Letters Payment to look after health

Incentive mechanisms require deeper understanding

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1135 (Published 06 August 2008) Cite this as: BMJ 2008;337:a1135
  1. Richard E Ashcroft, professor of bioethics1,
  2. Theresa M Marteau, professor of health psychology2,
  3. Adam Oliver, RCUK senior academic fellow in health economics and policy3
  1. 1Queen Mary, University of London, School of Law, London E1 4NS
  2. 2Psychology Department, Health Psychology Section, Guy’s Campus, London SE1 9RT
  3. 3LSE Health, London School of Economics, London WC2A 2AE

    Cookson and Popay make some important points about the merits and problems of using cash incentives to change health behaviour in disadvantaged populations.1 2

    Cookson makes three moral arguments and one prudential argument. Firstly, cash incentives provide an inducement to recipients to change their behaviour to lessen harm to third parties. We could go further and consider direct coercion, for instance, through criminal sanctions. …

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