This is the last installment in a four-part series.

LOS ANGELES (MarketWatch) -- Health analysts agree that its 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 theyve 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 hes been seeing 16% increases in his premiums every year, sometimes more. His last increase would have put his monthly premium at $1,850 a month, even though its just him and his wife on the policy now.

It will always outpace whatever the economic conditions are, by a lot, he said. I dont have an infinite budget for health insurance. So Smith is opting out of the individual market and latching on to a health plan through his wifes new job, which should cut his monthly premiums down to $500.

Health reforms will have little meaningful effect on prices that continue to outpace inflation unless consumers get in the game and start to push back, experts say.

They agree that if the U.S. is to maintain a free-market style of health care, those who buy health plans need to be active players in the system. Just as they would when buying a car or purchasing groceries, health-care consumers need to have enough information to know what a fair price is and to have enough leverage to demand that price.

(Read: 10 ways patients can lower their health-care costs.)

You cant be a citizen any longer and not realize there are no more magical solutions to these problems, said Dr. Reed Tuckson, a former executive for UnitedHealth Group Inc. and the American Medical Association, now an industry consultant. The increase in Medicare expenditures is so huge. And theres no way that youre going to have any kind of taxation that could possibly solve that dilemma.

Accomplishing the task of becoming price-conscious wont be easy, however, for a group of consumers that for decades had insurers screen their costs for them.

Read more here:

Health Exchange: Health-care costs: Its time for patients to take control