The health care reform bill appearing this legislative session will, it appears, be free of any mandates to own insurance.

The libertarian part of me is happy. But my more wonkish side wonders if a mandate-less, market-oriented health care reform package can really accomplish anything.

An effective health care reform package must include some provisions that address the rising costs of health care and insurance.

In a market-based system, one way do to this is to increase the number of insured people - especially young, healthy people who are unlikely to have major health issues. This allows an insurer to amortize costs across a large swath of people, thereby reducing premiums for the individual consumer (in theory).

Utah lawmakers have rejected this provision, though. The new bill, at least according to the Tribune, does very little to combat the rising costs of health care.

But even if the reform were to include mandated insurance, I wouldn’t be too confident of any sea change in the cost and quality of care in Utah.

Why? Because such market-reforms only extend the status quo, rather than dramatically altering the economics of health care. I’ve being reading a fascinating book Overtreated that suggests a serious reexamination of health care economics is long overdue.

If we are serious about reducing the costs of health care, the entire economic scheme of the system needs to be radically altered. As the system works now, costly invasive procedures are incentivized at the expense of far less expensive and often more effective preventative care.