A new study out by Deloitte's Center for Health Solutions is a must read. The big consulting firm has produced the most comprehensive profile so far of the American health care consumer, under the direction of the center's executive director, Paul Keckley, Ph.D.

The 2008 Survey of Health Care Consumers found unequivocally that Americans are not passive patients willing to let others make decisions for them but are active consumers who want to be engaged in decisions.

They are hungry for information and want e-mail and web-based connections to their doctors, and given the chance, they would be value-shoppers, willing to make trade-offs, like accepting smaller networks of doctors to save money on insurance premiums.

At the same time, they are worried about future health care costs and are searching for alternative medicines and services that can save them money and offer convenience.

The survey, conducted last fall with a scientific online poll of more than 3,000 Americans, found many gaps between what consumers want, especially in timely and useful information and control over their health care decisions, and what's available to them today.

A few examples: 

• Four out of five people want to be able to make same-day appointments with their doctors, and three-quarters want online access to their medical records and to be able to communicate with their doctor by email.

  Few have these options. Payment policies must be modernized to allow doctors to get online -- and get paid for it. 

• Two out of three Americans want to participate in programs that will help them learn how to better manage their health, but only 17% have participated in a wellness program -- another gap just waiting to be filled.

And about health insurance:

• When given a choice between getting health insurance through an employer or on their own, 54% would prefer the employer. But almost as many -- 46% -- would prefer to get insurance on their own. This is great progress in a health sector where people have been brainwashed to think that the only place to get health insurance is through their jobs. They understand intuitively that portability is crucial.

• And what is the first thing they ask for in a health plan? Prescription drug coverage was at the top of the list, with 76% saying it was their most important consideration for health insurance, followed by 74% who say the monthly premium is most important. These issues were much more important than coverage for dependents (48%) or whether a plan covers mental health costs (33%).

The survey also shows that it would be a mistake to think of American health care consumers as a homogenous group. There are many different personality types with different levels of interest in navigating the health care system. Some are content and compliant, but the majority is interested in change, including innovative approaches to care and coverage and in having much more access to personalized, online information.

This barely skims the surface of this in-depth survey. It's worth a read by anyone, including political leaders, interested in finding out what services health care consumers want and will need in the future.

Market opportunities abound if politicians don't throw up roadblocks to progress.