Following widespread media coverage of health care reform, political debates and legislative initiatives over the past year, consumers still profess to know very little about the health care system in the United States, according to the 3rd Annual Deloitte Center for Health Solutions Survey of Health Care Consumers.

Less than a quarter (23 percent) of consumers surveyed say they understand how the health care system works, but 76 percent grade the system a

"C" or below and nearly half (48 percent) believe that 50 percent or more of health care dollars are wasted.

"In a year marked by historic debate over the future of the health care system, our survey indicates that not much has changed from 2009 to 2010 in terms of consumers' understanding and perceptions of the system," said Paul H. Keckley, Ph.D., and executive director of the Deloitte Center for Health Solutions.

More than half (57 percent) of consumers surveyed say they are satisfied with their health plan, yet less than half (46 percent) say they understand their health insurance coverage, and one in four does not know how much they are paying for health insurance.

The survey also identified a variety of contradictions concerning consumers' perceptions, attitudes and behaviors about their health care decisions and personal health status:

Consumers perceive themselves to be healthy; Suffer from chronic conditions

Seven out of eight (88 percent) consumers surveyed believe they are in "excellent," "very good," or "good," health, yet more than half (54 percent) have been diagnosed with one or more chronic conditions and, of the 56 percent who take prescription medications, almost half (47 percent) take three or more daily.

"At a time when U.S. obesity rates are at an all time high and diabetes and other chronic conditions continue to soar, the fact that people still believe they are healthy when reality tells a different story is a serious problem that will continue to challenge the health care system," added Keckley.

Split on government's role in health care; Prefer private competition

Consumers also have mixed emotions over government's role in the health care system. More than 40 percent (42 percent) support government-mandated health insurance, compared to 38 percent who oppose it. However, more consumers (42 percent) would choose an employer-sponsored plan versus the government's (25 percent), all other factors being equal. Less than half (46 percent) believe the competition from the government would be fair to private insurance plans and one in three consumers believe that the market needs 10 or more insurance companies competing to ensure consumer choice.