Wednesday, December 05, 2007

Fat and Happy

Should health-care companies, employers, or the government pay you to lose weight?

My instant reaction is, of course: No fucking way! The people who stand to gain the most are the people who have let themselves go the most. But if I examine the problem rationally, instead of spitefully, it's hard to escape the conclusion that it makes economic sense.

The reason this type of incentive program works, instead of seemingly more important incentives like longer lifespan and higher quality of life, actually makes a lot of sense. Similar incentive programs have worked for drug addicts and prengant smokers as well. People who abuse drugs or eat too much are more focused on immediate gratification and short-term benefits than their non-addicted counterparts. Long-term benefits, no matter how terrific they may be, simply don't outweigh the short-term reward of a double cheeseburger. But instantly replacing that burger or cigarette with a couple bucks is a powerful incentive for the personality type most susceptible to overindulgence. After several rounds of payment, the long-term benefits become apparent, thus replacing the need for a continued monetary incentive.

So if a health-care company, or employer, or government, could save $1 million dollars by giving away $100k, then aren't they compelled to make the investment? Even if it's not exactly a fair distribution of resources? What if you start skinny, and then put on 50 pounds...can you game the system to make a few bucks? Would we actually be incenting people to get fat, and then lose weight, instead of maintaining a healthy lifestyle? Or would you pay people who start off skinny too?

I'm essentially a libertarian with strong feelings of personal responsibility, so I'm having a hard time rationalizing this type of plan. But if it saves money for everyone in the end, by reducing the cost of health insurance, then on what grounds can I rationally oppose it? (Besides, I'd stand to gain a few bucks from this plan myself.) Not sure how to disentangle myself from this logical snare.


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