It’s long been a truism that voters give high marks to their own congressmen and senators, but hold a low opinion of Congress generally. A similar disconnect, it seems, is prevalent among workers on the topic of health care.

According to the most recent issue of the Employee Benefits Research Institute (EBRI), most workers continue to be satisfied with their own health plan, but a growing number give low ratings to the health care system generally.

When EBRI surveyed workers to rate the U.S. health care system, roughly 3 in 10 describe it as poor (29 percent) or fair (32 percent). One quarter consider it good, while only a small minority rate it as very good (10 percent) or excellent (1 percent).

Dissatisfaction with the health care system, the study adds, is focused mainly on cost.

In contrast, the survey shows, one-half of those with health insurance coverage are “extremely satisfied” or “very satisfied” with the quality of their plans.

While confidence in the health care system has remained steady since passage of the Patient Protection and Affordable Care Act (PPACA) — 47 percent of workers report being extremely or very confident that they can get the treatments they need — this confidence declines as workers look to the future.

Just 3 in 10 workers (30 percent) are confident in their ability to get needed care over the next decade. And just 19 percent are confident about this once they are eligible for Medicare.

Similarly, almost 4 in 10 workers (38 percent) are confident they have enough choices about who provides their medical care today, but only 26 percent are confident about this aspect of the health care system over the next 10 years. And just 18 percent are confident they will have enough choices once they are eligible for Medicare.

Additionally, 24 percent of workers they are they will be able to afford health care without financial hardship, but this percentage decreases to 20 percent when workers they look out over the next 10 years; and to 17 percent when they consider the Medicare years.