Medicare Survey

Please answer the following questions. Your responsses will be used to help develop future research and educational initiatives.

1. After reading the brochure, I have a better understanding of Medicare's financial problems.

Agree Strongly
Agree somewhat strongly
Disagree somewhat
Disagree
I work in the healthcare/financial security field, so this is not new information to me.

2. Do you plan to pass this brochure along to anyone else?

Yes No

3. From what sources do you expect to pay for your healthcare costs after you retire? (Check one box in A, B, C, and D)

A. I expect Medicare to be:

a major source
a minor source
no source

B. I expect an employer paid health insurance plan to be:

a major source
a minor source
no source

C. I expect my own private insurance to be:

a major source
a minor source
no source

D. I expect my own personal savings to be:

a major source
a minor source
no source

4. Choose one statement below that best describes your view of what government should do to protect the long-term financial stability of the Medicare system?

It should cut some services but not raise taxes.
It should not cut services but should raise taxes.
It should both cut services and raise taxes.
It should not cut services or raise taxes.

5. Please complete the following information

Age: under 25 25-34 35-44 45-54 55-64 65 and over

Marital Status: Single Married

Gender: Male Female