The majority of Americans are not satisfied with health care costs, and many have been forced to change the way they use the health care system. Some changes have been positive, such as an increased attempt to take better care of themselves, and others have been negative, such as skipping prescriptions or delaying doctor visits, according to a report released by the Employee Benefit Research Institute yesterday.

Roughly 63% of Americans with health insurance reported an increase in costs in 2007. A substantial portion of this group indicated the cost hike caused them to take better care of themselves (81% in 2007, compared to 71% in 2005) and to speak with doctors more carefully about treatment options and costs (66% in 2007, compared to 57% in 2005).

Conversely, a growing number of Americans went to the doctor only for serious conditions or symptoms (64% in 2007, up from 54% in 2005) or delayed going to the doctor (50% in 2007, up from 40% in 2005). Another 28% skipped medication doses or didn't fill needed prescriptions this year, up from 21% in 2005.

Health care inflation is causing workers to skimp in other areas, too. Those experiencing cost increases were likely to report a decrease in contributions to retirement plans (30%) and other savings (52%), as well as a difficulty in paying for basic necessities (29%) and other bills (36%).

• 42% of Americans said all employers, regardless of size, should be included in a mandate requiring them to provide and contribute to health insurance coverage for their workers.
• 76% of those with employer-provided coverage would prefer $7,500 in employer-based health benefits to an additional $7,500 in taxable income. When those preferring to keep their coverage were asked how much they would need in additional taxable income to willingly give up coverage, the median response was $12,000.
• Many Americans rated the health care system as fair (29%) or poor (30%). Many feel the system needs a complete overhaul (24%) or requires major changes (47%).
• 28% of workers were extremely confident their employer would continue to offer health benefits. Just 16% felt extremely or very confident that they could purchase health insurance on their own without the assistance of an employer.