Holman W. Jenkins, Jr.:

Managed care, whatever its prospects for running Medicare better, is facing gradual eclipse in the private sector by the new strategy of consumer-directed health care, based on tax-free health savings accounts, enacted in the same 2003 Bush-promoted law that gave us giant subsidies for the managed-care business. In a new report, McKinsey likens the arrival of HSAs to the creation of 401(k)s in the 1980s, an opportunity that largely bypassed traditional banks and pension managers and was captured by mutual fund firms like Fidelity and Vanguard.