Mirroring the debate in Washington, most Americans agree that Medicare needs to undergo some form of change, but they're not in agreement on the nature of the reform.

According to a health poll from Truven Health Analytics, 65 percent of Americans believe changes need to be made to the federal health insurance system. Republicans—at 71 percent—felt stronger about the need for changes to the program than Democrats (58 percent). The highest rate (80 percent) of respondents who said they would favor changes to the Medicare system was among those who make over $100,000 per year.

Half said Medicare would benefit by encouraging competition within the program; 69 percent of Republicans and 31 percent of Democrats said changes to encourage competition were necessary.

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Less popular was the idea of a voucher plan. When a voucher plan similar to the one Congressman Paul Ryan proposed prior to the presidential election was described for respondents, just 35 percent agreed it would be the right way to reform Medicare. Slightly over half of Republicans (52 percent) and one-in-five Democrats (19 percent) agreed with Medicare being turned into a voucher program.

Medicare reform has been in the spotlight in the last year: During the presidential election, both candidates had drastically different ways of reforming the program. And now, it's come in debate over how the government will reduce the deficit.

 "The first step in any change process is to realize that change is needed," says Raymond Fabiuschief medical officer at Truven Health Analytics. "With two-thirds of the public agreeing on the need for Medicare reform, the nation can now focus on solutions."

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