TUESDAY, March 25 (HealthDay News) -- One-third of Americans -- even those with health insurance -- say high costs force them to skip needed medical care, a new survey shows.

And one-quarter of the respondents said they had serious problems paying for the care they needed, while 79 percent said health care will be a top issue in this year's presidential election, according to the survey, sponsored by the AFL-CIO.

"The survey results paint a devastating picture of a health-care system that costs too much, covers too little, leaves too many behind, and is getting worse," AFL-CIO President John Sweeney said during a Tuesday teleconference.

Conventional wisdom holds that only the uninsured care about health-care reform, Sweeney said.

"Our survey results turn that conventional wisdom on its head. Of the more than 26,000 people who took the survey, most are insured and employed, most are college graduates, and most are union members. These are the people you would think are the lucky ones, but they're not," Sweeney said.

Sweeney said the survey respondents are the very people struggling to pay medical bills and skipping doctors' visits and prescription medications because of cost.

The solution to the health-care crisis is a national program under which everybody receives affordable health care, Sweeney said. The AFL-CIO has already determined that the plan offered by probable Republican presidential candidate John McCain is inadequate and merely a continuation of Bush administration policies, the labor leader said.

The AFL-CIO, a federation of 56 national and international labor unions representing 10.5 million members, is pinning its hopes on proposals put forth by Democratic presidential candidates Hillary Clinton or Barack Obama, Sweeney said. Either Democrat's health-care proposals are a good basis for developing a national health-care system, he said.

The online 2008 Health Care for America Survey, sponsored by the AFL-CIO and Working America, the union's outreach program, surveyed 26,419 people between Jan. 14 and March 3, 2008.

Among those surveyed, 95 percent said health care in America needed fundamental change or a complete overhaul. Seventy-four percent of 18- to 29-year-olds said health care was a very important election issue, as did 80 percent of 50- to 64-year olds.

More than 50 percent of those with health insurance said their insurance didn't cover the care they need at a price they can pay. Typical problems include not being able to afford prescription drugs, follow-up care or preventive care, the survey found. This was particularly true for people who buy their own health insurance, compared with those who get health insurance through their job.

Among college graduates, one-third said they or a family member had to skip medical care because of cost. Forty-six percent of those surveyed said out-of-pocket costs for health care in the past year ranged from $1,000 to $5,000. Seventeen percent spent more than $5,000, according to the survey.

For Medicare recipients, 53 percent said their prescription drug costs weren't covered or affordable, even though they had prescription drug coverage under Medicare part D.

Among the uninsured, 76 percent said that someone in their family didn't see a doctor during the past year when they were sick because of cost. And 57 percent of the uninsured said they had to choose between paying medical costs or their rent, mortgage or utilities.

Ninety-five percent of those surveyed said they were concerned about being able to afford health insurance in the coming years. Sixty-one percent with employer-based health insurance said their costs had gotten worse in the last few years.

One critic of the survey, Mike Tuffin, executive vice president of America's Health Insurance Plans, a health insurance company lobbying group, said the findings were at odds with other research that showed private health insurance is affordable and provides good access to care.

"There is a lot of data that suggests that those who do have private health-care coverage are very satisfied," said Tuffin. One survey found that "87 percent of respondents with private insurance said their health-care coverage gives access to good medical care at an affordable cost," he said.

But Cathy Schoen, executive vice president of The Commonwealth Fund, said she thinks the survey represents the real concerns that many Americans have with their health care.

"This survey is very consistent with what we see in general population surveys -- in particular the rising concerns with access and costs among the insured," Schoen said. "We are also seeing a lack of confidence in the U.S. health-care system overall."

More information

For more on health care in America, visit the The Commonwealth Fund.

SOURCES: March 25, 2008, teleconference with John Sweeney, president AFL-CIO; Cathy Schoen, executive vice president, The Commonwealth Fund, New York City; Mike Tuffin, executive vice president, America's Health Insurance Plans, Washington, D.C.; 2008 Health Care for America Survey

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