The SGR is a perfect illustration of the only approach the political class has ever tried to control health spending — and a preview of what is certain to happen under ObamaCare. As costs explode, Congress will try to wring out ever more “savings” by underpaying doctors and hospitals, and this central planning will be far easier because it will control the bulk of U.S. health dollars. Physicians — especially the specialists who provide expensive treatments that the White House has decided qualify as “waste” — will gradually be converted into civil servants a la the U.K. or Canada. All medicine will function, or not function, like Medicare does today, but much worse.

Some doctors realize as much. A coalition of 17 state medical associations and three specialty organizations is poised to break with the AMA over its Washington work. Another group of state hospital associations is at odds with their Beltway representatives over the deal cut with the White House to help defray universal coverage with $155 billion in across-the-board Medicare cuts. The plan “will do nothing to encourage changes in the delivery of health-care services,” their protest reads, while hurting the nearly half of U.S. hospitals operating on a deficit or close to it.