{"id":2689,"date":"2015-02-21T13:36:09","date_gmt":"2015-02-21T02:36:09","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=2689"},"modified":"2015-02-21T13:36:09","modified_gmt":"2015-02-21T02:36:09","slug":"should-we-pay-people-to-look-after-their-health","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=2689","title":{"rendered":"Should we pay people to look after their health?"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>http:\/\/theconversation.com\/should-we-pay-people-to-look-after-their-health-24012<\/p>\n<header class=\"grid-prepend-four grid-twelve\"><time datetime=\"2014-03-05T19:23:22Z\">6 March 2014, 6.23am AEDT<\/time><\/p>\n<h1 class=\"entry-title grid-eight instapaper_title\">Should we pay people to look after their\u00a0health?<\/h1>\n<\/header>\n<div class=\"entry-summary\"><\/div>\n<aside id=\"meta\" class=\"grid-four\">\n<section id=\"authors\" class=\"module\">\n<h4>AUTHOR<\/h4>\n<ol class=\"semantic\">\n<li id=\"author-118723\" class=\"vcard author-avatar large\"><a href=\"http:\/\/theconversation.com\/profiles\/kevin-volpp-118723\" rel=\"author\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/avatars\/118723\/thumb54\/RackMultipart20140305-32224-1efjh9z.jpg\" alt=\"\" width=\"54\" height=\"54\" \/><\/a><br \/>\n<h3 class=\"fn\">Kevin Volpp<\/h3>\n<p><span class=\"role\">Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute &amp; Professor of Medicine, Perelman School of Medicine and Health Care Management, Wharton School at University of Pennsylvania<\/span><\/li>\n<\/ol>\n<\/section>\n<section id=\"disclosure-statement\" class=\"module\">\n<h4>DISCLOSURE STATEMENT<\/h4>\n<p>Kevin Volpp has received funding from AIA Australia to present at a national forum on incentivising health. He is affiliated with the University of Pennsylvania and ValHealth.<\/p>\n<\/section>\n<section id=\"funding\" class=\"module nocontent\"><strong>The Conversation is funded by<\/strong> CSIRO, Melbourne, Monash, RMIT, UTS, UWA, ACU, ANU, ASB, Baker IDI, Canberra, CDU, Curtin, Deakin, Flinders, Griffith, the Harry Perkins Institute, JCU, La Trobe, Massey, Murdoch, Newcastle, UQ, QUT, SAHMRI, Swinburne, Sydney, UNDA, UNE, UniSA, USC, USQ, UTAS, UWS, VU and Wollongong.<\/p>\n<\/section>\n<section class=\"jobs-events-list clearfix\">\n<h4>JOBS<\/h4>\n<ul>\n<li>\n<h5><a href=\"https:\/\/jobs.theconversation.com\/jobs\/9773-senior-lecturer-social-pedagogy?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=sidebar_job\">Senior Lecturer (Social Pedagogy)<\/a><\/h5>\n<p>Victoria University<\/li>\n<li>\n<h5><a href=\"https:\/\/jobs.theconversation.com\/jobs\/9766-graduate-services-coordinator?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=sidebar_job\">Graduate Services Coordinator<\/a><\/h5>\n<p>University of Melbourne<\/li>\n<li>\n<h5><a href=\"https:\/\/jobs.theconversation.com\/jobs\/9763-senior-research-fellow-part-time?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=sidebar_job\">Senior Research Fellow | Part Time<\/a><\/h5>\n<p>Monash University<\/li>\n<li>\n<h5><a href=\"https:\/\/jobs.theconversation.com\/jobs\/9762-lecturer-art-in-public-space-part-time-urgent-start?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=sidebar_job\">Lecturer Art In Public Space (Part Time Urgent Start)<\/a><\/h5>\n<p>RMIT University<\/li>\n<li>\n<h5><a href=\"https:\/\/jobs.theconversation.com\/jobs\/9764-postdoctoral-research-fellow-in-community-engaged-learning-and-research?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=sidebar_job\">Postdoctoral Research Fellow In Community Engaged Learning And Research<\/a><\/h5>\n<p>Macquarie University<\/li>\n<\/ul>\n<p><a class=\"view-more clearfix\" href=\"https:\/\/jobs.theconversation.com\/?utm_source=theconversation.com&amp;utm_medium=website&amp;utm_campaign=article_call_to_action\"><i class=\"icon-the-conversation\"><\/i><span class=\"action\">MORE JOBS<\/span><\/a><\/section>\n<section class=\"jobs-events-list clearfix\">\n<h4>EVENTS<\/h4>\n<ul>\n<li class=\"event\"><a href=\"http:\/\/theconversation.com\/au\/events\/centre-for-business-growth-program-accelerating-growth-998\" target=\"_blank\" rel=\"nofollow\"><span class=\"name\">Centre for Business Growth Program: Accelerating Growth<\/span> \u2014 <span class=\"institution\">University of South Australia<\/span> \u2014 <span class=\"location\">Adelaide, South Australia<\/span><\/a><\/li>\n<li class=\"event\"><a href=\"http:\/\/theconversation.com\/au\/events\/sydney-ideas-hal-foster-contemporary-art-and-mimetic-excess-1056\" target=\"_blank\" rel=\"nofollow\"><span class=\"name\">Sydney Ideas &#8211; HAL FOSTER: Contemporary Art and Mimetic Excess<\/span>\u2014 <span class=\"institution\">University of Sydney<\/span> \u2014 <span class=\"location\">Sydney, New South Wales<\/span><\/a><\/li>\n<li class=\"event\"><a href=\"http:\/\/theconversation.com\/au\/events\/communicating-climate-change-free-public-forum-with-george-marshall-1151\" target=\"_blank\" rel=\"nofollow\"><span class=\"name\">Communicating Climate Change &#8211; free public forum with George Marshall<\/span> \u2014<span class=\"institution\">University of Technology, Sydney<\/span> \u2014<span class=\"location\">Potts Point, New South Wales<\/span><\/a><\/li>\n<li class=\"event\"><a href=\"http:\/\/theconversation.com\/au\/events\/communicating-climate-change-when-our-brains-are-wired-to-ignore-it-1150\" target=\"_blank\" rel=\"nofollow\"><span class=\"name\">Communicating climate change when our brains are wired to ignore it<\/span> \u2014<span class=\"institution\">University of Technology, Sydney<\/span> \u2014<span class=\"location\">Ultimo, New South Wales<\/span><\/a><\/li>\n<\/ul>\n<p><a class=\"view-more\" href=\"http:\/\/theconversation.com\/au\/events\"><i class=\"icon-the-conversation\"><\/i><span class=\"action\">MORE EVENTS<\/span><\/a><\/section>\n<\/aside>\n<div class=\"grid-twelve grid-last content-wrapper\">\n<div class=\"grid-twelve instapaper_body\">\n<div class=\"content entry-content\">\n<figure class=\"lead-image grid-eight grid-last\"><img decoding=\"async\" src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/43175\/width668\/gk8rwfbv-1393999301.jpg\" alt=\"\" data-id=\"43175\" \/><figcaption>The key to using incentives may be to do so with a high enough frequency to create healthy habits. <span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.flickr.com\/photos\/healthgauge\/10062531106\/sizes\/l\/\">Health Gauge\/Flickr<\/a>, <a class=\"license\" href=\"http:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA<\/a><\/span><\/figcaption><\/figure>\n<div class=\"body grid-eight\">\n<p>With the Tony Abbott government expressing concern about the growing health budget and emphasising personal responsibility, perhaps it\u2019s time to consider some creative ways of curbing what Australia spends on ill health. One solution is to pay people to either get well or avoid becoming unwell in the first instance.<\/p>\n<p>The United Kingdom is already doing this kind of thing <a href=\"http:\/\/www.bbc.com\/news\/health-24900650\">with a current trial<\/a> of giving mothers from disadvantaged suburbs A$340 worth of food vouchers for breastfeeding newborn babies. And from January 1 this year, <a href=\"http:\/\/www.dol.gov\/ebsa\/newsroom\/fswellnessprogram.html\">employers in the United States<\/a>can provide increasingly significant rewards to employees for having better health outcomes, as part of the Affordable Care Act.<\/p>\n<p>But should people really be paid to make healthy choices? Shouldn\u2019t they be motivated to improve their health on their own anyway?<\/p>\n<h2>Encouraging right decisions<\/h2>\n<p>People don\u2019t do what\u2019s in their best interest in the long term for many reasons. When making decisions we tend to take <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23836740\">mental short cuts<\/a>; we allow the desires and distractions of the moment get in the way of pursuing what\u2019s best.<\/p>\n<p>One such \u201cirrationality\u201d is our tendency to focus on the immediate benefits or costs of a situation while undervaluing future consequences. Known as <a href=\"http:\/\/www.cmu.edu\/dietrich\/sds\/docs\/loewenstein\/TimeDiscounting.pdf\">present bias<\/a>, this is evident every time you hit the snooze button instead of going for a morning jog.<\/p>\n<p><a href=\"http:\/\/www.cmu.edu\/dietrich\/sds\/docs\/loewenstein\/CanBEHealthier.pdf\">Researchers have found<\/a> effective incentive programs can offset present bias by providing rewards that make it more attractive to make the healthy choice in the present.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19213683\">Research conducted in US workplaces<\/a>, for instance, found people who were given US$750 to quit smoking were three times more successful than those who weren\u2019t given any incentives. Even after the incentive was removed for six months, there was still a quit rate ratio of 2.6 between the incentive and control groups \u2013 9.4% of the incentive group stayed cigarette-free versus only 3.6% of the control group.<\/p>\n<h2>A refined approach<\/h2>\n<p>Still, while research on using financial incentives to encourage healthy behaviours is promising, it isn\u2019t as straightforward as doling out cash in exchange for good behaviour.<\/p>\n<p>Standard economic theory posits that the higher the reward, the bigger the impact \u2013 but this is only one ingredient to success. Behavioural economics shows that when and how you distribute incentives can determine the success of the program.<\/p>\n<p>Here are a few basic principles to consider. First, small rewards can have a big impact on behaviour if they\u2019re provided frequently and soon after the healthy choice is made. We have found this to be true in the context of <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19066383\">weight-loss programs<\/a>, <a href=\"http:\/\/www.biomedcentral.com\/1472-6963\/8\/272\">medication adherence<\/a>, and even to <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8031230\">quit the use of drugs<\/a> such as cocaine.<\/p>\n<p>Games of chance are an effective way of distributing rewards as <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23836740\">research has found<\/a> people tend to focus on the value of the reward rather than their chance of winning the prize. Many people think that a 0.0001 and a 0.0000001 chance of winning a prize are roughly equivalent even though in reality they are vastly different probabilities.<\/p>\n<p>Finally, people are more influenced by the prospect of losses than by gains. <a href=\"http:\/\/www.princeton.edu\/~kahneman\/docs\/Publications\/Anomalies_DK_JLK_RHT_1991.pdf\">Studies show<\/a> people put much greater weight on losing something than gaining something of a similar value.<\/p>\n<p>In one <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19066383\">weight-loss experiment<\/a>, for instance, participants were asked to place money into a deposit account. If they didn\u2019t achieve their weight goals, the money would be forfeited, but if they were successful, the initial deposit would be doubled and theirs to keep.<\/p>\n<p>Reluctant to lose their deposits, participants in the deposit group lost over three times more weight than the control group, who were simply weighed each month.<\/p>\n<h2>Creating good habits<\/h2>\n<p>Incentives are particularly effective at changing one-time behaviours, such as encouraging vaccination or attendance at health screenings. But with increasing rates of obesity and other lifestyle-related diseases, we need to focus on how incentives can be used to achieve habit formation and long-term sustained weight loss.<\/p>\n<p>We know <a href=\"http:\/\/management.ucsd.edu\/faculty\/directory\/gneezy\/pub\/docs\/incentives-exercise.pdf\">financial incentives can increase gym usage<\/a> and positively impact weight, waist size and pulse rate, but how to sustain gym use after the incentive is removed? The key may be to use incentives to achieve a high frequency of attendance for long enough to create a healthy habit.<\/p>\n<p>We also need to consider how we can leverage social incentives, such as peer support and recognition, together with new technologies to maximise the impact of incentive-based programs.<\/p>\n<p>Innovative solutions, like paying people to encourage the right health choices, may help to reduce both the health and economic impact of Australia\u2019s growing burden of disease.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; http:\/\/theconversation.com\/should-we-pay-people-to-look-after-their-health-24012 6 March 2014, 6.23am AEDT Should we pay people to look after their\u00a0health? AUTHOR Kevin Volpp Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute &amp; Professor of Medicine, Perelman School of Medicine and Health Care Management, Wharton School at University of Pennsylvania DISCLOSURE STATEMENT Kevin Volpp has received funding from &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=2689\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Should we pay people to look after their health?<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,5,35,8,26,33,9,10,13,22,6,4,3],"tags":[],"class_list":["post-2689","post","type-post","status-publish","format-standard","hentry","category-complex-adaptive-systems","category-data-saving-lives","category-ef","category-entrepreneurship","category-facts-data-points","category-health-market-quality","category-healthcare","category-healthy-habits","category-nutrition","category-policy","category-politics","category-quantified-self","category-rapid-learning-health-systems"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2689","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2689"}],"version-history":[{"count":1,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2689\/revisions"}],"predecessor-version":[{"id":2690,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2689\/revisions\/2690"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2689"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2689"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2689"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}