The reason: While Congress is focusing on whether consumers should have a right to sue their managed-care plans, the patients themselves have more immediate concerns, according to a survey released August 30.

Nearly half the respondents in a poll conducted by the Henry J. Kaiser Family Foundation and Harvard University reported delays or denial of care and other difficulties with their HMOs in the past year. And they’re anxious about reducing health care costs and providing prescription drug coverage for senior citizens. The poll found little interest in the dispute over making it easier to sue HMOs.

“People are not grasping a huge fundamental difference between the approaches of the different sides,” said Drew E. Altman, president of the Kaiser foundation.

A Democratic bill in the Senate makes it easier to file lawsuits, and a Republican version in the House, brokered by Rep. Charlie Norwood (R-Ga.), is more restrictive. Norwood’s version has the backing of the White House.

The polling figures indicate people “would accept a limited right to sue,” Altman said. But after more than five years of talk without action, he said, the public appears to have grown weary of the debate.

Only oil companies rated lower than HMOs in the public’s esteem, according to the survey, which questioned 1,205 adults during July and August. Fifty-two percent said oil companies do a “bad job” of serving consumers, while 46 percent said the same about HMOs. In contrast, only 4 percent rated nurses poorly, 10 percent felt the Postal Service does a bad job and 29 percent scored lawyers.

Despite dissatisfaction with the managed care industry as a whole, 62 percent graded their own HMOs as good or excellent.

The survey offered some mixed signals to Congress, which returns next week to take up work on the patients’ rights bill.

Eight-one percent of respondents said they favored the legislation, but when the question included the possibility that some employers might drop health care coverage for their workers, support fell to just 34 percent.

When respondents were asked to rank health care issues in order of importance, 7 percent put patients’ rights on top.

In contrast, 30 percent said controlling cost was most important, and 15 percent chose prescription drug benefits.

The findings offered encouragement to some opponents of the patients’ rights legislation.

“We’ve always felt that the public has not been clamoring for it, and, once they do learn the consequences of the legislation, then support drops dramatically,” said Todd Irons, spokesman for the Health Benefits Coalition. The industry group has led a protracted battle to stall the patients’ rights bill.

Irons conceded that the managed-care industry has failed to rally public concerns that the legislation would dramatically raise costs or reduce coverage.

Robert J. Blendon, a professor at the Harvard School of Public Health, said the survey findings convince him the politically safe move for lawmakers would be to enact a compromise.

“Incumbents, both Democrats and Republicans, would gain by saying that they passed some health care bill during this term,” he said. “There’s a win on a compromise piece of legislation. There’s no win in taking this into the election season.”

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