The Medicare prescription drug benefit President Bush signed into law in December has not provided the political boost among seniors that the White House and independent analysts expected, according to a comprehensive survey released yesterday.
Nearly half of Medicare beneficiaries view the new law negatively, though that dissatisfaction has not translated into a severe backlash, say pollsters for the Harvard School of Public Health and the Kaiser Family Foundation.
Seven months after enactment and despite the administration's $87 million promotional effort, the program remains largely a muddle for the elderly and disabled whom it is meant to help, the survey found. A fraction -- less than 10 percent -- of the 41 million eligible for the first component, a new drug discount card, have signed up.
"At least at this very early stage, they view the glass as more empty than full," said Drew E. Altman, president of the Kaiser foundation. Of the 1,223 Medicare recipients surveyed, 47 percent had an unfavorable view of the benefit, 26 percent had a favorable view and 25 percent said they did not know enough to form an opinion.
By comfortable margins, respondents said they expect the new law to help low-income seniors and people with large drug bills. Yet fewer less than one-third of them expect to personally benefit from the 10-year, $564 billion program.
Bush administration officials said they recognize that they face a significant educational challenge but are confident that the more people learn, the more they will embrace the program.
"The majority think the new law will be helpful," said Department of Health and Human Services spokesman Kevin Keane. "Seniors don't want the benefits taken away. That's a powerful statement."
Just 10 percent endorsed outright repeal of the law, though large majorities support two major changes: legalizing drug importation from countries such as Canada and giving the government authority to negotiate directly with pharmaceutical companies for lower prices. The Bush administration has opposed both ideas; the Democratic presidential nominee, Sen. John F. Kerry (Mass.), supports both.
The pollsters expressed surprise that the enactment of the largest health care package in 40 years has not benefited Bush. In the Kaiser foundation's survey, Kerry held a five-percentage-point advantage over Bush on whom respondents trust to do a better job of handling Medicare drug benefits, while a recent survey by a Democratic consortium called Democracy Corps put Kerry's edge on prescription drugs at 22 percentage points. Bush "led an initiative that looks to be helping his challenger," Harvard's Robert Blendon said.
Although the economy, Iraq and terrorism overshadow concerns about Medicare drug benefits, if the election remains close, "this issue can provide decisive votes," Blendon said.
Keane blamed the lack of enthusiasm on a "hurricane of harsh rhetoric and misinformation" from Kerry and fellow Democrats. But he also predicted that by Election Day, Medicare will be a political winner for the president. "This shows he's addressing a challenging health care issue," he said.