The Washington Post editorializes,

There is no silver bullet to controlling health-care costs

Until somebody listens, I will keep shouting that it is not health care “costs” that are out of control. It is the utilization of medical services. To put it in terms that will provoke some, it is the consumption of medical care.

There are many procedures for which the benefits are small or speculative. Often, the patient gets a ray of hope, or comfort that doctors are making an effort. Less often, the procedures improve the outcome.

The Post talks about health care exchanges (where insurance companies compete on price offering government-approved health plans) as if they were part of the solution to limiting utilization. They do nothing to control utilization, as the Massachusetts experience demonstrates. Why treat insurance exchanges as a silver bullet when you’ve started your editorial by pointing out that there is no such thing?

The issue boils down to whether health care rationing is going to be undertaken by government officials or instead by individuals making their own decisions with their own money. The default option is neither, with the Democrats blocking anything that resembles a voucher and the Republicans blocking anything that resembles a government panel.