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Debating patient incentive programs

money1.jpgThe New York Times’ Room for Debate hosts a fascinating discussion this week on the concept of incentivizing healthy behavior.

The motion: Paying people to quit smoking, lose weight, take their medications as prescribed and otherwise be good little boys and girls will cut health-care costs in the long term.

Arguing for the motion is Okay, so none of the experts here really loves the idea. Notes Arthur Caplan, PhD, professor of bioethics at the University of Pennsylvania School of Medicine:

Sure, you can give me an incentive to be healthy but be fair - punish all who sin. Will you pay people to not ski, fill in the pools in their backyards where accidents frequently happen, give them cash not to ride on horses and slip a $20 to all who forgo contact sports?

Yes, money can be saved by financially tweaking the sinners, but, given their numbers, that’s not much of a solution for the high cost of care.

It's not that financial rewards don't work for some, writes Kevin Pho, MD:

Last year, the New England Journal of Medicine found that paying patients $750 significantly increased their chances of quitting smoking. And in a Journal of the American Medical Association study in 2008, cash rewards made patients more likely to lose weight.

It's just that incentives haven't been shown to work for everyone - for example, those who can’t afford gym memberships, smoking cessation drugs or more nutritious food.

Previously: Trying to cut health-care costs by improving consumer behavior
Photo by AMagill

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