"Check please!" may be the easy way out of a bad date, but Americans are finding it increasingly hard to pick up the tab on health care, according to a new survey from the Commonwealth Fund.

Examining data from its biennial survey, Commonwealth finds that in 2007, nearly two-thirds of U.S. adults—or 116 million people—were either uninsured for some or all of the year, were underinsured, had trouble paying medical bills, and/or went without needed health care because of cost.

Reported in the Washington Post, the findings have also been picked up in the blogs. Jonathan Cohn over at The New Republic gives his take on the survey noting, the high costs of health care are hitting home for all income groups. Health Populi's Jane Sarasohn-Kahn takes an in-depth look at the survey's findings on medical debt. (Check out Commonwealth's specific companion brief on medical debt here).

Here are some more take-home points from the survey:

• One-third of adults spent 10 percent or more of their income on health insurance and health care in i2007. That number was even higher for low–income adults, with more than half of adults from families with incomes less than $20,000 spending a large fraction of their income on health care and insurance.
• Four out of 10 adults, or 72 million Americans, struggled to pay medical bills and debt in 2007, and more than 60 percent reported having health insurance at the time care was provided.
• In 2007, the share of adults who reported problems getting needed medical care because of cost rose to 45 percent, up from 29 percent in 2001.

The survey comes at an interesting time in the health care debate when, as Jill Zuckman of the Chicago Tribune noted today, the presidential campaigns have gone mostly silent on the issue, at least for the moment. Campaign topics go in and out of vogue of course -- whoever thought we'd be hearing about South Ossetia —but we'd feel better if we heard as much about health now that the general campaign is starting as we heard from candidates in both parties during the primaries.

Yet, silence—never a good sign on a first date—won't solve America's health care problems. The key to any good relationship is communication, and fortunately there are ongoing, bipartisan conversations in Congress and elsewhere around several pieces of legislation. (For a brief tasting menu of such delicious discussions, check out some of our previous posts here, here, here, and here).

Blogging on a recent Kaiser Family Foundation tracking poll, our colleague, Joanne Kenen, notes that health care remains among the top-four election issues with the economy standing as the voters' chief concern. The Commonwealth report helps illustrate how closely health care (and health reform) is tied to the economic well-being of all Americans. As Sara Collins, one of the study's authors, told the Post: "Health-care costs are climbing much more rapidly than incomes or the growth in the overall economy," and "What is notable is how these problems are spreading up the income scale."

Gas prices fall, and the economy (and the news) moves in cycles; yet, the burden of health care continues to grow. Voters and journalists alike need to make sure that politicians don't take us out to a nice seafood dinner with promises of affordable, comprehensive health reform, and then never call us again.