I was listening to XM radio's POTUS '08 channel yesterday and caught a segment on health care reform. Consumer Reports Health did a survey on American's views on health reform that confirms we have now reached the point where the majority favors reforming our health care system.

Poll respondents agreed broadly that reform should improve access and coverage, but there's less consensus on how to achieve it.

Right now, pessimism about U.S. health-care costs prevails among consumers regardless of age, gender, political orientation, or family income.

One of the more surprising findings of the survey is that the public, even Republicans, are rejecting the reform policies supported by the slate of Republican candidates.

Only 26 percent supported the idea of giving tax incentives for individuals to purchase insurance and relying on market pressures and competition among insurance companies to hold prices down. Versions of that idea have been proposed by several leading Republican candidates.

Interestingly, even respondents who identified themselves as conservatives picked a mixed public/private system as their top choice, and one-third favored an all-public plan.

While this appears to make the choices between the policies of the Republicans verses those offered by Democrats more clear, they noted there is not a consensus on what changes the public is willing to accept.

The Achilles' heel of reform is that most Americans do have some source of insurance most of the time, says Jacob S. Hacker, a political science professor at Yale University who has studied health-care reform. "The easiest way to kill reform is to say that this change will destroy what you have and will make you pay more for less," he says. Reformers need to put forth a "clear, simple, and unthreatening vision of reform that meets public concerns head-on."

The more disturbing aspect of the survey is that public's perception of what is driving the high price of healthcare is different from reality.

Drug companies, insurers, politicians, lawyers, and the bad habits of Americans all figure into high and rising health-care costs. But the biggest contributors to high costs—doctors and hospitals—get off easier among consumers, our survey found.

The article provides some good information on the actual contribution of each player in comparison to how the public rated the contribution. I found the following to be significant since there has been so much money thrown at building this perception:

Lawyers. Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.

Yet 60 percent of respondents blamed lawyers for high costs, and 69 percent specifically pointed to "frivolous lawsuits."

In summary, the outlook for reforming the U.S. healthcare system is improving. I think it will be one of the major issues in deciding who will be elected as our next president. The question is who will be able to convince the voters that they have the best policy.