Are Incentives Corrupting? The Case of Paying People to be Healthy.

Written by Dr Rebecca Brown

Financial incentives are commonplace in everyday life. As tools of states, corporations and individuals, they enable the ‘tweaking’ of motivations in ways more desirable to the incentiviser. A parent may pay her child £1 to practice the piano for an hour; a café offers a free coffee for every nine the customer buys; governments offer tax breaks for homeowners who make their houses more energy efficient. Most people, most of the time, would probably find the use of financial incentives unobjectionable.

More recently, incentives have been proposed as a means of promoting health. The thinking goes: many diseases people currently suffer from, and are likely to suffer from in the future, are largely the result of behavioural factors (i.e. ‘lifestyles’). Certain behaviours, such as eating energy dense diets, taking little exercise, smoking and drinking large amounts of alcohol, increase the risk that someone will suffer from diseases like cancer, heart disease, lung disease and type II diabetes. These diseases are very unpleasant – sometimes fatal – for those who suffer from them, their friends and family. They also create economic harms, requiring healthcare resources to be directed towards caring for those who are sick and result in reduced productivity through lost working hours. For instance,the annual cost to the economy of obesity-related disease is variously estimated as £2.47 billion£5.1 billion and a whopping $73 billion (around £56.5 billion), depending on what factors are taken into account and how these are calculated. Since incentives are generally seen as useful tools for influencing people’s behaviour, why not use them to change health-related behaviours? Why not simply pay people to be healthy? Continue reading

Spin city: why improving collective epistemology matters

The gene for internet addiction has been found! Well, actually it turns out that 27% of internet addicts have the genetic variant, compared to 17% of non-addicts. The Encode project has overturned the theory of ‘junk DNA‘! Well, actually we already knew that that DNA was doing things long before, and the definition of ‘function’ used is iffy. Alzheimer’s disease is a new ‘type 3 diabetes‘! Except that no diabetes researchers believe it. Sensationalist reporting of science is everywhere, distorting public understanding of what science has discovered and its relative importance. If media ought to try to give a full picture of the situation, they seem to be failing.

But before we start blaming science journalists, maybe we should look sharply at the scientists. A new study shows that 47% of press releases about controlled trials contained spin, emphasizing the beneficial effect of the experimental treatment. This carried over to subsequent news stories, often copying the original spin. Maybe we could try blaming university press officers, but the study found spin in 41% of the abstracts of the papers too, typically overestimating the benefit of the intervention or downplaying risks. The only way of actually finding out the real story is to read the content of the paper, something requiring a bit of skill – and quite often paying for access.

Who to blame, and what to do about it?

Continue reading

The Ethics of Gamification: Little Rewards for Everything

[note: the original version of this post contained some interactive code, which has been removed from the archives]

Notice that the first word of this post is red. Point your mouse cursor at the words as you read them, and each subsequent word will turn red as you read. You are now being graded on how quickly you read these words. And there’s a little visual reward in store for anyone who reads the first paragraph quickly. Now look to the right of this post, where it says ‘Top Posts’. One of the reasons we have that is to help readers to find the most popular posts on the blog. But another reason we have it is so that our contributors will be motivated to write more interesting and thought-provoking commentaries for the site. It is a high score table, and the winner is the philosopher with the most interesting post.

Continue reading


Subscribe Via Email