Despite the great strides that we have made in health care over the last 50 years, we find ourselves in 2008 with an interesting problem: There is growing acknowledgement that human behavior has been unable to maintain pace with scientific understanding. When it first became obvious that we as a population were not seizing the opportunities for health that were right in front of our noses -- like not smoking, staying on medication for high blood pressure to avoid stroke, and maintaining healthy weights and exercise to avoid diabetes -- economists felt more information and mild financial incentives would do the trick. That hasn’t worked as planned and now the relatively new field of behavioral economics -- the marriage of conventional economics and psychology – is pondering this issue.
Behavioral economists say we are difficult to motivate not because we are bad persons or terminally obstinate, but because our brains are programmed in such a way that we are biased to make bad decisions. For example, we prefer to "stay put" rather than change. So our minds, presented with a change option, will place more value on the "status quo," and less value on the advantages of what is new. A whole host of behavioral factors get in the way of good decision-making when it comes to health.
So how can we start to drive behaviors in the right direction? According to the experts, some of the answers to behavior change involve simple common sense. Example: In schools, set up the food in the cafeteria so that items that are most nutritionally sound appear first. Many similar approaches can be applied, thanks to the new insights gained when we combine the theories of economics and psychology.
One thing is clear – our public institutions have to be aligned with personal incentives if we are going to affect health care behavior. To learn more, watch this week’s program, embedded with this blog, and then leave a comment. Are we providing the kinds of incentives that will lead to a healthier society?