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Tina Rosenberg writes:

Four years ago, I visited a hospital in a Johannesburg township of Alexandra where just over half of all pregnant women agreed to take an AIDS test. At the same time at the Chris Hani Baragwanath Hospital in Soweto, 98 percent of pregnant women took an AIDS test. There, women are informed that the test is part of the standard package of prenatal tests. A woman can opt out if she chooses.

This makes a lot of sense. AIDS testing was designed to be opt in back when there was no overwhelming reason for people to know their H.I.V. status, as there was very little that could be done for them if they tested positive. Today, even in the poorest countries, patients who learn they are H.I.V. positive can get lifesaving therapy and pregnant woman can take medicines to avoid passing the virus along to their babies.

The change to opt-out helped Botswana increase acceptance of AIDS tests from 64 percent to 83 percent in just one year. Test rates in clinics in Zimbabwe went from 65 percent to 99 percent with a similar change. In 2004, the United Nations AIDS agency and the World Health Organization began recommending opt-out testing in countries where AIDS is widespread.

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A Kellogg economist proposes the Dieter’s Paradox. Put a healthy vegetable next to something fatty or fried and people think there are fewer calories in the two items combined versus when looking at the fatty/fried item alone.

Those who viewed the chili alone rated it as averaging 699 calories. By contrast, those who were shown the chili combined with the green salad estimated the meal to have only 656 calories. Thus, adding a green salad to the bowl of chili lowered the perceived caloric content of the entire meal by 43 calories — as if the green salad had negative calories. This negative-calorie illusion was observed with all four meals tested, indicating the prevalence of the belief that one can consume fewer calories simply by adding a healthy item to a meal.

“Because people believe that adding a healthy option can lower a meal’s caloric content, the negative-calorie illusion can lead to overconsumption, thus contributing to the obesity trend,” said Chernev.

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1) More overconfidence. Spotting drunk people.

2) More calories tomorrow. Calorie counts, that is.

3) More productive employees. Just say thank you to them. Hat tip: Simoleon Sense.

4) More mail. Gmail’s inbox gets smarter.

5) More bang for your buck. In Massachusetts, a 30 percent food stamp discount for buying fresh fruits and vegetables. But will the discount be visible enough?

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In 2006, a group of researchers studied senior citizens’ decision about Medicare Part D plans. Plenty of seniors got confused and picked suboptimal plans. It sounded like bad news, but there was a potential bright spot: If their doctors helped them out, presumably they’d make better choices.

In a new study (gated here) of medical students and residents at a leading (unnamed) hospital looking at simplified versions of 3, 10 and 20 Medicare Part D plans, the researchers found that more than two-thirds of doctors picked the right one. However, poor choices increased with the number of plans offered. Keep in mind that most states offer more than 50 plans whose descriptions are not nearly as streamlined as the ones in this study. Discouragingly, physician confidence rose as the number of mistakes increased.

But doctors with better numerical skills performed better with their choices. Unfortunately, there’s no easy way to use that piece of information when making physician choices today. if you’re picking a primary care physician from a health insurance provider’s list, you are often told what medical school a doctor attended, but not what that doctor majored in back in college.

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In order to increase the rate at which patients renew (and hopefully take) their medicines, CVS experimented with moving the point at which users are asked if they’d like automatic refills when filling out an online order. By moving the question from after the prescription had been filled to before, CVS says sign-up rates doubled. Reports the WSJ:

The test prompt required users to click either yes or no when asked about auto refills, rather than just offering a box to be checked for more information, (says Bari Harlam, senior VP at CVS Caremark). “It’s both things,” she says. “This is very much about using clear, plain language, and also offering it at the right time.”

More on the CVS results can be found here.

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1) Department of confusing legal arguments: Vitaminwater is being sued on the grounds that it doesn’t provide the health benefits it claims. Vitaminwater’s defense? “No consumer could reasonably be misled into thinking Vitaminwater was a healthy beverage.

2) A health care provider teams up with a coupon distributor to send its plan members coupons for products targeted to alleviate their chronic conditions. Hat tip: Zach Perry.

3) Nudge unit at 10 Downing street.

4) A series of “green” default options at this year’s Association for Consumer Research conference. Hat tip: Dan Goldstein.

5) Princeton economist Uwe Reinhardt on a new wrinkle to a nudge-friendly proposal to automatically enrolling Americans in a health plan, but give them they option to opt-out. The wrinkle is having opt-outers lose the right to buy health insurance under the terms of the recent legislation (meaning they’d buy insurance in today’s market) for some number of years.

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1) Self-control and self-admiration are part of a virtuous feedback loop.

2) Humans grossly underestimate the likelihood that someone will give them help if they ask for it. It turns out that others are more willing to help than most think.

3) A North Carolina electric company adopts a version of the Keep the Change program called Operate Round Up. Customers can choose to have their utility bills rounded up to the nearest dollar with the difference donated to area charities. The average donation is $6/year and the company serves about 2 million North Carolinians. So that could work out to about $12 million a year in charitable donations if every customer participated. Hat tip: Colin Smith

4) Virtual worlds give behavioral economists better environments to test models of behavior.

5) First carbon footprints, now water footprints.

6) A healthy behavioral decision isn’t as simple as taking personal responsibility. Hat tip: Jodi Beggs.

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1) Yale’s Dean Karlan says it’s not a surprise that taxes on junk food are more effective than subsidies for healthy food at changing consumer habits. It’s about loss aversion: “People are just more responsive to price increases than decreases.”

2) Colleges are trying Trayless Tuesdays. Is yours?

3) San Francisco has adopted a public school matching algorithm similar to the one mentioned in the school choice chapter of Nudge. Hat tip: Market Design, which notes “the nice thing is that the underlying choice architecture will make it safe for parents to state their true preferences however the priorities are adjusted.”

4) Pepsi is cutting sugary drinks from schools around the world.

5) More women are asking surgeons to remove a healthy breast along with a cancerous breast, even though removing the healthy breast doesn’t change their odds of survival, says the New York Times. Why? “But women who have opted for the procedure say it’s not about the statistics. Once they receive a breast cancer diagnosis, they never again want to experience the stress of a mammogram or biopsy.”

Addendum: A pilot project using Netflix like technology to predict which patients need checkups and send them email alerts. Hat tip: Marginal Revolution.

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Assorted links

1) Richard Thaler and George Osborne in the Guardian. U.K. pilot recycling programs to replace fines with rewards are showing results.

2) A new study finds calorie labeling for a hypothetical McDonald’s meal reduces calorie consumption. One key difference from past studies: People aren’t ordering meals for themselves. Parents are ordering meals for their children. Hat tip: Patti Hunter.

3) Crayola’s law says that the number of Crayola colors doubles every 28 years. How much faster do children who color with the original box of crayons finish compared to those with the mega 120-color box? Hat tip: Christopher Daggett.

4) A web-based version of Dustin Hoffman’s mason jars. Hat tip: Elliot Crosby-McCullough.

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1) The New Yorker interview with Richard Thaler.

2) London’s mayor wants to start a recycling bank program that gives people shopping vouchers for their recyclables.

3) Another plug this past weekend for the automatic tax return. California says it costs $2.59 to process a paper return, but only 34 cents to process its version of the automatic tax return, ReadyReturn. The makers of Turbo Tax have been trying to end the program, most recently this fall.

4) Calorie postings at Starbucks led to lower calorie consumption by six percent–except around the holidays. Hat tip: Farnam Street.

5) Will Obama mention the automatic IRA in his State of the Union speech Wednesday?

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