Americans have mixed feelings about what changes should be made to the popular Medicare program. Although 53 percent say the program needs fundamental changes, 58 percent say it is working fine the way it is.  Americans were asked to decide which of three statements is closest to their viewpoints: “Medicare works pretty well and only minor changes are necessary to make it work better”; “There are some good things about Medicare, but fundamental changes are needed”; or “Medicare has so much wrong with it that we need to completely rebuild it.”

Twenty-seven percent – including 36 percent of Democrats – believe that only minor changes are needed.  Another 13 percent said the program needs to be completely rebuilt.  Fully 53 percent said Medicare needs fundamental changes — even though the program has many good points.  People who want basic changes include a majority of Republicans and independents, though just 43 percent of Democrats support the plan.  A majority of Americans between ages 18 and 64 want significant changes.  Just 37 percent of those 65 and older agree.

Additionally, respondents were asked if they wanted to see Medicare “continue the way it is set up now, as a program that pays the doctors and hospitals that treat senior citizens” or “if they think it should be transformed into “a program that gives senior citizens payments towards the purchase of private insurance.”  Democrats want to retain Medicare in its present form; Republicans want to transform it into a voucher system in which seniors choose their coverage and are given money to cover their insurance premiums.

So strongly does the Senate Democratic leadership feel,  they have reaffirmed that Medicare cuts should not be on the table during the debt ceiling discussions.  “Seniors can’t afford it,” Senate Majority Leader Harry Reid (D-NV) said.  “The vast majority of the American people, including most Republicans, do not support changing Medicare as we know it, as articulated in that piece of legislation that came from the House.  That” piece of legislation is the Paul Ryan (R-WI) plan, “The Path to Prosperity”, which slashes the budget deficit by about $5 trillion over the next decade.

Ryan’s plan would overturn the Patient Protection and Affordable Care Act (ACA) and proposes major reforms to Medicaid and Medicare.  Medicaid would become a block grant system; the federal government would allocate money to states, giving them greater flexibility to shape their healthcare programs that serve the poor.  Currently, the government matches every dollar that states spend on Medicaid; the formula varies from state to state.

Senator Charles Schumer (D-NY) said Democrats will not accept a “mini” Ryan plan.  “The Ryan plan to end Medicare as we know it must be taken off the table, but Republicans should know that we will not support any mini version plan of ‘Ryan’ either,” Schumer said.  “We want to make our position on Medicare perfectly clear.  No matter what we do in these debt-limit talks, we must preserve the program in its current form, and we will not allow cuts to seniors’ benefits.“

Slashing Medicare will be a major issue in the 2012 election. According to Harvard political scientist and pollster Robert Blendon, “Older Americans tend to vote at much higher rates than other voters,” he said.  “They are the group that most care about healthcare as a voting issue.”

“Medicare for us is a pillar of health and economic security for our seniors,” said Representative Nancy Pelosi (D-CA), who is the House Minority Leader.  “It’s an ethic, it’s a value…and we intend to fight for it.  Pelosi is well aware that there is a problem with Medicare and acknowledges that the program is not financially sound enough to support the retirement of 78 million baby boomers who are joining the program.  Additionally, she knows that Medicare costs strongly impact the nation’s debt and deficit problem.  Additionally, she says that she prefers not to use Medicare as a weapon against Republicans.  “Would you rather have success with the issue, or would you rather have a fight in the election?  Of course you’d rather have success,” she said.  “That’s what you came here to do.  That’s what’s important to the well-being of the American people.”

Another recent poll, conducted by the Pew Research Center,  found that older Americans do not have a favorable opinion about privatizing Medicare.  Fifty-one percent of people aged 50 and over oppose the plan, while just 29 percent support it.  Even among Republicans, more respondents oppose the plan than support it.  The changes are designed to save the program’s finances by trimming government benefits for all Americans under the age of 55.  Medicare says it will run out of funds to pay full benefits by 2024.  One person polled is Michael A. Smith, a 54-year-old lifelong Republican who is currently unemployed and lives in the Philadelphia suburbs.  “A community like this, they want jobs and no changes in the funds they’ve paid into all their lives,” Smith said.

The nonpartisan Congressional Budget Office has stated that Ryan’s plan would not allow insurers to charge sick people more than healthy ones. Insurance companies would set premiums at the same level for everyone of the same age.  Although Ryan’s plan would leave Medicare intact for anyone now 55 or older, Jack Pitney, a political science professor at Claremont McKenna College in Claremont, CA, said older voters have a hard time believing that.  “Anytime you say, `But this doesn’t affect current senior citizens,’ they think it’s going to affect them,” he said.  “Seniors are very, very sophisticated when it comes to these programs.  They figure any change could have a loophole or an exception or a provision that could end up hurting them after all.  They’re very zealous about safeguarding the programs from which they benefit.”