Figure ES-1
Majorities of Adults Across Political Affiliation
Express Interest in Medicare Health Accounts*
Percent of adults ages 50–70 in working families
interested in a Medicare Health Account
100
75
69
68
71
71
Total
Democrat
Republican
Independent
50
25
0
* 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).
Figure ES-2
Percent of Adults Ages 50–64 Who Are
Very/Somewhat Interested in Receiving Medicare
Before Age 65, by Insurance Status and Income
Percent of adults ages 50–64
and not on Medicare
94
100
75
50
25
0
Somewhat interested
84
73
32
41
Total
68
24
26
Very interested
86
22
81
31
34
58
70
64
34
Employer Individual Uninsured
Less
than
$25,000
Source: The Commonwealth Fund Survey of Older Adults (2004).
50
$25,000–
$39,999
73
33
40
$40,000–
$59,999
66
36
30
$60,000
or more
Access Problems Because of Cost
Figure ES-3
Percent of adults who had any of four access problems*
in past year because of cost
75
57
50
25
24
32
21
23
Total, Ages
Total
Medicare
50–70
Insured
18
0
Employer
Individual
Uninsured
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
More than One-Third of Older Adults
Report Medical Bill Problems
Figure ES-4
Percent of adults ages 50–70 with any medical bill problems
or outstanding medical debt*
75
54
50
35
33
35
Total, Ages
Total
Medicare
50–70
Insured
39
30
25
0
Employer
Individual
Uninsured
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 1
Older Adults Have High Rates
of Chronic Conditions*
Total
<200% poverty
200% poverty or more
Percent of adults with a chronic condition*
100
75
70
84
80
67
67
75
93
81
64
50
25
0
Ages 50–70
Ages 50–64
Ages 65–70
* Includes hypertension/high blood pressure, heart disease/heart attack, cancer, diabetes,
arthritis, or high cholesterol.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 2
Insurance Instability Among Adults Ages 50–64
Is Highest Among Those with Low Incomes
Percent of adults ages 50–64
Insured all last year, time uninsured since age 50
Insured now, time uninsured in past year
Uninsured now
75
51
50
25
0
14
25
8
7
10
Total
14
23
Less than
$25,000
31
12
18
7
12
6
7
5
$25,000–
39,999
$40,000–
$59,999
Note: Income groups based on 2003 household income.
Source: The Commonwealth Fund Survey of Older Adults (2004).
2
1
6
3
$60,000
or more
More than Half of Older Adults with
Individual Coverage Spend $3,600 or More
Annually on Premiums
Figure 3
Percent of insured adults ages 50–70
75
Annual premium $6,000 or more
Annual premium $3,600–$5,999
54
50
26
25
0
17
16
6
10
Total Insured
6
6
4
2
Medicare
28
11
Employer
Source: The Commonwealth Fund Survey of Older Adults (2004).
Individual
Figure 4
More than Two of Five Older Adults with Individual
Coverage Have Annual Deductibles of $1,000 or More
Percent of insured adults ages 50–70
75
Annual deductible $1,000 or more
Annual deductible $500–$999
54
50
42
25
0
19
18
8
9
10
7
Total insured
Medicare
7
2
12
12
Employer
Individual
Source: The Commonwealth Fund Survey of Older Adults (2004).
Annual Out-of-Pocket Medical Expenses,
Including Prescription Drugs*
Figure 5
Percent of insured adults ages 50–70
75
Annual out-of-pocket expenses $5,000 or more
Annual out-of-pocket expenses $1,000–$4,999
50
25
22
36
8
10
27
26
Individual
Uninsured
22
20
3
35
2
3
19
17
20
Total
insured
Medicare
Employer
0
* Does not include premiums.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 6
Percent of Insured Older Adults
Who Are “Underinsured”*
Percent of insured adults 50–70
50
32
25
17
10
5
0
Total Insured
Medicare
Employer
Individual
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Access Problems Because of Cost
Figure 7
Percent of adults who had any of four access problems*
in past year because of cost
75
57
50
25
24
32
21
23
Total, Ages
Total
Medicare
50–70
Insured
18
0
Employer
Individual
Uninsured
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Access Problems in Past Year,
by Size of Deductible
Figure 8
Percent who had any of four access problems*
in past year because of costs
75
50
25
35
21
18
21
22
$1–$499
$500–$999
0
Total
None
$1,000 or
more
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 9
More than One-Third of Older Adults
Report Medical Bill Problems
Percent of adults ages 50–70 with any medical bill problems
or outstanding medical debt*
75
54
50
35
33
35
Total, Ages
Total
Medicare
50–70
insured
39
30
25
0
Employer
Individual
Uninsured
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 10
Medical Bill or Debt Problems in Past Year,
by Size of Deductible
Percent of insured adults ages 50–70 with
any medical bill problem or outstanding debt*
75
50
42
33
28
47
34
25
0
Total
None
$1–$499
$500–$999
$1,000 or
more
* 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.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 11
Percent of Medicare Beneficiaries
Who Were Uninsured Just Before Medicare
Percent of Medicare beneficiaries ages 50–70
75
50
25
41
24
38
18
11
0
All on
Medicare
Ages 65–70
Ages 50–64,
Less than
200% poverty
disabled
200% poverty
or more
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 12
Importance of Becoming Eligible for Medicare
Percent of Medicare beneficiaries ages 50–70 who said
it was “very important” to become eligible for Medicare
100
75
85
84
71
66
58
50
25
0
All on
Medicare
Age 65–70
Age 50–64,
Less than
200% poverty
disabled
200% poverty
or more
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 13
Ratings of Insurance Coverage
Percent of adults rating insurance coverage
“excellent” or “very good”
Very Good
75
55
55
57
32
28
35
Excellent
50
25
32
20
23
27
All insured,
Medicare
22
0
Employer
ages 50–70
Source: The Commonwealth Fund Survey of Older Adults (2004).
12
Individual
Figure 14
Medicare Beneficiaries and Older Adults
with Employer Coverage Are Most Satisfied
with Health Care Quality
Percent who said they were “very satisfied” with their health care
75
54
57
60
58
50
41
23
25
0
Total, Ages
Total
50–70
insured
Medicare
Employer
Source: The Commonwealth Fund Survey of Older Adults (2004).
Individual
Uninsured
Figure 15
Medicare Beneficiaries and Older Adults
with Employer-Sponsored Coverage Are
Most Confident in Getting the Best Medical Care
Percent reporting they were “very confident”
in getting the best medical care
75
50
49
52
56
52
45
18
25
0
Total, Ages
Total
50–70
insured
Medicare
Employer
Source: The Commonwealth Fund Survey of Older Adults (2004).
Individual
Uninsured
Figure 16
Two of Five Older Adults Are Not Confident
in Their Retirement Security: Older Adults
with Low Incomes Are the Least Confident
Percent of adults who are not too or not at all confident they’ll
have enough income and savings to live comfortably in retirement
Total
100
75
50
<200% poverty
69
64
39
200% poverty or more
41
30
50
32
25
29
15
0
Ages 50–70
Ages 50–64
Source: The Commonwealth Fund Survey of Older Adults (2004).
Ages 65–70
Total Bank or Stock Market Savings
Figure 17
Percent of adults ages 50–70 with savings of the following amounts
Don’t know/Refused
16%
Less than $25,000
38%
$100,000 or more
25%
$50,000–$99,999
11%
$25,000–$49,999
10%
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 18
Total Bank or Stock Market Savings,
by Income, Adults Ages 50–70
Don’t know/Refused
7%
Less than
$25,000
80%
Don’t know/ Refused
10%
Less than
$25,000
26%
$100,000
or more
2%
$50,000–
$99,999
5%
$25,000–
$49,999
6%
Less than 200% Poverty
$100,000
or more
37%
$25,000–
$49,999
13%
$50,000–$99,999
14%
200% Poverty or More
Source: The Commonwealth Fund Survey of Older Adults (2004).
The Quality of Retiree Health Benefits
Is Eroding
Figure 19
Percent of adults ages 50–70 with retiree health benefits
or who expect to have them
75
50
48
27
28
25
0
Increases in amount Any cuts in benefits
paid for benefits
Source: The Commonwealth Fund Survey of Older Adults (2004).
Heard of plans to
cut benefits
Figure 20
Majorities of Older Adults Are Worried
They Won’t Be Able to Afford Needed Medical Care
Percent “very/somewhat worried” about affording medical care
Somewhat worried
100
75
50
25
Very worried
63
67
51
33
35
28
30
32
Total,
Total,
Total,
Ages
Ages
Ages
50–70
50–64
65–70
23
56
30
26
64
36
28
71
77
24
36
35
53
0
Medicare Employer Individual Uninsured
Source: The Commonwealth Fund Survey of Older Adults (2004).
Interest in Medicare Health Accounts
Is Strong Across Income Group*
Figure 21
Percent of adults ages 50–70 in working families
interested in a Medicare Health Account
100
75
69
69
67
Total
Less than
$20,000
$20,000–
$34,999
73
72
$35,000–
59,999
$60,000 or
more
50
25
0
* 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).
Figure 22
Percent of Adults Ages 50–64 Who Are
Very/Somewhat Interested in Receiving Medicare
Before Age 65, by Insurance Status and Income
Percent of adults ages 50–64
and not on Medicare
94
100
75
50
25
0
Somewhat interested
84
73
32
41
Total
68
24
26
Very interested
86
22
81
31
34
58
70
64
34
Employer Individual Uninsured
Less
than
$25,000
Source: The Commonwealth Fund Survey of Older Adults (2004).
50
$25,000–
$39,999
73
33
40
$40,000–
$59,999
66
36
30
$60,000
or more
Figure 23
Amount Willing to Pay to Buy into Medicare
Before Age 65
Total
50–64
Less than
$40,000
$40,000
or more
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
Percent of adults ages 50–64 and
not on Medicare who are interested
in buying into Medicare
Note: Columns may not sum properly because of rounding.
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 24
How Interested Would You Be in Paying
an Extra $100 per Month to Medicare to Have
All Your Health Services, Including Rx, Covered?
Percent of respondents on Medicare
Don’t know/Refused
3%
Very interested
25%
Not at all interested
34%
Not too interested
13%
Somewhat interested
25%
Source: The Commonwealth Fund Survey of Older Adults (2004).
Figure 25
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?
Percent of adults ages 50–70 who responded yes
75
50
50
53
34
25
0
Total, Ages 50–70
Ages 50–64
Source: The Commonwealth Fund Survey of Older Adults (2004).
Ages 65–70
Figure 26
Should Medicare or Your Insurance Plan
Require You to Sign Up for a Doctor
Who Would Be Your Regular Source of Care?
Percent of adults ages 50–70 who responded yes
75
50
36
39
24
25
0
Total, Ages 50–70
Ages 50–64
Source: The Commonwealth Fund Survey of Older Adults (2004).
Ages 65–70