Mixed Signals From Public Underscore Need for Medicare Innovation

A new poll shows that the American public’s desire for deficit reduction is running head-on against a strong reluctance to cut Medicare spending.

According to a new NBC News/Wall Street Journal survey, fewer than 20 percent of Americans support Medicare spending cuts, while 54 percent of respondents said they definitely oppose any reductions.

If this kind of public sentiment holds, then it will be extremely difficult for this or future Congresses to target Medicare as a source for budget savings.  (Underscoring public concerns are announcements like that made by Cleveland Clinic CEO Toby Cosgrove this week, that the new health reform law will cost the Clinic $174 million in revenue by 2015, largely because of low reimbursement rates that don’t keep up with inflation.)

The problem is that public antipathy doesn’t change the need to make Medicare a more cost-efficient program.  These poll findings emphasize, however, the need to achieve those efficiencies through delivery and payment reforms, rather than simply taking an ax to budgets.

It’s interesting that the NBC/WSJ poll looked at one approach to reform, asking people what they thought of bringing a different approach to Medicare in which beneficiaries would be provided with payments which they could use to purchase coverage from competing plans.  28 percent said they strongly opposed such an idea, while 12 percent said it was “totally acceptable.”

Those numbers tell me a couple of things.  One, that intense political rhetoric demonizing a voucher-type approach hasn’t succeeded in building a strong wall of opposition and, two, the relatively low number in both the support and opposition columns mean that the public is keeping an open mind to changes in Medicare, even if they oppose outright cuts.