Is being healthy a conscious decision? Does it result primarily from individual irrationality and insufficient incentives to be healthy? If you answer a definite "yes" to both questions, then you might think there is some logic in Esther Dyson's hail of the business enterprise of connecting health to social status.
And why not indeed, social status might motivate people to stay healthy. If I can flash my fancy card around, avoid queues, have free WiFi in waiting rooms, enjoy special treatments, luxurious air-port lounges and personal phone lines to my medical service, why wouldn't I want to be healthy. It is a double benefit - one's both healthy and socially "rewarded"... Assumed social inequality is acceptable and non-problematic and I would be the person to enjoy such benefits.
1997 "Gattaca" with Ethan Hawke and Uma Thurman represent a pretty good idea of what a social status fixation on health would look like. A novel technology and complete regulatory control enable a precise identification of genetic information. So by just scanning somebody's DNA, it could be determined if that person would be a healthy and strong one or would be liable to all kinds of diseases. The genetic scan is used for a total segregation of society into "valids" and "in-valids", where the second group is a social underclass, living in ghettos and acquiring only cleaners' jobs. Even if the example seems a bit exaggerated for the business entrepreneurship of connecting health and social class, it bears fictional relevance. Some people are not consciously unhealthy.
For one, I would like to agree that incentives and encouragement are a good thing: a free yoga class or gym membership as well as some discounts on organic food are excellent initiatives. Creating a "healthy" high class blows the matter out of proportion. What I mainly wondered about is: healthy people usually don't take pills, most would not train excessively (at least five times a week?!) and are not to be frequently found in doctors' waiting rooms. Or is it about the less-healthy of the healthy that Esther Dyson refers to?
By the way: no space travel for "in-valids".
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Hi Velichka,
ReplyDeleteI think also it might be just the other way around, namely that being unhealthy is subsidized. For instance corn syrup is heavily subsidized in the US and a component of a lot of unhealthy and "obesity generating food". I dont know what the food pricing policies are in EU but obviously bio food is more expensive then regular A&P...so maybe the discrepancy in health outcomes on top of the wealthy having the money to consume more healthy food its also due to the fact that junk food is made cheaper...
more on that in this witty article:
ReplyDeletehttp://www.slate.com/id/2228713/
Well, I guess the government clearly isn't doing enough for their citizens, but the point I wanted to make doesn't concern subsidies or tax brakes.
ReplyDeleteHealth insurance is like any other insurance: companies try to cover as little as possible, because they are minimizing their costs. For very sick patients, let's say cancer.. people who really need regular and expensive treatments, insurance rarely covers all costs. This "innovative business idea" of connecting social status to health service is just a new way to discriminate people with health problems and make them pay more for insurance.
Additionally, people from higher social strata are already healthier than the working class: they can afford organic food and sports club memberships. And healthy people are already socially rewarded - they would look good and have a high self-esteem.
Diving healthy and unhealthy people in order to incentivise, let's say obese people, will not have a massive effect. Obese people would feel more excluded than before, more frustrated and angry. Having some small benefits here and there doesn't teach one a healthier lifestyle. Eating and activity habits need a lot more to be transformed.
Is being healthy a conscious decision? I think there's a general understanding now that many decisions are not only driven economic principles (e.g. subsidies) but work through social interaction and particularly socialization.
ReplyDeleteUnfortunately, such a hypothesis is very difficult to test given the problems to disentangle effects driven by self-selection.
Luckily, there is a brand new NBER paper (Nov 2011) on this. Specifically, the authors test whether your decision to be obese is causally influenced by the health status of your friends. The empirical strategy exploits an exogenous "friend assignment" at the US Air Force Academy. Quite a fun read: http://papers.nber.org/papers/W16518