71% of Americans are worried about how to pay for rising health care and insurance costs.

6 in 10 Americans blame increases in the cost of health premiums on the profits of insurance companies and prescription drug manufacturers. 1 in 2 Americans point to hospital prices as the cause of higher health costs.

Only 18% of people blame their own higher use of medical services as a prime cost of health care cost increases.

This Harris Interactive/Health Day survey, Nearly Half of Americans Worried About Rising Health-Care Costs, examines Americans’ health care cost concerns and who’s to blame for them. In two different survey questions, the answer is clear: health plans and drug companies.

Worries are common across different demographic groups: even 40% of those with household incomes above $75,000, the highest income segment in the study, are “extremely” or “very worried” about paying more for health care and insurance.

An intriguing finding in the survey is that 37% of Americans blame higher costs of health on the increasing number of overweight and obese people who require more medical care.

The survey was conducted online between March 11 and 15, 2010 among 2,389 adults aged 18 and older in the U.S.

Two questions this survey raise in terms of Americans’ personal health economics are (1) What is the value of health insurance? Health care? and (2) Why am “I” not culpable in the equation of higher health costs?

First, it’s clear that health consumers’ perceptions of the cost of health care exceed the value they perceive in health care products and services that relate to the health insurance premium: that is, services and prescription drugs. Health plans and drug companies have the heavy lifting in both product development and specifications, and in marketing and sales, to articulate the value proposition of their goods and services. Engaging with consumers will require big-time trust-building, as well as a new approach to “getting to know You,” The Patient.

It’s not only up to this top-tier of blame, though, to rationalize health care costs: all stakeholders play starring roles, which have been discussed in Health Populi for many months.

The one culprit that consumers don’t much point to is…themselves. “Increased utilization of medical services by patients” ranked last on the roster of who’s-to-blame for health insurance cost increases. But health costs are a direct function of (utilization) X (price). Health consumers have to get literate about a prime driver of health costs and quality deterioration in the U.S.: over-treatment and waste, some of which is driven by the patient herself.