If we continue my line of reasoning in “Is the individual mandate necessary for health care reform?” to its logical conclusion, the individual mandate does not have either a positive or negative impact on health care costs. Whether the mandate is at the state or national level, it appears to be a freedom we have sacrificed for no apparent reason. The battle to put cost reduction into health care reform will inevitably center around how to put a little of Adam Smith’s invisible hand into the reform.

A good place to start is make sure the the United State’s “minimum creditable coverage” is flexible enough to allow these plans to be used. I suspect that this provision in Massachusetts is primary culprit causing the healthy people to overpay for their health insurance. Removing these excess funds would probably encourage a healthy re-evaluation of health care spending in Massachusetts. Massachusetts looks like it has a spending problem.