Should governments pay its citizens to improve their health? The National Institute for Health and Clinical Excellent recently issued a report on the use of incentives to improve health care in the UK.
The report concluded that in response to a vote on the question “Are there any circumstances in which incentives are acceptable?” 37.5% of members voted “No” and 62.5% voted “yes” but with conditions.
Critics argue that we shouldn’t reward people to develop healthy habits and use public money which could be better spent on reducing the countries national debt. The report looked at a number of social experiments conducted on both adults and children. The schemes included giving pregnant women shopping vouchers, valued at £650, to stop smoking and another study in Wales where schools gave children toys in exchange of eating fruit and vegetables.
The report questioned whether incentives encourage people to adopt unhealthy behaviours to reap the rewards and if this leads to abuse such as cheating or delaying the desired behaviour change to reap the reward.
The members that voted ‘yes’ did so with a number of caveats including:
• People seeking to join incentive schemes should not do so unless they have decided they really want to change
• Time limits and safeguards are needed if private companies are involved
• Incentive schemes should allow for the collection of evidence
• Cash incentives should be last resort
• Personal contracts should be arranged with participants
• The behaviour of participants while taking part in the scheme should be monitored.
• Incentives should not be exchangeable for tobacco and alcohol
Despite the majority of members voting ‘yes’, the report found little evidence to suggest that such incentives made a difference to people’s health. In one anti smocking project costing £43,000, the report acknowledged that 80% of participants were smoking again within 3 months.
What are your thoughts, do you think we should incentivize people to be healthier. Is the cost of incentivizing less than the future medical costs?