Familiarity = confidence

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With a little over three weeks left before the May 15 deadline to sign upforthenew Medicare drug benefit, a tale of two types of seniors is emerging. While the early press coverage painted the new drug insurance program as universally confusing and intimidating, experience is proving that narrative wrong. Seniors who signed up for the program exhibit systematically different and overwhelmingly positive attitudes on a variety of issues related to the new Medicare program compared to those who stay on the sidelines. The concrete experience of signing up clearly sways opinion.

Consider the overall approval or disapproval of the underlying law. Dutko Research's March survey (800 registered voters; March 14-19) finds 40 percent of voters approve of the Medicare prescription-drug legislation, while 47 percent disapprove. Yet seniors who have signed up for the benefit approve by a solid 58 percent to 38 percent margin.

Participation also influences whether voters believe there are "too many choices" in the program. Again, in our overall sample, 44 percent say the program offers too many choices. But among seniors who have enrolled, that percentage drops to 38 percent.

Other surveys also point to satisfaction among those who have actual experience with the Medicare prescription-drug program. An ABC/Washington Post survey (April 6-9) finds among those enrolled a 74 percent to 24 percent margin saying enrollment was easy, not difficult. An AARP survey of enrolled seniors (March 9-April 3) finds nearly 8 in 10 satisfied with their new drug coverage. And 67 percent say they already are saving money.

Attitudes about the new Medicare prescription-drug insurance program follow a pattern we have witnessed before with other broad-based changes in government policy. For example, after the original Medicare program started in 1966, many newspapers reported widespread skepticism and confusion. Those attitudes changed quickly, however, after Americans dove in, experienced the program and received benefits.

Perhaps most importantly, these changes in attitude after experiencing the program are essential for the prospect of longer-term health-care policy reforms. Raising Americans' comfort level with making choices in health care is a component of promoting such change. Demonstrating success through seniors making choices, and saving money, will not only help the Medicare program, but will also ease the adoption of other important consumer-directed health care policies in the future.

Gary Andres is vice chairman of research and policy for Dutko Worldwide and a former White House senior lobbyist. Dutko's clients include pharmaceutical and managed-care companies.