Most Americans see health care and insurance costs (search) as a more pressing problem than malpractice lawsuits, a survey says, although the Bush administration often cites litigation as a reason for high medical bills.

The Kaiser Family Foundation (search), a nonprofit organization that studies health care issues, and the Harvard School of Public Health said reducing malpractice jury awards (search) ranked 11th on a list of 12 items people thought should be health care priorities for the president and Congress.

Named most often, by 63 percent of respondents, was lowering the cost of health care and insurance, followed closely by making Medicare (search) more financially sound and increasing the number of Americans with insurance.

While not viewing malpractice reform with the same sense of urgency as the administration, Americans did say it was needed. Three out of five said malpractice lawsuits were a very important factor in causing higher health care costs, just below the 63 percent who mentioned high profits made by drug and insurance companies.

Seventy-two percent support legislation requiring an independent specialist review of a case before a lawsuit could be filed, and 63 percent favored caps on damages for pain and suffering.

"The public isn't pushing hard for malpractice reform but will be happy to have it if the lawyers, doctors, administration and Congress can agree to a plan," said Drew E. Altman, president of the Kaiser Foundation.

Allowing prescription drug imports (search) from Canada came in eighth on the priority list, at 31 percent, while malpractice lawsuits were mentioned by 26 percent, just behind those wanting a better flu vaccine system and ahead of increasing federal funds for stem cell research.

The importance of reducing jury awards was named more by Republicans, at 37 percent, than Democrats, at 17 percent.

Bush is seeking a $250,000 cap on non-economic damages that compensate for pain and suffering, saying large malpractice awards are driving up the costs of business and insurance and forcing doctors to give up their practices.

A Congressional Budget Office (search) analysis said malpractice costs represented less than 2 percent of overall health care spending in 2002.

The survey found that 73 percent favor changing the law to allow Americans to buy prescription drugs imported from Canada. That change is strongly opposed by the pharmaceutical industry, and the administration says it is too costly to do safely.

Four out of five surveyed also want the government to negotiate with drug companies for lower prices, a practice expressly banned by the Medicare law enacted in 2003. Among those 65 and older, 46 percent viewed that new law unfavorably, against 29 percent with a favorable impression. Four-fifths of those seniors said the law was too complicated for people to understand.

Among other findings:

--Forty-five percent would be willing to pay more in taxes or insurance premiums to help expand coverage to the uninsured. Fifty-one percent would be unwilling to do so.

--More than half those surveyed said they had not heard the term "health savings account," a concept strongly backed by the administration that would allow individuals with high-deductible insurance policies to make tax-free deposits for future medical expenses. Thirty percent said they had heard the term and know what it means.

--In general, health care ranked as the third most important issue the president and Congress must deal with this year. First was the war in Iraq (news - web sites), sighted by 27 percent, followed by the economy at 17 percent, and health care and terrorism, each at 10 percent.

The findings were based on a November telephone survey of 1,396 respondents. The margin of sampling error is plus or minus 4 percentage points for all respondents.