health

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1) A talking plate that tells you when you’re eating too fast. Yes, it actually talks. No, it doesn’t look fun to eat on. Hat tip: Nirant Gupta

2) A pilot program in the U.K. that gives loans to homeowners for buying energy efficient technologies at no upfront cost. Loan repayments are made over time. Hat tip: Kare Anderson.

3) A claim that cigarette warnings might encourage some people to smoke. Hat tip: Freakonomics.

4) Donate to Haitian relief via texting. Consider the American Red Cross and Yéle Haiti. These two options are not scams. Here’s more on what to know about text donations. Hat tip: Amy Schultz.

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1) Should perspective home buyers be required to watch a video about the pain of foreclosure before they qualify for a mortgage? Draft a budget? Pass an exam about loans?

2) Stefan Wobben reports on deceptive marketing defaults online; one for RyanAir and another for the Wifi at the Amsterdamn airport.

3) NIH is looking to give two $7.5 million grants to investigate health care nudges. Application here. Hat tip: Dan Goldstein.

4) Extremeness aversion and Starbucks coffee.

5) Before credit cards were accepted in cabs, New York riders averaged a 10 percent tip. Now that cabs allow cards, tips have jumped to an average of 22 percent. Hat tip: Steven Shechter.

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1) A high-tech substitute for the medical checklist.

Hat tip: Jason Bade.

2) Two manhole covers specifically for tourists. We could use these here in Chicago.

Hat tip: Danny Vincent.

3) More on the benefits of a nudge for long-term care insurance. The existing incentives aren’t strong enough to encourage long-term care purchases.

A decade ago, a handful of states—notably California, Connecticut, Indiana and New York—partnered with private insurers in an attempt to encourage people to purchase long-term care policies. As an incentive, these states allowed people to shield assets they might otherwise have to spend down in order to qualify for Medicaid. Since 2005, more than 30 states have taken similar steps.

Yet most observers have been disappointed by the results. “It’s not a model,” Feder says. “Even the most optimistic projections for the numbers of people it might cover over time don’t come remotely close to the coverage we have on health care—and we consider 16 percent uninsured a national disaster.” A 2005 study by the Congressional Research Service found that a majority of people who purchased these policies in California and Connecticut had more than $350,000 in assets—far more than the $55,000 held by the typical 55-year-old whom the program was hoping to reach.

4) The U.K. Natural History Museum has tacked on a voluntary tax-free donation of £1.50 to its £8 ticket price for online orders.

Hat tip: Jill Rutter.

5) Tweetwhatyoueat. Someone is really going to have to do a study on the effectiveness of all these twitter commitment strategies.

6) Don’t try to tackle all your new year’s resolutions at once. Spread them out over the course of the year.

Human routines are stubborn things, which helps explain why 88% of all resolutions end in failure, according to a 2007 survey of over 3,000 people conducted by the British psychologist Richard Wiseman.

Hat tip: Christopher Daggett.

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Roger Cohen says he was “mesmerized” by a Japanese treadmill.

At 35 calories (on the calorie count screen), there was a frothy cappuccino, and then at 75 two pieces of tuna sushi, to be followed at 126 by an ice cream cone, at 150 by a beer and at 204 by an elegant glass decanter of sake. The 300-calorie mark ushered in chocolate cake, which segued at 325 to cheesecake. At 450 calories I caught a sweat-drenched glimpse of an egg-topped sandwich suggestive of a Croque Madame. Whatever followed was lost in translation.

Although it’s not clear if the delicious imagery motivated Cohen to keep exercising.

But my sense is that the state I found myself in, of playful fixation on a screen, imagining the bite of the ice-cold beer and the unctuousness of the sushi, contained something peculiarly Japanese.

Hat tip: Sam Stuckey, a student in Ross Emmett’s Politics and Markets course

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In the A Dozen Nudges chapter, Nudge highlights private companies that have adopted incentive-based health plans that reward people for exercising and quitting smoking. In the U.S., one state has decided to tax unhealthy residents. Now legislators from Alberta, Canada, may be the first to give people a tax credit–$500–for exercising.

(O)rganized sports requiring “sustained, prolonged activity” likely will be eligible for the credit, including hockey, soccer and skiing, along with organized running and hiking clubs.

Hat tip: Justin McDonald

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Included in the new health care legislation winding its way through Congress is a proposed government-run long-term care insurance program in which participating companies would automatically enroll their eligible employees. These employees would have the option to opt-out.

Long-term care insurance helps pay for nursing home care or other bills of aging people who need living and medical assistance. With most people saving too little for retirement, they are failing to budget enough for these twilight years expenses.

“No one thinks they need long-term care until two years after they need it,” says Richard Thaler, the other co-author of “Nudge.” ”The theme of our book is we should try to help people make decisions without telling them what they have to do.”

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In his latest Economic View column, Richard Thaler uses a bit of probability theory to explain why the recent federal recommendation on delaying breast cancer screenings until age 50 is not such a terrible policy prescription.

Here is a quiz: Suppose that there is a one-in-1,000 chance that a woman in her 40s with no symptoms has breast cancer, and that 90 percent of the time a mammogram correctly classifies women as having cancer or not. If a woman in this group tests positive on her mammogram, what is the chance that she has cancer? The answer is not 90 percent. It is less than 1 percent, because of the large number of false positive results.

Thankfully, breast cancer is rare enough in this age group that a vast majority of positive hits are false positives. Do patients understand this while they are waiting for the results of the subsequent tests?

Full column is here.

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Nowhere are good nudges more needed than in medicine. Reader Chris Crittenden digs up a great one about CT scans, the x-rays that give doctors a nice three-dimensional picture of a patients’ organs or tissues. The risk with CT scans – also known as CAT scans – comes from the radiation doses they emit into patients’ bodies. Health experts warn that the repeated use of scans, which are intended to detect diseases, will actually end up causing thousands of new cancers. Until lower radiation emitting machines are developed, doctors will need to order them intelligently.

Dr. James Thrall, chairman of the American College of Radiology, agrees. He says at his institution, the Massachusetts General Hospital, doctors who order a CT scan or other imaging study must list the reason. A computer program feeds back an ”appropriateness score.” A low score indicates the test is unlikely to be necessary.

”Our experience over the last five years has been rather phenomenal,” Thrall says. Instead of an annual growth rate of 12 percent in CT scans, it’s now about 1 percent, lower than the hospital’s annual growth in patient load. ”That means we’re doing fewer scans per person,” he says.

To cut down on unnecessarily high radiation doses, Thrall says, the College of Radiology is also developing an ”alarm” system that will alert hospitals when their CT scan exceeds an acceptable dose. That will require hospitals to feed dose data to a central computer run by the radiology group.

Full story is here.

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Based on the scientific literature, we know that people who seek out and use calorie information are likely to be different from other eaters in many ways, including their motivation to cut calories. Sure, it’s possible that some people who looked at the information were persuaded to consume fewer calories, but it is equally plausible that those who were intending to order lower-calorie meals were more likely to seek out the calorie information.

By helping consumers make more informed decisions, calorie posting may be desirable even if it fails to reduce calorie intake. But effective policies to deal with obesity will need to involve much more than posting calories. People eat too much because calorie-dense foods are convenient and cheap, with large portion sizes priced to encourage overeating.

That’s Julie S. Downs, George Loewenstein, and Jessica Wisdom on the effectiveness of calorie posting nudges.

Wharton’s Kevin Volpp thinks a revised menu design might be a better nudge.

Incentivizing convenience of ordering low calorie food, by clustering these options together at the top of the menu, seems to have a significant impact. This indicates that traditional measures of informational provision are not always sufficient to motivate changes in unhealthy behavior.

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Assorted links

1) Atlanta is testing out an incentivized recycling program where residents can earn and exchange points for “rewards, gift cards, groceries, and products” with participating retailers. (Hat tip: Mike Erskine)

2a) Rewarding first-graders for eating fruits and vegetables with small prizes.

2b) “‘If you want to know if an urban environment supports cycling, you can forget about all the detailed ‘bikeability indexes’—just measure the proportion of cyclists who are female,’ says Jan Garrard, a senior lecturer at Deakin University in Melbourne, Australia, and author of several studies on biking and gender differences.” From Scientific American.

(Hat tips: Christopher Daggett)

3) A scale that tells the world how much you weigh via Twitter. (Hat tip: Justin Holz)

4) Photos of calorie counting nudges at Freakonomics.

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