More than two out of three Americans (68%) rate health care in this country as fair or poor, but a near identical number (69%) give good or excellent marks to their health insurance coverage and are very reluctant to change it.

A new Rasmussen Reports national survey finds just 29% of Americans think the U.S. health care system is good or excellent.

These numbers track very closely with the findings in another Rasmussen Reports survey last September.

While much of the political debate in recent years has focused on those who do not have health insurance, only 10% of Americans in the latest survey say they are not insured. Eighty-seven percent (87%) say they do have health insurance, and only 31% rate it poor or fair.

In addition, 65% of Americans say they want to keep their existing health insurance as opposed to 15% who are willing to switch to some form of government health insurance.

Republican presidential candidate John McCain has proposed that Americans who buy health insurance get a refundable tax credit. However, employer contributions to health insurance would be treated as income, subject to income taxes but not payroll taxes.

His Democratic opponent, Barack Obama, has called for a national insurance program for individuals and small businesses similar to what federal employees have.

Dissatisfaction with the U.S. health care system makes the issue a perennial campaign favorite. The fact that voters are generally reluctant to give up their own insurance coverage makes the issue resistant to reform.

A clear majority in the new survey (67%) think the same level of insurance coverage available to members of Congress should be available to everyone. Members of Congress can choose among dozens of alternative plans, regardless of the health conditions of themselves or their families, and keep their existing coverage when they move to a new job or retire.

Thirty-seven percent (37%) of men give good or excellent ratings to the U.S. health care system, as opposed to 23% of women. Nearly twice as many women (40%) rate it poor, contrasted with 33% of men.

But 70% of women give good or excellent marks to their own health insurance, while only 67% of men agree.

Democrats are dramatically more skeptical of the overall health care system than Republicans: 86% of Democrats rate it fair or poor, as opposed to 50% of Republicans who see it as good or excellent. Sixty-five percent (65%) of unaffiliated voters also give the system low marks.

Still, 64% of Democrats, 75% of Republicans and 67% of unaffiliated voters grade their own health insurance as good or excellent.

African-Americans, however, are nearly evenly divided in their assessment of their own health insurance programs, with 48% giving them excellent or good marks and 50% rating them fair or poor. Seventy-four percent (74%) of whites, by contrast, rate their own programs food or excellent, with only 26% giving them the lower marks.

Accordingly, blacks are nearly twice as likely as whites to favor switching to an insurance program administered by the government, 27% to 14%.

Dissatisfaction with both the overall health care system and their own health insurance was highest among those in the lowest income bracket, earning less than $20,000 per year.

A separate Rasmussen Reports survey last month found that only 11% of voters rate domestic issues like Social Security and health care as their number one concern.

In an April survey just 29% of Americans favored a national health insurance program overseen by the federal government. Nearly half (46%) believed the quality of care would suffer under such a program, and 42% expected the cost of health care to go up.

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