Gaming in Mass?

Austin Frakt covers the Boston Globe's look at gaming of the individual mandate....basically jumping in when sick but defying mandate when not. Here is his follow up today on this topic. This is an important issue, though since Mass is at 97% cover, it can only be so big of a problem. However, it is something to pay attention to in the roll out of the national reform....I for one, would be for strengthening the individual mandate based on the notion that if we are going to try it, lets try it.....with it being an individual mandate.

Frakt has other interesting stuff on whether we should have a repeat of the Health Insurance Experiment (HIE)....or whether a series of smaller observational studies would be money better spent. I think I would go with more observational studies. One problem with randomized trials of policy implementations is that while the internal validity is high (does x cause y), the external validity is often low (will this finding hold across settings, generally be applicable).