From a Kaiser Health News interview with former Congressional Budget Office director and current American Action Forum president Douglas Holtz-Eakin:
Fundamentally, what we have in all our health programs is the following: We say to beneficiaries, you can have all the highest quality medical science that we can provide. And we say to [medical] providers, 'God, that's expensive! Stop it!' And we cut back their payments or tell them not to do stuff. Then the beneficiary says, 'But you said,' and we go back and give it to them. It's incoherent.