This item ranks significantly above "taxes and spending," which comes in at 13 percent, and "education," which was cited by 12 percent.

However, it falls far below "the economy and jobs," which comes in at 74 percent, and "terrorism and national security," which is cited by 58 percent.

Still, nearly 75 percent of those surveyed cited rising health care costs as an "important" concern for voters in the Nov. 5 election.

"The beginning of the 2004 presidential election jockeying, combined with double-digit increases in health care spending and the resulting increase in the number of uninsured Americans, will thrust health care issues into the public spotlight in the months ahead," HIAA President Donald Young said at a press briefing.

The survey was conducted by Alexandria, Va.-based Public Opinion Strategies. Bill McInturff, a partner with the firm, said that several specific health care issues are seen as likely to receive legislative attention.

These include adding a prescription drug benefit to Medicare, expanding children's health insurance programs, passing a tax incentive for long-term care insurance, passing a patient's bill of rights that does not include the right to sue health plans, mental health parity, and capping medical malpractice awards.

However, Mr. McInturff said, the Washington insiders responding to the survey indicate skepticism that any of these legislative issues will become law.

"It appears that opinion leaders believe that more legislative stalemate will be the rule of the day in the next two years," he said.

Perhaps surprisingly, Mr. McInturff said, Republicans give a couple of key health care issues a higher chance of passing Congress than do Democrats.

He said that 49 percent of the Republicans responding to the survey cite a Medicare prescription drugs benefit as likely to pass, compared with only 39 percent of Democrats.

As for expansion of children's health insurance programs, 35 percent of Republicans see that as likely to pass Congress, compared with 26 percent of Democrats.

More generally, with a week to go before the election, the Washington insiders expect the Republicans to maintain control of the House, but they see the Senate as a tossup, Mr. McInturff said.

Looking ahead to the 2004 presidential campaign, he said, there is no strong consensus as to who is the front runner to be the Democratic Party candidate against President George Bush.

Former Vice President Al Gore and Sen. John Edwards, D-N.C., were each cited by 16 percent of the respondents as the likely nominee.

Sen. John Kerry, D-Mass., was named by 14 percent of respondents.

Sen. Joe Lieberman, D-Conn., was cited by nine percent; Sen. Tom Daschle, D-S.D., by eight percent; Rep. Dick Gephardt, D-Mo., by four percent; and former Sen. Bill Bradley of New Jersey by only one percent.