This page examines the possible use of financial incentives to promote health in the United Kingdom.
In 2011, the government does not lecture to the public on their health. Instead it encourages a sense of personal responsibility. It wants to assist the public to change, or ‘nudge’ their behaviour in a positive direction. ‘Nudging’ may help to alter public behaviour but such changes have not been measured over the long term.
One way of nudging behaviour is to use “financial incentives to encourage people to undertake healthy activities”. Arguably, even small amounts of financial incentive “can influence individuals' health-related behaviours”.
However, there have been criticisms of the use of financial incentives. Some criticism has centred on the use of “offers of payment to patients for adherence to antipsychotic drugs”. Such schemes have been seen as “undermining of patients’ autonomy and personal responsibility, as well as damaging the trust inherent in the doctor-patient relationship”.
Other critics of financial incentives have argued that they could reward bad behaviour and reduce an individual’s intrinsic motivation or “undermine the agency of the person”. Financial incentives could also be seen as 'bribing’ and coercive or paternalistic.
However, accusations of coercion and paternalism could also be levelled at 'harder' policy measures. In terms of food policy, 'harder' policy measures, such as taxes, regulations or bans are an alternative to 'softer' measures such as financial incentives.
If financial incentives are going to be used then they should be viewed as a tool to help promote healthy behaviour such as eating nutritious food. Such a tool should be used as “part of a broader package of activities, rather than being implemented in isolation”. Perhaps a food voucher, to reduce the cost of healthy food, could be given to people to encourage the consumption of fresh fruit and vegetables.
Finally, the relevance of ‘upstream interventions’ will need to be considered given that financial incentives are unlikely to work on their own. These interventions include changes to the public’s wider circumstances; such as people’s environment and their employment status. If a financial incentive, such as a money-off voucher, were to be offered to encourage healthy food consumption, then it would only work if people had adequate access to nutritious food.