The Aspen Institute's Health Stewardship Project this week held one of those forums about the presidential candidates and their health reform plans that have been popping up around Washington, and we were glad they added their voice to the call for health reform that addresses not just health insurance but also cost, quality, preventive care etc. We were particularly interested in a few elements of a Zogby poll Aspen commissioned on public attitudes toward personal responsibility in health care and also how people are using the Internet for their own health decisions.

Four-out-of-five Americans favor rewards for people who adopt a healthy lifestyle and financial incentives such as lower insurance premiums for people trying to make healthier choices. Conversely, 78 percent said people who make poor health choices should be held accountable, but the numbers slipped when they were asked precisely how that should be accomplished. Fifty-eight percent said they should pay more for health care; only 29 percent favored measures like fines for smoking or "fat taxes." This is in keeping with some other reports we've seen that show that rewarding good choices is probably more acceptable to the public than punishing bad ones—i.e. giving someone an insurance discount if they stop smoking, rather than imposing a surcharge if they keep smoking. There's a reason carrots are healthier than sticks.

We've seen lots of data suggesting that Americans typically are more worried about costs than covering the uninsured, and the Zogby poll had similar findings. More than half (54 percent) said they did not want to pay higher taxes so that everyone can be insured, although 56 percent were willing to pay taxes to cover all kids.

The poll asked several questions about Internet use and health, and it seems that people are using it more for mild or moderate health problems than to make decisions about truly serious conditions. Forty-four percent of those surveyed said they used the Internet for health weekly or monthly; only six percent said never. More than half used it for treatment for "mild to moderate" health problems, or for nutritional choices. One third checked the Internet to decide whether they needed to see a doctor. But fewer than one-in-five used online resources to figure out which treatment they should use for a serious problem.

On a related topic, the Health Populi blog has some information on health internet use in California. That survey found the most popular care-related used on the Internet includes searching for information about conditions and drugs, finding a doctor, and looking for claims and benefits insurance information (good luck!). About 13 percent of Californians can make doctors appointments online, and 12 percent get their prescriptions refiled. The blog also had this snippet from Prevention magazine, based on a poll by the American College of Surgeons:

How much time Americans spend researching:

Medical procedures or a surgeon: 1 hour

Vacation planning: 4 hours

Picking a new appliance: 5 hours

Thinking about a job change: 10 hours....