NEW YORK (TheStreet) -- Are American consumers ready to take control of their health care decisions?

Health care reform virtually demands they do, but evidence is mounting that consumers are unprepared for the changes scheduled to hit the marketplace next year.

Aflac , the Columbus, Ga.-based insurance mainstay, has taken the pulse of the health care market and how and if U.S. adults are ready for what's coming.

What the company found should be alarming to health care companies, government officials, and above all, U.S. health care customers.

According to fresh data from the its Workforces Report, released on Thursday:

Maybe that's why Aflac says Americans face an "uphill climb" with changes in the nation's health care system starting next year.

The firm says consumers are going to have to change the way they look at health care; the way they choose a plan; they way they prepare to pay for care (which, as it has been for decades, will continue to rise after reform, Aflac says); and the way they adhere to regulations that will change significantly.

The report, which tracked responses from 2,500 U.S. employees and 1,900 workplace managers, says that while Americans shouldn't be blamed for being unprepared for health care reform, blunders in dealing with those changes will fall on them, and them alone.

"It may be referred to as 'consumer-driven health care,' but in actuality, consumers aren't the ones driving these changes, so it's no surprise that many feel unprepared," said Audrey Boone Tillman, executive vice president of Corporate Services at Aflac. "The bottom line is if consumers aren't educated about the full scope of their options, they risk making costly mistakes without a financial back-up plan."

The study notes that 89% of health care consumers opt for the same health care plans every year, but don't understand what's in those plans. Furthermore, 76% say they are largely unaware of how so-called health care exchanges -- which are the foundation of health car reform -- work.

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Health Care Reform Will Still Shock America