New analysis of a national survey on consumer experiences with health coverage compared the responses of Medicare beneficiaries to nonelderly adults covered by private coverage. The analysis by Commonwealth Fund president Karen Davis and coauthors, published yesterday as a Health Affairs Web First article, found that those in the Medicare group were more satisfied with their insurance, less likely to report cost- or access-related problems, and more likely to report receiving excellent quality of care.

The study data came from The Commonwealth Fund 2010 Health Insurance Survey, a nationwide telephone survey of adults nineteen or older; the interviews took place between July and November of 2010. The final sample included 3,033 adults under the age of 65 and 940 adults age 65 and older. In addition to comparing non-Medicare and Medicare beneficiaries, Davis and her Commonwealth Fund colleagues looked for differences in experiences between those with traditional Medicare and those with private Medicare Advantage plans.

Some of the key findings include:

  • Eight percent of Medicare beneficiaries rated their insurance as fair or poor compared to 20 percent of nonelderly adults with employer insurance and 33 percent purchasing insurance on the individual market. Among Medicare beneficiaries, only 6 percent of those with traditional Medicare gave a fair or poor rating, compared to 15 percent of Medicare Advantage beneficiaries.
  • Thirty-seven percent of working adults with employer-sponsored coverage reported at least one access problem due to cost, compared to 23 percent of elderly adults with Medicare. Among Medicare beneficiaries, those with traditional plans were significantly less likely to report problems accessing care than those opting for Medicare Advantage (23 percent versus 32 percent).
  • For those with employer insurance, 27 percent reported difficulties paying bills, compared to 13 percent of Medicare beneficiaries. Just one-quarter (25 percent) of adults with employer-sponsored coverage reported receiving excellent quality of care, compared to 37 percent of elderly Medicare beneficiaries. Those with individual (17 percent) and no health insurance (12 percent) reported receiving excellent care at the lowest rates.
  • In describing access to a primary provider, 64 percent of Medicare beneficiaries and 51 percent of those with employer-based insurance said they had a regular doctor or place of care; only 26 percent of those without insurance claimed this degree of access to care.

“The evidence reported here…shows that Medicare is doing a better job than employer-sponsored plans at fulfilling the two main purposes of health insurance: ensuring access to care and providing financial protection,” conclude the authors. “In the policy debates over the federal budget deficit, the affordability of Medicare, and the expansion of health insurance through the Affordable Care Act, it is important to listen to what people have to say about being covered by Medicare or private employer insurance.”