Nudging Health

Nudging Health : Health Law and Behavioral Economics

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Behavioral nudges are everywhere: calorie counts on menus, automated text reminders to encourage medication adherence, a reminder bell when a driver's seatbelt isn't fastened. Designed to help people make better health choices, these reminders have become so commonplace that they often go unnoticed. In Nudging Health, forty-five experts in behavioral science and health policy from across academia, government, and private industry come together to explore whether and how these tools are effective in improving health outcomes.

Behavioral science has swept the fields of economics and law through the study of nudges, cognitive biases, and decisional heuristics-but it has only recently begun to impact the conversation on health care. Nudging Health wrestles with some of the thorny philosophical issues, legal limits, and conceptual questions raised by behavioral science as applied to health law and policy. The volume frames the fundamental issues surrounding health nudges by addressing ethical questions. Does cost-sharing for health expenditures cause patients to make poor decisions? Is it right to make it difficult for people to opt out of having their organs harvested for donation when they die? Are behavioral nudges paternalistic? The contributors examine specific applications of behavioral science, including efforts to address health care costs, improve vaccination rates, and encourage better decision-making by physicians. They wrestle with questions regarding the doctor-patient relationship and defaults in healthcare while engaging with larger, timely questions of healthcare reform.

Nudging Health is the first multi-voiced assessment of behavioral economics and health law to span such a wide array of issues-from the Affordable Care Act to prescription drugs.

Contributors: David A. Asch, Jerry Avorn, Jennifer Blumenthal-Barby, Alexander M. Capron, Niteesh K. Choudhry, I. Glenn Cohen, Sarah Conly, Gregory Curfman, Khaled El Emam, Barbara J. Evans, Nir Eyal, Andrea Freeman, Alan M. Garber, Jonathan Gingerich, Michael Hallsworth, Jim Hawkins, David Huffman, David A. Hyman, Julika Kaplan, Aaron S. Kesselheim, Nina A. Kohn, Russell Korobkin, Jeffrey T. Kullgren, Matthew J.B. Lawrence, George Loewenstein, Holly Fernandez Lynch, Ester Moher, Abigail R. Moncrieff, David Orentlicher, Manisha Padi, Christopher T. Robertson, Ameet Sarpatwari, Aditi P. Sen, Neel Shah, Zainab Shipchandler, Anna D. Sinaiko, Donna Spruijt-Metz, Cass R. Sunstein, Thomas S. Ulen, Kristen Underhill, Kevin G. Volpp, Mark D. White, David V. Yokum, Jennifer L. Zamzow, Richard J. Zeckhauser
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Product details

  • Paperback | 392 pages
  • 156 x 235 x 23mm | 567g
  • Baltimore, MD, United States
  • English
  • 8 Line drawings, black and white
  • 1421421011
  • 9781421421018
  • 597,078

Table of contents

AcknowledgmentsIntroductionChristopher T. Robertson, I. Glenn Cohen, and Holly Fernandez Lynch1. Behaviorally Informed Health Policy? Patient Autonomy, Active Choosing, and PaternalismCass R. Sunstein2. Three Choice Architecture Paradigms for Healthcare Policy Russell Korobkin3. Can Behavioral Economics Save Healthcare Reform? Alan M. Garber4. Seven Ways of Applying Behavioral Science to Health Policy Michael HallsworthPart I. The Ethics of Nudges in HealthcareIntroductionI. Glenn Cohen5. What Can PPACA Teach Us About Behavioral Law & Economics?David A. Hymen and Thomas S. Ulen6. Bad Medicine: Does the Unique Nature of Healthcare Decisions Justify Nudges? Mark D. White7. Nudging and Benign Manipulation for HealthNir Eyal8. The Political Morality of Nudges in HealthcareJonathan GingerichPart II. Nudging and Public Health PolicyIntroductionHolly Fernandez Lynch9. An Ethical Framework for Public Health Nudges: A Case Study of Incentives as Nudges for Vaccination in Rural IndiaJennifer Blumenthal-Barby, Zainab Shipchandler, and Julika Kaplan10. Behavioral Economics and Food Policy: The Limits of Nudging Andrea Freeman

Part III: Behavioral Economics and Healthcare CostsIntroduction Matthew J.B. Lawrence11. Cost-Sharing as Choice ArchitectureChristopher T. Robertson12. Using Behavioral Economics to Promote Physicians' Prescribing of Generic Drugs and Follow-On Biologics: What Are the Issues? Ameet Sarpatwari, Niteesh K. Choudhry, Jerry Avorn, and Aaron S. Kesselheim 13. Towards Behaviorally Informed Policies for Consumer Credit Decisions in Self-Pay Medical Markets Jim Hawkins

Part IV. Crowding-OutIntroductionNeel Shah14. Extrinsic Incentives, Intrinsic Motivation, and Motivational Crowding-Out in Health Law and PolicyKristin Underhill15. Do Financial Incentives Reduce Intrinsic Motivation for Weight Loss?: Evidence from Two Tests of Crowding-Out Aditi P. Sen, David Huffman, George Loewenstein, David A. Asch, Jeffrey T. Kullgren, and Kevin G. Volpp

Part V. Behavioral Economics and the Doctor-Patient RelationshipIntroduction Aaron S. Kesselheim16. Affective Forecasting in Medical Decision-Making: What Do Physicians Owe Their Patients?Jennifer L. Zamzow17. Behavioral Economics in the Physician-Patient Relationship: A Possible Role for Mobile Devices and Small Data Alexander M. Capron and Donna Spruijt-Metz18. The Perilous Promise of Privacy: Ironic Influences on Disclosure of Health Information Ester Moher and Khaled El Emam

Part VI. Deciding for Patients and Letting Patients Decide for ThemselvesIntroductionChristopher T. Robertson19. Procedural Justice by Default: Addressing Medicare's Backlog CrisisMatthew J.B. Lawrence20. Measuring the Welfare Effects of a Nudge: A Different Approach to Evaluating the Individual Mandate Manisha Padi and Abigail R. Moncrieff21. Better Off Dead-Paternalism and Persistent Unconsciousness Sarah Conly22. Improving Healthcare Decisions Through a Shared Preferences and Values Approach to Surrogate Selection Nina A. Kohn23. Consumer Protection in Genome Sequencing Barbara J. EvansPart VII. Defaults in HealthcareIntroductionGregory Curfman24. Forced to Choose Again: The Effects of Defaults on Individuals in Terminated Health Plans Anna D. Sinaiko and Richard J. Zeckhauser25. Presumed Consent to Organ Donation David OrentlicherList of ContributorsIndex
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Review quote

This volume is a "must have" for collections in behavioral economics, economic policy, and healthcare economics and policy. The editors have put together a collection of papers by some of the best writers in the field and have structured the book in seven parts that address everything from the ethics of nudges in healthcare to issues in costs and policy design. This reviewer highly recommends the book for the included papers, for the exceptional organization, and for the foreword written by Cass R. Sunstein. Essential. * Choice * Forty-five experts in behavioural science and health policy from across academia, government, and private industry have contributed to this reader. * Springer Journal *
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About Cass R. Sunstein

I. Glenn Cohen is a professor of law at Harvard Law School and the faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics. He is the author of Patients with Passports: Medical Tourism, Law, and Ethics. Holly Fernandez Lynch is the executive director of the Petrie-Flom Center. She is the author of Conflicts of Conscience in Health Care: An Institutional Compromise. Christopher T. Robertson is a professor of law and the associate dean for research and innovation at the University of Arizona's James E. Rogers College of Law. He is the coeditor of Blinding as a Solution to Bias: A Multidisciplinary Approach.
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