Only one in 10 people in the United States say the government works well and doesn’t need to be changed, a new poll indicates.

Half of the public, by contrast, said the government either needs “a lot of changes” or wanted a complete overhaul, according to a recent poll byThe Associated Press/NORC Center for Public Affairs Research.

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Seventy percent of people surveyed said they aren’t confident in the government’s ability “to make progress on the important problems and issues facing the country in 2014.”

The pollsters asked people which issues they want the government to tackle in 2014. Healthcare reform was at the top of the list, followed by jobs and the economy, and the nation’s debt and deficit spending.

Nearly 90 percent of those who identified healthcare reform as a top priority said they want the government to put “a lot” or a “great deal” of effort into it. Around half, 49 percent, are “not at all confident” lawmakers can make any progress.

Around 50 percent in the poll said they want the government to do less, and around the same percentage said the government should be doing more in general.

With the midterm elections in November, half said they’re pessimistic about the country’s ability to produce strong leaders.