WASHINGTON — Only a fraction of the nation's seniors understand the new Medicare prescription drug law, and the more they learn about it, the less they like it, according to a survey released Thursday by the Kaiser Family Foundation.
The complex law, which gives private insurance companies billions of dollars to lure beneficiaries away from fee-for-service Medicare and into managed care, will require more than 40 million seniors and disabled persons to make difficult choices about their healthcare.
The survey results suggest that seniors may be ill-prepared to make informed decisions, starting with whether to use a Medicare-endorsed drug discount card as of June 1 designed to provide stopgap relief from high drug costs. The full prescription drug benefit takes effect in 2006.
"Seniors are really confused, and there's a lot of work to do between now and implementation" of the law, said Drew E. Altman, president and CEO of the Palo Alto-based Kaiser Family Foundation, a nonprofit health policy research institute. "If seniors are going to make the best of this law, they're going to need a lot of help."
Seniors' lack of understanding also makes the law "ripe for political demagoguery on both sides as we enter the election season," Altman said.
Those who work directly with beneficiaries were not surprised by the survey's findings.
"There is no question that seniors all across the country are confused, bewildered and perplexed by the new legislation and have a very difficult time navigating the choices that are in their best interest," said Ron Pollack, executive director of the consumer advocacy group Families USA.
Robert M. Hayes, president of the New York-based Medicare Rights Center, said the survey "statistically proves what is overwhelmingly obvious from the trenches: There is massive confusion, great anxiety and frustration on the part of people with Medicare."
The Kaiser telephone survey queried 1,201 adults -- 237 of them 65 or older -- about the law from Feb. 5-8, a few days after the Department of Health and Human Services began airing its 30-second "Same Medicare, Better Benefits" television commercials.
Although 64% of seniors said they had followed last fall's debate on the Medicare prescription drug bill "somewhat" or "very closely," 70% did not know that Congress had passed the bill and that President Bush had signed it into law.
Just 15% of seniors said they understood the law "very well," while another 24% said they understood it "somewhat well." But 60% said they understood the law "not too well" or "not well at all."
Awareness of the law does not appear to be bringing an appreciation of it. While 43% of seniors who were unaware of the law's passage said they had an unfavorable impression of it, 73% of seniors who knew the law had passed felt that way about it.
The Bush administration and private advocacy groups, including the 35-million-member AARP, have a range of Medicare education plans in the works. But it remains unclear if they will meet what Altman and Hayes see as the greatest need: one-on-one counseling to help seniors and the disabled determine which drug card is best for them, whether they should sign up for the voluntary drug benefit in 2006 and, as Medicare premiums and benefits change, whether to join a private health plan or stay with their own doctors.
The government's $12.6-million advertising campaign, which airs about 110 TV spots a week, will continue running through the end of March, said HHS spokesman Kevin Keane. The ad encourages seniors to call a toll-free number, (800) MEDICARE, for more information.
The administration has also spent about $10 million printing a two-page flier about the law. Until now, the information in the fliers only has been available on the www.medicare.gov website. Beginning next week, HHS will mail the fliers to all beneficiaries, a process that Keane said was expected to take about nine weeks.
In late April, the government will send all beneficiaries a mailing describing the Medicare-endorsed drug discount card. Beginning May 3, seniors are likely to be bombarded with mailings and commercials from private drug companies and other businesses offering the cards. To help seniors sort through the information, the government is creating an online and telephone service that would identify their best card options based on where they lived and which prescription drugs they took.
Democratic lawmakers have attacked the administration's early education efforts, calling them propaganda and an illegal use of taxpayer funds. The General Accounting Office, the investigative arm of Congress, is evaluating the charges.
The Medicare Rights Center's Hayes said the government's commercials were too vague to help. Seniors' confusion, he said, was further "complicated by all the political posturing" by lawmakers, presidential candidates and the Bush administration.
While "it's important for people to know whether this is a good bill or a bad bill," he said, "that's not really relevant to, 'What do I do to get affordable medicine?' "
To address that question, Pollack's group is conducting a 22-city "Medicare road show" featuring a 13-minute video narrated by longtime newsman Walter Cronkite. The group is sending 10,000 copies of the video, in English and Spanish, to senior centers and retirement communities nationwide.
The government, AARP and other advocacy groups are making special efforts to reach low-income seniors, who are eligible for a $600 annual subsidy on the drug discount card.