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Paying for our mistakes

14:39 / 20.04.04

In response to this, posted today on BBC News Online.

Aside from paying poorer students to go and get an education*, what of the other financial incentives mentioned? Paying smokers to quit? Paying coke addicts to try harder to give up on their addictions and dependencies? Are these morally defensible campaigns, when put forth either by private or government agencies?

In a liberal individualist society, there seems to be something problematic with a goverment that pays individuals to give up bad habits they have acquired voluntarily.

Take smoking for example. Granted, some people might have started due to peer pressure, at an age when health concerns weren't foregrounded in their minds, but given the high number of adult smokers who have successfully given up with no incentive other than improved health and the financial savings of just not buying cigarettes, why should we pay (and pay for) those stubborn few who either refuse to (or can't?) give up?

Aside from the idea, as mentioned in the article, that dangling the cash carrot in front of peoples' eyes will just encourage people to start, just so they can in turn give up, why should the money of the many go to those few who, as yet, haven't quit properly?

Thoughts please?

*which I think isn't such a bad idea. Rather than be pressured by lack of funds into getting a job, people are able to concentrate on furthering their educations. Good thing, in my book, but that's beside the point.

(PS - excuse muddlement of a number of concepts in one lump, but work distractions call. And, uh, I'm new.)

Our Lady Has Left the Building

16:47 / 22.04.04

Good post.

One of the most obvious problems with using it for alternative plans is that you can measure whether students come in to school, it's called a register. You can't easily measure whether Mr Blobby is staying away from fast food outlets or isn't smoking unless he's given a minder to watch him every second of the day. And how long are we going to pay Mr Blobby for problems for which, okay society might be to blame but for which there's a certain element of his own fecklessness? What happens if at the end of whatever period, he has not lost weight or kicked cigarettes? There are moral problems with either giving him more money (why? It didn't work the first time!) or not giving him money (So x months ago we cared about his health enough to try and encourage him to stop but now we don't?). And rightly there's me over here, who isn't overweight (if a little out of shape) and who doesn't smoke (except at Barbemeets when I'm surrounded by people who do), who wonders whether it would be to my advantage to develop bad habits. When she was 18 my sister started smoking because while working at Dominos Pizza the smokers got a 5 minute longer break time.

I have to say, I think the desire to quit smoking or to loose weight comes from within and shouldn't be contingent on outside factors. If someone has the money to buy junk food and cigarettes they have enough money to buy nicorette patches and healthier, if boring, food. If Mr Blobby doesn't want to kick bad habits for his own good then we should leave him to his burgers and wait for the camera crew to come round and film him as an attempt to scare the younger generation into giving up smoking.

17:27 / 22.04.04

In terms of using the cash payment as an incentive to kick a drugs habit, you'd run up against the problem that some druggies would milk the system as long as possible to finance the drug habit. Slightly pessimistic view maybe.

Our Lady Has Left the Building

17:37 / 22.04.04

And going off topic slightly, why do we pay sixteen year olds to continue education but charge eighteen year olds for the same?

20:59 / 22.04.04

If you want to make people quit smoking, wouldn't it be better to install a special tax on cigarettes, so the government would be making money off the venture, rather than losing it?

I could see the idea that just being given money is a better incentive, but if economics are going to make you quit at all, the tax might well be enough.

21:39 / 22.04.04

They already do have a special tax on cigarettes, that goes up pretty often from what I understand.

Overall, I would say the money is better spent in educating people about the risks of their behaviour, providing support for people actually wanting to quit, or on the health system in general. For example, rather than paying people not to eat junk food, why not do what a few European countries do, and provide fitness programs through your GP?

Our Lady Has Left the Building

08:26 / 23.04.04

As a good middle class person I'm probably the wrong person to talk about this, but is it really a question of education? Do people who eat at McDs (and I'm one) go in there thinking "Gosh, this food is both cheap AND good for me!"? Do people really start smoking thinking "thank goodness there are no negative effects on my health from smoking this"?

12:31 / 25.04.04

Here's a problem with the cigarette taxation process. Basically if they wanted to make cigarettes really expensive and really stop people smoking they could do so by just putting enormous amounts of tax on it. The consequence of this would be that there would be enormous public resentment from smokers. Let's ignore that for a second. The more important consequence would be that the revenue from smoking would plummet, because people would actually quit (this is if a pack of fags cost - say £10 or £25 rather than getting on for £5). Now the effects of smoking would still be felt throughout the NHS for decades even if everyone stopped today. So it seems to me that one reason not to stop people smoking in one go (from the government's point of view) is that it would leave a block of years in which there was no money coming in and lots of people left to treat. Am I right in thinking there would be an enormous hole in the public purse, and that that is why more gradual moves seem to be favoured?

Otherwise, the financial angle is tricky. Clearly most of the things that they'd like to pay people to stop doing currently cost us all quite a lot of money. A crack addict will be funding drugs operations that require finances to battle, they'll also be a disproportionate strain on the NHS, quite apart from not contributing to tax. So you can understand why a central government position would be to say, "why shoud we pay £100 a week in advertising to try and stop them taking crack when we could just pay them £30 a week not to take it plus £50 a month for a drugs test".

The problem as I see it is that it has the possibility to reward a perpetual state of coming off things, or staying on at school in the most unengaged way, and that it seems eminently gameable and - on occasion - actually a little unfair on people who aren't taking drugs and would have stayed at school anyway. Plus the idea that you should - in essence - pay people to behave in ways that you find ethically / socially appropriate seems a little suspect, although I have no doubt that we do it everyday anyway. Basically - I understand the rationale, but it's unsettling somehow and seems open to abuse.

16:08 / 25.04.04

is it really a question of education? Do people who eat at McDs (and I'm one) go in there thinking "Gosh, this food is both cheap AND good for me!"? Do people really start smoking thinking "thank goodness there are no negative effects on my health from smoking this"?

Obviously, there are limits to what education can do, and people will always engage in self destructive behaviour. But, it can work. And it doesn't have to be as direct as ad campaigns with pictures of rotting lungs, either. Pay to take teenagers around cancer wards, for example. Maybe it won't have that much of an effect. Or put the money towards providing services to help people give up. But, if you are going to spend money on this kind of thing, at least it isn't going towards something that might actually keep people from giving up (as some people have pointed out)?

Either that or just leave people to make their own mistakes.