This Sean P. Murphy/Boston Globe article details how local government-subsidized health insulation ìinsuranceî plans are crippling municipal budgets throughout Massachusetts.

On the other hand, this WSJ op-ed by Indiana Governor Mitch Daniels explains how the state is saving $20 million of health care expenses in 2010 through the introduction of a highly-popular state employee health finance plan based upon Heath Savings Accounts.

This is not surprising. The most efficient way to spend less on health care is to consume less of it. As a result, someone ñ be it the consumer, an insurer or the government ñ at some point has to say no to the consumption of more health care. As Steve Lansburg recently pointed out, that eating more cake diet just doesnít work. The WSJ’s Holman Jenkins agrees.

Unfortunately, the present U.S. employer and government-based, third-party payor health care finance system provides powerful incentives to consume more health care. And, as Milton Friedman was fond of saying, consumers will consume as much health care as they can so long as someone else is paying for it.

Until we change the reliance on such consumer insulation from health care decisions, the dynamic of rising costs is unlikely to cease.