As Americans reflect on their blessings this Thanksgiving, will they count the U.S. health care system among them?

Politicians, the media, and probably most people would say no. But if we alter the question, directing it toward the individual and away from the system, the answer changes drastically.

A startling majority of Americans – 77 percent – said the quality of their own health care was “excellent” or “good” in a recent study.

The Council for Excellence in Government, in coordination with the Institute of Medicine, Accenture and Gallup, conducted the study to find out what real Americans think about health care. “The American Public on Health Care: The Missing Perspective” was released in October.

The “missing perspective,” indeed.

Though we hear of nothing but a “broken” system in need of an overhaul, a lot of people seem to favor that overhaul for the benefit of others.

Another survey, in March 2008 by the Harvard School of Public Health and the Robert Wood Johnson Foundation, revealed a combined 82 percent rating their own medical care “excellent” or “good,” for those who had received care in the past year.

What politician can claim approval ratings in the high 70s to lower 80s?

That doesn’t mean the vast majority of people love the structure of the U.S. system. But it does highlight something missing in our dialogue: Americans are saying they’re receiving good health care. Elected officials focused on reform should find out why. The aspects of care that people like are the ones we should keep if we’re going to have an overhaul.

Unfortunately, “The Missing Perspective” didn’t report why people felt positively about their care. It could have been people’s doctors, nurses, access to care, recovery from disease – we don’t know. That data point was overshadowed by an emphasis on survey respondents’ concerns and desires for the future, as expected for an election-focused release.

So let’s take a look at what the people want.

They favor portable health insurance policies. A full 78 percent said they want to be able to take their coverage with them from job to job. With one in four Americans changing jobs every year, this is necessary to modernize insurance and health care delivery. Continued...