Americans have little idea how long-term supports and services are paid for, according to a new poll by Harris Interactive and the medical publishers HealthDay. Yet, they are worried about the cost, believe most people should buy long-term care insurance, and also favor a new government program to pay some or all of the costs of LTC.

It is hard to make much sense of these results, although the public’s confusion in this poll seems consistent with past surveys.

For instance, although Medicaid pays for as much as 60 percent of long-term care costs, only about one in five of those surveyed believe the program is the major payer of these services. One-third think Medicare is the biggest funder, though the program pays for almost no LTC costs. Half think individuals pay the most. In reality, families pay only about one-fifth of the cost of paid services, though of course they do provide the vast bulk of uncompensated care.

When asked who should pay these costs, 29 percent said individuals and their families while 27 percent said the federal government. Interestingly only 9 percent thought state and local governments should pay even though states are already a major payer through their share of Medicaid. Fully one-third said they don’t know who should pay.

Not surprisingly, Republicans were much more likely to say paying for long-term care should be primarily a family responsibility while more Democrats and independents felt government should play some role.  Still, only about half of self-identified Republicans said LTC should be primarily an individual responsibility while nearly one-third were not sure.

Only one-third of Democrats said government should pay most LTC costs while 20 percent said it should be a family responsibility. Another third of Democrats, like Republicans, were not sure who should take on this role.

Two-thirds of all respondents felt “most people” should buy long-term care insurance. Unfortunately, the survey did not ask people if they wanted to buy this insurance themselves. Only about 10 percent of Americans own LTC insurance.

Regardless of political affiliation, respondents overwhelmingly favored a tax break to subsidize the cost of long-term care insurance. More than 80 percent of Democrats and Republicans supported this idea, possibly unaware that most states already have such tax incentives.

Most surprisingly, nearly 70 percent of respondents favored a new government program to pay at least some long-term care costs. Half of Republicans, 80 percent of Democrats, and 68 percent of Independents supported this model.

The survey also asked if people were worried about the cost of long-term supports and services. Overall, 68 percent said they were very or somewhat worried. Women more much more likely to be concerned than men by 74 percent to 61 percent. By age, those least likely to be concerned were 18-24 (not surprising) and those 65 and older (very surprising). Those most likely to worry were aged 40-49.

The Harris survey, of 2,028 adults, was taken in September.

What’s the take-away of all this? Americans recognize that long-term supports and services are a major financial risk, yet they are deeply uncertain about how long-term care is paid for today and what to do about it. And they seem open to some sort of new government program to help, perhaps one that is insurance-based in some way.