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PHOENIX — Arizonans are unhappy enough with some elements of health care in this country that almost half would support having the government provide insurance, a new poll suggests.

The statewide survey also indicates Arizonans are equally divided about paying higher taxes to ensure that all state residents have health care. And while they also are split about both the quality of health care and access to it, most believe that it costs far too much.

The results could be good news for Health Arizona, which is planning an initiative for the state's 2008 ballot to expand health coverage. Eve Shapiro, the Tucson physician who chairs the group, said the proposal will include some tax increases.

But Shapiro said the division the poll shows about the role of government in guaranteeing health care for all shores up her group's decision not to push a system like the one adopted in Massachusetts, where everyone is required to purchase insurance.

"Mandatory systems do not fly in this state," she said.

She also said her own group's polling suggests that raising overall state taxes to expand health coverage would be a hard sell at the ballot box.

Instead, the Healthy Arizona initiative would raise "sin taxes" — a term linked to things like alcohol and tobacco — though Shapiro would not identify what would be taxed and how much the levy would be.

She said the amount collected would be limited, meaning even if her group's initiative passes there still would be Arizonans without health insurance.

"It will obviously be dependent on how much funding we can raise," Shapiro said. At best, Shapiro said, the plan would "cover more people" than now.

The U.S. Census Bureau reports that about 1.3 million Arizonans — more than one out of every five — were without health insurance last year.

That is on top of the Arizona Health Care Cost Containment System, a taxpayer-funded program which provides free health care for anyone below the federal poverty level, which is about $20,650 for a family of four. About 1 million Arizonans are enrolled.

A separate program provides heavily subsidized coverage for about 65,000 children in families earning up to twice that much.

Shapiro said the Healthy Arizona initiative will not be a handout.

"People should pay something towards their health-insurance costs," she said. Shapiro said the Healthy Arizona initiative will include a sliding fee scale, "with some kind of a subsidy, depending on income, that's reasonable."

Pollster Fred Solop, who conducted the new health-care survey for the Social Research Laboratory at Northern Arizona University, said 37 percent of the 400 residents questioned earlier this month reported they had major trouble within the past year paying for the cost of a major illness.

And 15 percent said they or someone in their family needed but did not get medical care in the last year because it was too expensive.

That reflects in the results of another question, where 72 percent of those asked said they are dissatisfied with the cost of health care in this country.

But other queries yielded closer results.

Solop found 52 percent dissatisfied with the quality of care. But only 42 percent said they are unhappy with availability.

The survey has a potential margin of error of 5 percent.

The plan by Shapiro's group may not be the only one on the 2008 ballot dealing with health care. Two doctors already have launched an initiative to constitutionally prohibit the government from requiring anyone in Arizona to purchase health insurance.

Shapiro said her organization's plan is designed so it would not be undermined if that measure also is approved.