One in three Americans would choose to die young rather than swallow a pill every day that would reduce the risk of heart disease, according to a new study. The findings highlight a medical conundrum: Patients often refuse to take their meds, even when doing so could save their lives.

Researchers surveyed 1,000 middle-aged people and asked just how far they’d go to live a little bit longer. Participants were asked to imagine that scientists had discovered a cost-free medication that prevented heart disease and had no side effects whatsoever. Nearly 10 percent said they would rather lose two years of their lives than take the pill, and another 21 percent said they’d give up a year of life. Some people would even pay money to ditch their meds: Some 21 percent told researchers they’d pay $1,000 to avoid a hypothetical, life-saving medication that would cost them nothing.

It’s a problem that plagues physicians and researchers alike: People hate daily pills. An estimated 60 percent of patients do not take their meds regularly. Non-compliance is such a rampant issue that clinical trials often end up skewed by people who take experimental drugs sporadically, and, of course, so many people stop taking antibiotics early that superbugs are on the rise.

Scientists are trying to find creative ways to get patients to take their meds, including smart drug dispensers that tattle on you if you miss a pill. But patients are only human, and humans forget, or compromise, or stubbornly refuse treatment. Right now, if scientists stumbled upon a miracle pill, it’s safe to say a whole lot of people probably wouldn’t take it.