Those are the three choices offered by Robert Samuelson in a scathing piece on the Obama administration's health reform initiative in today's Washington Post:

It's hard to know whether President Obama's health-care "reform" is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it's imperative to control runaway health spending. He's right. The trouble is that what's being promoted as health-care "reform" almost certainly won't suppress spending and, quite probably, will do the opposite.

* * *

[The Obama administration] talk[s] endlessly about restraining health spending — "bending the curve" is the buzz — as if talk will suffice.

* * *

The central cause of runaway health spending is clear. Hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, either private or governmental. The open-ended payment system encourages doctors and hospitals to provide more services — and patients to expect them. It also favors new medical technologies, which are made profitable by heavy use. Unfortunately, what pleases providers and patients individually hurts the nation as a whole. That's the crux of the health-care dilemma, and Obama hasn't confronted it. His emphasis on controlling costs is cosmetic.

* * * What's needed is a fundamental remaking of the health-care sector -- a sweeping "restructuring" -- that would overhaul fee-for-service payment and reduce the fragmentation of care.

For more on the role of the payment system in our current state of affairs, including the degree of fragmentation, see this forthcoming piece.

Edited to add a further sentence to the block quote, and to revise the final sentence