If the nation is ever to get insane healthcare costs under control, the methods used are likely to be tougher, stronger versions of what's going on in Maryland: Stop certain hospitals and doctors from enriching themselves with unneeded procedures. Pay the system for keeping people healthy and curing the sick, not for performing tests and surgery. Cap prices by administrative decree and force hospitals to be more efficient. So the biggest changes in years at Maryland's price-setting agency for hospitals merit the attention of consumers, employers and everybody else. The Health Services Cost Review Commission can continue pressing providers to reduce waste and stop the spiral that makes American medicine the most expensive system in the world -- with mediocre results. Or it can cave in to Maryland's powerful healthcare industry, ensure that hospital revenues keep soaring, and present patients, employers and taxpayers with the bill.