Tuesday, April 14, 2009

"Bribery" Used in Public Health Program

(London, England) The government advisory group, Health England, has recommended the use of financial incentives to deter people from unhealthy activities. The approach has divided the health community with critics condemning the scheme as bribery.
Obese patients in Kent are being paid up to £425 to lose weight by the NHS in a trial to test whether financial incentives can be used to change unhealthy behaviour.

In Essex, pregnant women who smoke are being offered up to £60 in food vouchers on the NHS if they give up. Payments are made after one week, one month and one year.
Unfortunately, evidence indicates that bribing people has little lasting effect.
A review of 17 trials of the use of payments to help people give up smoking found the effects only lasted as long as the incentives were paid. Similarly nine weight loss trials showed no benefit from payments after 18 months.
Some believe that the effectiveness of the incentive/bribery program would be enhanced if it were more sophisticated and nuanced (whatever that means).

I suggest that the one-shot incentive payments will never work. People have flaws and, sure, many will correct the flaws as long as they are paid. However, once the payments stop, the flaws, i.e. unhealthy habits, will most likely return.

In any event, one must presume the authorities realize that before Britain can be certified as an official socialist utopia, an incentive/bribery program must incorporate all unhealthy habits of all people for their entire lives.

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