Including Rx, Covered?

Percent of respondents on Medicare

Very interested 25%

Not at all interested 34%

Not too interested13%


Somewhat interested 25%

Don’t know/Refused 3%

Figure 24

If Medicare or Your Insurance Plan Charged You a Lower Monthly Premium If You Agreed to Go to Doctors That Provided the Best Care at the Lowest Cost, Would You Participate, Even

If It Meant You Had to Change Doctors?

50 53

34

0

25

50

75

Total, Ages 50–70 Ages 50–64 Ages 65–70

Percent of adults ages 50–70 who responded yes


Figure 25

Should Medicare or Your Insurance PlanRequire You to Sign Up for a Doctor

Who Would Be Your Regular Source of Care?

36 39

24

0

25

50

75

Total, Ages 50–70 Ages 50–64 Ages 65–70

Percent of adults ages 50–70 who responded yes


Figure 26

* Respondents were asked: Thinking about paying for your healthcare in the future, would you be interested in having 1% of your (and/or your spouses) earnings.

Documents

majorities of adults

cost percent of adults

income percent of adults

medical bills

medicare accounts

access problems

outstanding medical

medicare health accounts