Medicare versus private insurance: rhetoric and reality.

Many policymakers have called for the remodeling of Medicare to more closely resemble private insurance, which is often assumed to work better than public programs do. However, evidence from this 2001 survey demonstrates that Medicare beneficiaries are generally more satisfied with their health care than are persons under age sixty-five who are covered by private insurance. Medicare beneficiaries report fewer problems getting access to care, greater confidence about their access, and fewer instances of financial hardship as a result of medical bills. Making the program more like private insurance runs the risk of undermining a program that is working well from the perspective of beneficiaries.