Law & Governance

Law & Governance 16(5) April 2013
Invited Essay

A Nudge Too Far? A Nudge at All? On Paying People to Be Healthy

Adam Oliver


[This article was originally published in HealthcarePapers, 12(4)

Paying people to engage in healthy behaviours, such as adhering to medications, quitting smoking and losing weight, has been linked to the nudge agenda. However, "user financial incentives" (UFI) can only be classified as nudges if they meet a strict set of requirements. Perhaps more importantly, UFI have thus far showed some promise only for "single shot" behaviour change, such as that associated with many acts of medical adherence, and have been generally unfruitful in effecting the sustained behaviour change that is necessary to influence broader lifestyle decisions, such as those associated with smoking and weight. Possibly more importantly still, the legitimacy of government-sponsored interventions intended to influence directly broad lifestyle behaviours, providing that those behaviours are not unduly harming others, ought to be scrutinized.



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