“The Republicans, who really worked to pass this law, have not gotten tremendous bounce or tremendous credit for having passed and added a prescription drug benefit in the Medicare program,” Brodie said.

Respondents also indicated their support for two legislative proposals recently debated in Congress. Around 80 percent of beneficiaries of Medicare favored changing the law to allow Americans to buy cheaper prescription drugs from Canada and to allow the federal government to negotiate with drug companies for lower prices.

The survey found that seniors on Medicare were not particularly supportive of the drug discount cards, with a little over half saying that the cards were confusing and didn’t sufficiently reduce drug costs. But 34 percent said the cards were “worthwhile because they give people on Medicare immediate help before the full prescription drug benefit is available in 2006, and they provide another way to cut drug costs.”

“From a policy perspective, [the Republicans] delivered a piece of the program right away,” Brodie said. “It isn’t being appreciated or seen as helpful as perhaps the expectations were.”

For now, Brodie said that people under Medicare need to have a better understanding of how the law operates.

“I think the most important implication from this is that there’s a lot of work to be done from a public education standpoint to get people to understand how this law will affect them personally and the kind of choices they’ll have to make in 15 months,” Brodie said.

Robert J. Blendon, an HSPH professor of health policy who also helped design and analyze the survey, was out of town on vacation and could not be reached for comment.

The poll was administered by telephone between June 16 and July 21, 2004 and surveyed 1,233 Medicare beneficiaries. The margin of sampling error was plus or minus 4 percentage points.

—Staff writer Margaret W. Ho can be reached at mwho@fas.harvard.edu.