Americans would be more judicious in seeking health care — they would self-ration — if the right incentives were in place. An effective way to cut overuse and bring down costs would be to encourage through public policy the use of health savings accounts. If consumers used HSAs to pay the full amount for medical care at the point of service rather than letting employer-funded insurance or a government program pay the bills, the demand would fall.

The Democrats’ health care legislation, however, puts more distance between Americans and the payment process and promotes dependence on government. That will only drive down consumers’ out-of-pocket expenses even further and force overall health care spending upward. Under such a regime, the system will be worse off than it is now.