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Nudging Health

Nudging Health

9781421421018

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Behavioral nudges are everywhere: calorie counts on menus, automated text reminders to encourage medication adherence, a reminder bell when a driver's seatbelt isn't fastened. Designed to help people make better health choices, these reminders have become so commonplace that they often go unnoticed. In Nudging Health, forty-five experts in behavioral science and health policy from across academia, government, and private industry come together to explore whether and how these tools are effective in improving health outcomes.
 
Behavioral science has swept the fields of economics and law through the study of nudges, cognitive biases, and decisional heuristics—but it has only recently begun to impact the conversation on health care.  Nudging Health wrestles with some of the thorny philosophical issues, legal limits, and conceptual questions raised by behavioral science as applied to health law and policy. The volume frames the fundamental issues surrounding health nudges by addressing ethical questions. Does cost-sharing for health expenditures cause patients to make poor decisions?
 
Is it right to make it difficult for people to opt out of having their organs harvested for donation when they die? Are behavioral nudges paternalistic? The contributors examine specific applications of behavioral science, including efforts to address health care costs, improve vaccination rates, and encourage better decision-making by physicians. They wrestle with questions regarding the doctor-patient relationship and defaults in healthcare while engaging with larger, timely questions of healthcare reform.
 
Nudging Health is the first multi-voiced assessment of behavioral economics and health law to span such a wide array of issues—from the Affordable Care Act to prescription drugs.
 
Contributors: David A. Asch, Jerry Avorn, Jennifer Blumenthal-Barby, Alexander M. Capron, Niteesh K. Choudhry, I. Glenn Cohen, Sarah Conly, Gregory Curfman, Khaled El Emam, Barbara J. Evans, Nir Eyal, Andrea Freeman, Alan M. Garber, Jonathan Gingerich, Michael Hallsworth, Jim Hawkins, David Huffman, David A. Hyman, Julika Kaplan, Aaron S. Kesselheim, Nina A. Kohn, Russell Korobkin, Jeffrey T. Kullgren, Matthew J.B. Lawrence, George Loewenstein, Holly Fernandez Lynch, Ester Moher, Abigail R. Moncrieff, David Orentlicher, Manisha Padi, Christopher T. Robertson, Ameet Sarpatwari, Aditi P. Sen, Neel Shah, Zainab Shipchandler, Anna D. Sinaiko, Donna Spruijt-Metz, Cass R. Sunstein, Thomas S. Ulen, Kristen Underhill, Kevin G. Volpp, Mark D. White, David V. Yokum, Jennifer L. Zamzow, Richard J. Zeckhauser
 

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Table of Content

<P>Acknowledgments<BR>Introduction<BR>Christopher T. Robertson, I. Glenn Cohen, and Holly Fernandez Lynch<BR>1. Behaviorally Informed Health Policy? Patient Autonomy, Active Choosing, and Paternalism<BR>Cass R. Sunstein<BR>2. Three Choice Architecture Paradigms for Healthcare Policy<BR> Russell Korobkin<BR>3. Can Behavioral Economics Save Healthcare Reform?<BR> Alan M. Garber<BR>4. Seven Ways of Applying Behavioral Science to Health Policy<BR> Michael Hallsworth<BR>Part I. The Ethics of Nudges in Healthcare<BR>Introduction<BR>I. Glenn Cohen<BR>5. What Can PPACA Teach Us About Behavioral Law & Economics?<BR>David A. Hymen and Thomas S. Ulen<BR>6. Bad Medicine: Does the Unique Nature of Healthcare Decisions Justify Nudges?<BR> Mark D. White<BR>7. Nudging and Benign Manipulation for Health<BR>Nir Eyal<BR>8. The Political Morality of Nudges in Healthcare<BR>Jonathan Gingerich<BR>Part II. Nudging and Public Health Policy<BR>Introduction<BR>Holly Fernandez Lynch<BR>9. An Ethical Framework for Public Health Nudges: A Case Study of Incentives as Nudges for Vaccination in Rural India<BR>Jennifer Blumenthal-Barby, Zainab Shipchandler, and Julika Kaplan<BR>10. Behavioral Economics and Food Policy: The Limits of Nudging<BR> Andrea Freeman</P><P>Part III: Behavioral Economics and Healthcare Costs<BR>Introduction<BR> Matthew J.B. Lawrence<BR>11. Cost-Sharing as Choice Architecture<BR>Christopher T. Robertson<BR>12. Using Behavioral Economics to Promote Physicians' Prescribing of Generic Drugs and Follow-On Biologics: What Are the Issues? <BR> Ameet Sarpatwari, Niteesh K. Choudhry, Jerry Avorn, and Aaron S. Kesselheim <BR>13. Towards Behaviorally Informed Policies for Consumer Credit Decisions in Self-Pay Medical Markets<BR> Jim Hawkins</P><P>Part IV. Crowding-Out<BR>Introduction<BR>Neel Shah<BR>14. Extrinsic Incentives, Intrinsic Motivation, and Motivational Crowding-Out in Health Law and Policy<BR>Kristin Underhill<BR>15. Do Financial Incentives Reduce Intrinsic Motivation for Weight Loss?: Evidence from Two Tests of Crowding-Out <BR> Aditi P. Sen, David Huffman, George Loewenstein, David A. Asch, Jeffrey T. Kullgren, and Kevin G. Volpp</P><P>Part V. Behavioral Economics and the Doctor-Patient Relationship<BR>Introduction<BR> Aaron S. Kesselheim<BR>16. Affective Forecasting in Medical Decision-Making: What Do Physicians Owe Their Patients?<BR>Jennifer L. Zamzow<BR>17. Behavioral Economics in the Physician-Patient Relationship: A Possible Role for Mobile Devices and Small Data<BR> Alexander M. Capron and Donna Spruijt-Metz<BR>18. The Perilous Promise of Privacy: Ironic Influences on Disclosure of Health Information<BR> Ester Moher and Khaled El Emam</P><P>Part VI. Deciding for Patients and Letting Patients Decide for Themselves<BR>Introduction<BR>Christopher T. Robertson<BR>19. Procedural Justice by Default: Addressing Medicare's Backlog Crisis<BR>Matthew J.B. Lawrence<BR>20. Measuring the Welfare Effects of a Nudge: A Different Approach to Evaluating the Individual Mandate<BR> Manisha Padi and Abigail R. Moncrieff<BR>21. Better Off Dead—Paternalism and Persistent Unconsciousness<BR> Sarah Conly<BR>22. Improving Healthcare Decisions Through a Shared Preferences and Values Approach to Surrogate Selection<BR> Nina A. Kohn<BR>23. Consumer Protection in Genome Sequencing<BR> Barbara J. Evans<BR>Part VII. Defaults in Healthcare<BR>Introduction<BR>Gregory Curfman<BR>24. Forced to Choose Again: The Effects of Defaults on Individuals in Terminated Health Plans<BR> Anna D. Sinaiko and Richard J. Zeckhauser<BR>25. Presumed Consent to Organ Donation<BR> David Orentlicher<BR>List of Contributors<BR>Index</P>
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