High-deductible health policies and Rep. Paul Ryan's budget plans for Medicare both assume that health costs can be kept down by treating patients more like consumers.

The thought is that those of us with insurance are disconnected from the price of our health care -- since we usually don't pick up the bill -- and that having more skin in the game would make us more fiscally careful about the goods and services we use. As one commenter, SLC, wrote in response to our recent post on high-deductible plans, "Let consumers take...