Most Americans are frustrated by decisions that limit the use of high-cost prescriptions and treatments, according to a survey by the Harvard School of Public Health and the Alliance for Aging Research.

A majority say they oppose decisions by the government or health insurance plans where prescription drugs or medical or surgical treatments are not paid for because the payors determine the benefits and do not justify the cost. The exception is if there's evidence that something else works equally well but costs less. Sixty-four percent believe the government or health insurance plans should not pay for a more expensive prescription drug or medical or surgical treatment if it has not been shown to work better than less expensive ones. Majorities in Italy and Germany share both of these beliefs with the U.S. public. In the United Kingdom, at least a plurality shares these beliefs.

"The results of the survey underscore the need for balance between measures to control health care costs and ensuring that Americans receive high quality health care at all stages of life, particularly for the growing aging population," says Daniel Perry, president and CEO of Alliance for Aging Research.

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New efforts to slow the growth of health care costs may be hampered by the belief of two-thirds (67 percent) of Americans that government or health insurance plans already often withhold high-cost prescription drugs and medical or surgical treatments from some people who might benefit from them in order to save money. Majorities in Italy and Germany, but not the U.K., also believe this to be the case in their own countries.

"Despite a common presumption that public resistance to placing limits on the use of expensive drugs and treatments is an American phenomenon, similar attitudes also exist in other countries," says Robert Blendon, professor of Health Policy and Political Analysis at the Harvard School of Public Health.

The survey found that Americans differ from the public in the other countries on one important matter. A majority of Americans do not support having a government decision-making body that recommends whether government programs should pay for or provide prescription drugs and medical or surgical treatments if they think they cost too much (43 percent favor, 54 percent oppose), while majorities in Italy and Germany do support having such a decision-making body and the public in the U.K. is about evenly divided.

When it comes to governmental decision-making in health care, the survey also found that compared with the public in the other three countries, Americans have the lowest level of trust (34 percent) in the national government to make the right health care decisions.

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