More than a quarter of the population say they have to forgo medical care because of the high cost, while 40 percent of them claim their health declined and some even required hospitalization because they did not receive proper treatment in time. This is one of the findings of a survey conducted for the Israel Medical Association (IMA) and released on Monday. IMA chairman Dr. Yoram Blachar said the findings were "shameful" because it meant that the state has "sentenced" a large segment of the population to illness because they can't afford copayments. The public purse often does not save, because if their health declines, instead of being treated in the community clinic, they often have to be hospitalized for long periods at public expense. "The 'egalitarian medicine' that was hailed at the launching of the state has collapsed, and the government must do all it can to find an urgent solutuion," Blachar added. The poll, conducted by Prof. Avi Degani and dr. Rina Degani of the Geocartography Institute, surveyed a representative sample of 503 adults, with a polling error of +/-4.2%. The new IMA survey, similar to one held a year ago; did not show any improvement in the situation compared to 2004. Of the 28% who testified that they or their children do not get the medical care they're entitled to because they cannot afford copayments, many said they don't go to their doctor (usually a specialist) because of the fee that must be paid each quarter. Others said they can't afford the copayment for prescription drugs. Nine percent said they refrained from taking their children for the medical care they needed because they couldn't afford it. Fourteen percent said they have elderly parents who forgo a doctor's visit because they can't pay the fee, and eight percent can't buy the medications they needed - even those in the basket of health services - because of the cost of patient participation. Unsurprisingly, those with the lowest educational levels and income and Jews of Sephardic origin are most likely to be among this disadvantaged and medically neglected group. A total of 85% of the public - including many of the lower socioecononic groups, have some kind of supplementary health insurance in addition to the basic basket of health services, but this does not eliminate their poorer access to health care because of copayments. Fully 63% of those surveyed said the burden of health costs was "too high," and 43% said they are paying "more than in the past" for medical care.