Despite worries about skyrocketing medical bills, Americans may not be doing much to change the cost or quantity of the care that they use.

Researchers at the Employee Benefit Research Institute, Washington, and Mathew Greenwald and Associates Inc., Washington, have published statistics hinting at consumers’ lack of action on health care costs in a summary of a telephone survey of 1,000 U.S. residents ages 21 and older.

Participants in the survey, which was underwritten by Principal Financial Group Inc., Des Moines, Iowa, complained about their out-of-pocket health care costs.

The percentage of participants who said the United States has a poor health care system has increased to 31% this year, from 15% in 1998.

The percentage of survey participants who said they are “not at all satisfied” with “health costs not covered by insurance” increased to 32% over the same 8-year period, from 18%.

But the researchers found that consumers still are somewhat more alarmed by the cost of health coverage than by the magnitude of out-of-pocket costs: The percentage of participants who said they are not at all satisfied with the cost of health insurance has jumped to 35% this year, from 13%.

Some participants say rising health care and health coverage costs are having concrete effects on their lives.

The percentage of participants who said health costs are forcing them to cut back on retirement savings efforts has increased to 36% this year, from 25% in 2004, researchers report.

But participants were no more likely to say they had delayed going to the doctor or talked more carefully to their doctors about symptoms this year than they were 2 years ago, and the percentage who said they had looked for less expensive health care providers fell to 26%, from 28%.

Participants said they like the idea of getting more provider cost and quality information, but only 26% said total cost would outweigh quality when they picked a provider for an annual physical exam, and only 13% said cost information would outweigh quality considerations in the selection of a colon cancer screening provider.

Only 27% of the participants said a program limiting their selection of providers would improve the health care system, and only 13% said the health care system would be better if they paid a larger portion of their health care costs themselves.

In related news, Milliman, Seattle, has released results of its survey of health maintenance organizations and preferred provider organizations.

Milliman researchers have found that HMO rates are up 6% this year and PPO rates are up 4%.

The 2007 “manual rates” are up about 10% for HMO coverage and 12% for PPO coverage, but “actual rate increases will likely differ due to group experience, contract negotiations, changes in cost sharing, and market conditions,” Milliman says.

Participating carriers expect premium revenue from health plans that incorporate health savings accounts or health reimbursement arrangements to amount to 5.1% of total commercial premium revenue in 2007, up from 3.6% this year, Milliman says.