American consumers want greater online ties to health care providers and medical records, custom-made health insurance coverage and greater access to budding advances such as retail clinics, according to a new survey from a unit of Deloitte & Touche USA L.L.P., New York.

At the same time, they say they are anxious about future health care costs, notes Deloitte Consulting L.L.C., which conducted the study. Only 7% say they’re adequately prepared financially for health care costs and increasingly search for alternative medicines and services that can save them money and offer convenience. Many also say, however, they are willing to pay extra for wellness programs and to support tax increases to cover the uninsured.

The “2008 Survey of Health Care Consumers,” a poll of more than 3,000 Americans between the ages of 18 and 75, was conducted by the Deloitte Center for Health Solutions. It was directed by Paul Keckley, executive director of the Deloitte Center for Health Solutions, and William Copeland, Jr., national managing director of the life sciences and health care practice of Deloitte Consulting.

Basically, the researchers conclude, Americans are seeking more from their health care system than they’re currently getting.

“More than anything, the findings convince us that Americans no longer see themselves only as patients, but as consumers who want to take greater control of their health care,” Keckley said. “Consumers will redefine our health care market, but how they do it is the most important strategic question the health care industry must answer.”

Among the survey’s key findings:

93% of consumers say they are not well prepared for future health care costs.

79% believe health care will be an important issue in the 2008 election; 46% percent described it as one of the top 3 issues affecting their vote.

34% say they would use a retail clinic; 16 percent already have.

60% want physicians to provide online access to medical records and test results, and online appointment scheduling; 25% say they would pay more for the such services.

33% say they want more holistic and alternative therapies in their treatment.

75% want expanded use of in-home monitoring devices and online tools that would reduce the need for visits and allow individuals to be more active in their care.

84% prefer generic drugs to name brands.

29% support a tax increase to help cover the uninsured, while another 34% say they would consider a tax hike.

52% say they understand their insurance coverage, but only 8% understand their policies completely.

Such findings suggest the potential for dramatic near-term changes in the way U.S. doctors, hospitals, health plan administrators, drug makers and biotech companies operate, Keckley said.