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All Things Considered

Granite Geek: Get Paid For Buying Healthy? An Insurer Tests The Idea

Ale Viyie via Flickr Creative Commons

The rewards card is everywhere these days. It usually works like this: the more consumers buy, the more incentives and discounts stores hand out.

Harvard Pilgrim Health Care is testing a grocery rewards card that gives incentives not for buying more, but for buying healthier. It's called Eat Right Rewards, and to learn more we turn to David Brooks, who wrote about the program in his weekly Granite Geek science column for the Nashua Telegraph and GraniteGeek.org.

And we should say that this is a rather attention-getting reward. Cold hard cash!

Yeah, you know, it’s not a ton of money, it’s like twenty bucks a month maximum, and it’s based on this rather long and complicated scoring system about what things are healthy. So it’s not just, you know, buy seven apples and get a dollar or anything like that.

You don’t get disqualified if you have a donut in your cart, for example.

Well, you kind of do, actually. That’s one of the interesting things about it, is that it averages up everything you buy over the course of a month and gives it an average score. And your average score has to be above a certain number, in this case sixty, in order to get the reward. So if you suddenly go on a binge and buy a whole bunch of junk, you can draw down your average. So one of the people I talked to over at the column talked about how she would lend her card to her sister, and told her sister, you know you can’t buy soda with my card, you have to buy something else. So the sister sort of begun racking more [points] up.

So people can kind of gain the system, interesting.

Well they can, and actually it kind of reminded me of when we got our first hybrid car and, you know, you got the gasoline mileage read out and you find yourself driving really slowly or doing a lot more coasting, just trying to get the number up because it was very much like a game. I expect this is kind of the same idea, but that’s great, that’s terrific. I mean if it’s fun, and “gamification”, to use a trendy term,and the net result is that you eat a little bit healthier, then all the more power to it.

Harvard Pilgrim Healthcare has been testing the program, and are people responding to that incentive, the cash reward, in ways other than simply asking someone else to buy their donuts for them?

Well, for all I know Harvard Pilgrim has a secret donut buyer for the whole company that goes out and gets all the junk food for everybody. No, they talk about in the first couple of months of the test, they had about 4,000 shopping trips and about two thirds of them had ended up with a score of sixty, which is the quote healthy score. It’s a pilot program, it’s hard to know whether the kind of people who would sign up for this to start with would have bought the healthy food anyway, but I can’t imagine that it doesn’t prod people; you know, skip over the Twinkies and go for something else.

It comes back to that idea which we’ve talked about before: nudging. That if you prod someone’s behavior even just a little bit with an incentive, or making the better choice a little easier, it’s enough of an incentive where the larger idea of being healthy may not be an incentive on its own.

Many people wouldn’t consider this a nudge because they actually hand you cash, that’s a pretty unsubtle nudge, but it’s the same sort of idea. Instead of demanding or enforcing particular behavior, you just increase incentives for that behavior. And you think being healthy would be enough of an incentive, but of course it isn’t for all of us as we all know; partly because the payoff and the reward are in the distance, and it’s not immediately obvious. Eating this one donut isn’t going to give me a heart attack immediately, but it might increase slightly the chance that I have a heart attack in the next fifteen year. That’s a distant payoff and very hard to alter behavior, whereas the reward of eating the donut is very immediate, so this gives a more immediate kind of reward as well. The whole idea of nudging, it’s kind of hyped, as things tend to be. But that doesn’t mean it’s not legitimate, that there aren’t legitimate aspects to it. The British government had a whole nudge unit, cabinet-level office that developed government programs that would sort of nudge people into doing certain things such as increasing the amount of money they put aside for retirement, or doing less binge drinking, and stuff like that: nudge people into doing it without making new laws or fining them, or hiring more police officers or something like that. So it’s a valuable and interesting area of study and behavior. 

There’s a parallel in car insurance, where you can agree to have the car insurance put a little device in your car that basically tracks your driving in return for a slight discount. Are there critics saying, as they do about this car insurance tracking, that people should really ask themselves whether a reward is worth letting their insurance company in on this previously private information?

Absolutely, there’s always a downside to everything in life, and you put your finger on a good one. You open yourself up to more examination by “The Man”, if you will. The obvious downside with an insurance company is, having gotten this information, they’ll increase the fines if you don’t do it, or they’ll make it more and more expensive, and so basically eventually mandate certain kinds of behavior. But people don’t really seem to mind opening themselves up too much in return for money, or even convenience, because if you think about it the standard rewards card in a grocery store, they collect all sorts of information on you. And that’s the whole reason they do it, is so they can find out who’s shopping what and buying what things when, and they can say the right kinds of incentives to buy more stuff. So you’re giving them a real insight into yourself in return for a little bit of savings, or even just convenience—so why not do it in return for a little bit of health?

And, if you have somebody else there who might buy your bacon bites or your pork rinds, then who’s going to be the wiser?

Pork rinds! Wow, pork rinds…I’m not sure that there’s any moral justification for eating those.

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