BMJ: Can behavioural economics make us healthy

  • BE policies are by design less coercive and more effective than traditional approaches
  • It is generally far more effective to punish than to reward
  • Sticks masquerading as carrots – simultaneous, zero-sum incentives and penalties
  • References to policies which have and have not worked – but why can’t policy be research?
  • Conventional economics can therefore justify regulatory interventions, such as targeted taxes and subsidies, only in situations in which an individual’s actions imposes costs on others—for example, second hand cigarette smoke. But the potential reach of behavioural economics is much greater. By recognising the prevalence of less than perfectly rational behaviour, behavioural economics points to a large category of situations in which policy intervention might be justified—those characterised by costs which people impose on themselves (internalities), such as the long term health consequences of smoking on smokers.
  •  Is it fair to say that in a universal health care system, any preventable ill health imposes costs on others, as it is the tax payer who picks up the cost of treatment?
  • present bias: the tendancy for decision makers tend to put too much weight on costs and benefits that are immediate and too little on those that are delayed. Present bias can be used to positive effect by providing small, frequent (i.e. immediate) payments for beneficial behaviours e.g. smoking cessation, medication adherence, weight loss
  • “peanuts effect” decision error: the tendency to pay too little attention to the small but cumulative consequences of repeated decisions, such as the effect on weightof repeated consumption of sugared beverages or the cumulative health effect of smoking.
  • competition and peer support are more powerful forms of behaviourally mediated interventions

Care of Nicholas Gruen.

PDF: CanBehaviouralEconomicsMakeUsHealthier_BMJ

Similarly in Health Affairs: http://content.healthaffairs.org/content/32/4/661.short