Health analysts agree that it's time for the patient to start being more of a consumer. Obamacare, controls on Medicare spending, cutting back on malpractice litigation, more preventive care and even healthier lifestyles have all been touted as ways to cut costs in the health-care system. But together they've made little more than a dent in the ever-rising cost of health care, which has been outpacing inflation for decades. Mark Smith, 61, a self-employed documentary and commercial producer in Jersey City, N.J., has been paying for an individual policy for his family for several years. He says he's been seeing 16% increases in his premiums every year, sometimes more.