Many Americans are really struggling to understand the shifting landscape of the U.S. health care system. Millions don't know or don't understand basic components of their health insurance, which may be a factor in the high number who avoid seeing a physician because they think they won't be able to afford the care.

These were among the results of a Harris poll of more than 2,000 adults in the U.S., 1,872 of whom had health insurance at the time of the survey. The survey was commissioned by SCIO Health Analytics.

"Approximately two in five insured Americans (38 percent) do not have a good understanding of which health care services are covered under their current plan," the report said. "One in five insured Americans, or approximately 44 million people, have avoided visiting a doctor for a general health concern within the past 12 months because of cost concerns."

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.