An increasing number of Americans, many with health insurance, are delaying or forgoing medical care because of concern about cost, according to a report from the Center for Studying Health System Change. A 2007 survey of 18,000 people found that 20% of the respondents said that they had put off or gone without needed medical treatment at some point in the prior year, up from 14% in a 2003 survey. Of those who said in the 2007 survey they had put off care, 69% cited concern about cost as a reason.