It's no secret that many Americans think changes need to be made in the healthcare system. While the government has created a number of new laws, there is still room for improvement in most people's eyes.

According to a survey by the Commonwealth Fund, 56 percent of healthcare opinion leaders feel there needs to be a change in the way doctors are paid. Those respondents indicated they were in favor of a system where the government sets rates for all payers. The researchers indicated that switching to such a method may result in savings from fewer administrative needs.

Other research has shown that healthcare costs have steadily increased over the years.

Fewer expenses may result in savings getting passed down to consumers with either a group or individual health insurance plan.

Commonwealth Fund president Karen Davis says the current healthcare system results in price variations.

"Experts agree that if private payers and public programs could come together and agree to pay the same way, and the same amount, we can improve the efficiency of our health care system, eliminate administrative waste, and create better experiences for patients," says Davis.

Most Americans will be required to have health insurance by 2014. A number of people may end up purchasing individual health insurance plans, obtaining group coverage, or filing for government assistance as a result. While that date may seem far away for the average consumer, the clock is ticking for those who have to ensure all the appropriate measures are in place.

Iowa is set to receive a grant worth more than $313,700 to help the state guide consumers through the process of enrolling in healthcare programs. Given the number of uninsured Americans, however, there are a number of people that will need help navigating the enrollment process.

Governor Chet Culver says he is pleased the state has received the grant.

"This is very good news for Iowa's consumers," says Culver. "This grant will ensure that Iowans will have quick and immediate help in entering into the new health care system."

Culver has voiced his concerns over healthcare and insurance in the past. Earlier this year, he called on a major health insurance provider in the state to justify an 18 percent rate hike. At that time, Culver said he was concerned about the increases.

Health insurance companies have been under intense scrutiny as of late for their rates. On Thursday, insurance regulators finalized their recommendations for what percentage of of money should go towards patient care.

Now, the rules are set to go to the U.S. Department of Health and Human Services Secretary Kathleen Sebelius. Under reform, insurers will be required to spend at least 80 percent on medical care next year.

Companies are fighting for the broadest possible definition of direct health care, whereas consumer groups have been urging for less leniency on terms.

Consumer Watchdog Washington DC director Carmen Balber says that while it's good regulators aren't backing down, a cap still needs to be put in place .

"The law still does nothing to cap rates and consumers are struggling to pay double-digit premium increases now," says Balber. "President Obama should forbid premium hikes until insurance companies comply with pricing provisions of the new federal law and explain increases before they take effect."

In addition to regulating how much money insurers must spend on care, reform will also require most people to have health insurance coverage in the future. People can obtain insurance through an employer or purchase an individual health insurance plan.

Anyone who has searched for affordable health insurance quotes knows that premiums can vary depending on plane type and company. Rates can also fluctuate based on new government regulation.

The New York State Insurance Department recently made public how they have been working to keep premiums down. Laws require health insurance companies to submit a formal request of approval before they can go into effect. Before the regulation was in place, insurers simply had to file rates and then use them.

New York Department of Insurance superintendent James Wrynn says proposed rate increases have been reduced because of prior approval.

"We certainly are not happy with even the reduced increases, and we will keep working to keep costs down," says Wrynn. "But at least we could make sure these increases were justified by the rising cost of health care in New York. We reduced every rate increase request that we found excessive or unreasonable."

Data from Families USA shows other states have also shown success with prior approval. In Indiana, for example, officials say they get health insurance companies to lower increases half the time.

A number of state officials have begun to implement measures to help people find affordable health insurance quotes and keep premiums at bay. There are, however, some groups that are against such actions.

The Consumer Watchdog group is asserting that health insurance companies are trying to raise rates while they still can. Furthermore, the group is urging President Barack Obama to prohibit insurers from hiking rates again.

Consumer Watchdog Washington D.C. director Carmen Balber says more needs to be done to keep companies in check.

"In the meantime, insurers rush to raise premiums now just in case they have to rein in spending tomorrow," says Balber. "President Obama has the power to protect consumers from arbitrary price hikes by freezing premiums until insurers explain how they're spent in the full light of day."

Premium increases and the like have been subject of much debate. Earlier this year, a health insurance provider withdrew a rate increase request in California after an error was detected in their mathematical calculations.