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A l'occasion d'un séminaire donné lors de sa visite à Sciences Po, Jody Sindelar, économiste à l'Université de Yale et spécialiste de la consommation de produits addictifs, a rencontré le sociologue Henri Bergeron, co-directeur de l'axe "Politiques de santé". Retrouvez un extrait de leurs échanges ci-dessous.
Health economics professor Jody Sindelar, from Yale University, was visiting at LIEPP in September 2014. She gave a seminar entitled “Using behavioral economics to change behavior. Financial incentives, framing, and other approaches to encourage smoking cessation.” She presented several of her on-going studies, which subjects range from analysing the effect of financial incentives on drug use in the United States to testing loyalty points programs designed to reduce the prevalence of obesity in Mexico.
Her demonstration insisted upon the powerful insights that can be drawn from behavioral economics, compared with neoclassical models based on rational expectations. For instance, her findings allow shedding light on the importance of the structure of payments rather than the amounts involved when designing health policy related financial incentives. Policies based on optimal choice architecture and nudge theory take advantage of biases revealed by behavioral economics in order to design solutions to public health problems such as smoking, drug use, gambling, or obesity. In the United States and the United Kingdom, instruments such as pre-commitment devices, financial incentives, framing, lotteries, priming, mental accounting and menu labeling, etc. are implemented into regulation by nudge units working with governments.
Professor Sindelar’s work aims at deepening our understanding of such mechanisms. One of her more recent study focuses on low income decision makers, building on the hypothesis that these mechanisms can be most effective on people who usually dispose of little decision-making support. This study compared the efficiency of financial incentives versus health motivations to encourage low income smokers to quit smoking. Financial message turned out to be more effective, especially when displayed in “financial-related settings” such as a bank (as opposed to “neutral setting” such as a grocery store). This finding led to the award of a $ 10 million grant to finance a new study in which low income people will be paid to quit smoking in Connecticut.
Sociologist Henri Bergeron, co-director of LIEPP “health policy research group”, led the discussion following the seminar.
Henri Bergeron: “Developments of behavioral economics presented in your intervention come as a confirmation to the work of political sociologists, especially regarding the key role played by framing processes as reform levers. Yet, beyond their net intellectual value, remains the question of why these instruments based on nudge theory are appealing to politicians. And there, it must be noted that these instruments are used to design policies that are cheap, non-aggressive against concerned industries, etc. “
Jody Sindelar: “I agree. I would add that these policies are doubly cheap: indeed, ‘nudge units’ linked to governments in the UK and US don’t have their own budgets. There is a growing intellectual interest, but the financial reality is a hard limit to the development of these policies.”
H.B.: “Nudge theory does not take into account socio-economic factors but tries to correct various irrationality biases leading to risky health behaviours. Specific biases, like time inconsistency, rather than socio-economic factors, are assumed to cause risky behaviour. Yet, we know that much risky behaviour inducing health problems tend to cluster in specific socio-economic groups. This means that specific socioeconomic factors would give birth to specific biases, which aren’t randomly distributed. In other worlds, it would mean that rationality clusters in specific groups. If this idea does not seem scientifically acceptable, then it means that socioeconomic factors, rather than irrationality biases, are the real cause of risky behaviour… And thus one wonders about the effectiveness of nudge strategies to begin with.
J.S.: “It is hard to know whether these nudges are more effective on some people than on others. It is indeed possible that it works better on more rational population groups. I would also qualify the claim that risk behaviour cluster in low income socio-economic groups. This used to be true, but it isn’t always accurate anymore: the education gradient has flattened up.”