Americans borrowed an estimated $88 billion last year to pay for health care, according to a survey released Tuesday by Gallup and the nonprofit West Health.

The survey also found that 1 in 4 Americans have skipped treatment because of the cost, and that nearly half fear bankruptcy in the event of a health emergency.

There was a partisan divide when respondents were asked whether they believed that the American health care system is among the best in the world: Among Republicans, 67 percent of respondents said they believed so; that number was 38 percent among Democrats.

But Democrats and Republicans had similar responses about putting off medical treatment. Asked if they had deferred treatment because of the cost, 27 percent of Democrats said they had, compared with 21 percent of Republicans and 30 percent of independents.

Respondents from across the political spectrum also reported pessimism about their leaders’ abilities to reduce health care costs. About 70 percent of respondents said they had no confidence in their elected officials to bring prices down. And 77 percent said they were concerned that rising health care costs would damage the American economy.

At the same time, 64 percent of respondents said they were mostly satisfied with their experiences in the health care system. When asked if they were satisfied with how well the system was serving Americans generally, only 39 percent said they were. The survey’s authors noted that Americans’ feelings were complicated and at times conflicted. But one thing was clear: High health care costs had created significant anxiety. Even among households earning $180,000 or more a year, one-third of respondents said they were concerned about the specter of personal bankruptcy due to a health crisis.

Many American families earning less than that, of course, feel the effects of high health care costs acutely. They are forced to cut back on other expenses to pay for health care, or skip appointments and prescription refills, creating health risks down the road.

Twelve percent of respondents said they had borrowed money for care.