When it comes to real health-care reform, an overwhelming majority of Americans believe an ounce of prevention is worth a pound — maybe two — of cure.

According to survey results released Monday by the Robert Wood Johnson Foundation and Trust for America's Health, more than three-quarters of Americans — 76 percent — say the U.S. health-care system should get serious about reorienting away from expensive, specialized sick care and toward much cheaper and more effective programs to prevent health problems in the first place.

Investing in prevention programs and public-awareness campaigns about how people can stay healthy will do more to reduce costs and improve the quality of U.S. health care than any of the proposals, such as better records management, better surgical procedures or regulating private insurers, according to the poll results.

Dr. Paul Grundy, a health-care consultant to IBM who was in Salt Lake City recently for a conference of preventive-medicine physicians, said surveys extolling the benefits of prevention will continue to mount. He noted that Utah's health-care-reform effort, now in its third year, recognizes and is facilitating more consumer involvement that is needed nationwide.

"The problem is there is no money to speak of in preventing illnesses," he said. "It's all in treating people after they're sick."

The current system isn't a system at all, Grundy said, but a kind of controlled chaos of sick-care providers treating diseases such as diabetes and heart disease that are chronic and growing illnesses of an overeating, underexercising population.

According to the poll and other recent best estimates, nearly $800 billion of the $2.4 trillion Americans spend on health care every year goes for treatment of health problems that are directly linked to lifestyle and poor health habits.

"We gave Americans a list of proposals being considered to reform health care, and investing in prevention trumped them all," said pollster Bill McInturff. "It's clear that Americans see the value of prevention for reducing disease, improving quality of life and lowering health-care costs."

The poll, which reflects responses from 1,014 registered voters, was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies from May 7 to 12, 2009, and is available at www.healthyamericans.org. The margin of error was 3.1 percent.

E-mail: jthalman@desnews.com