Nudge, not nanny

“Hmmm… I could pickle a pike with that.” Does anyone else find the Yukon government’s new anti-salt ad annoying?

“Hmmm… I could pickle a pike with that.” Does anyone else find the Yukon government’s new anti-salt ad annoying?

It pops up often, presumably via Google Ads, when I’m reading all kinds of local and Outside websites. First I wonder how much of our tax money is leaving the territory to prop up Google’s $350 billion market cap, and then I wonder how many Yukoners actually eat less salt after seeing an ad on Slate.com.

It would be fascinating to see the data if the Health Department is running a control group and can compare the salt consumption of people who have seen the ads and people who haven’t. One hopes they’re not just spending money on advertising without any data to prove its effectiveness.

The CEO of Caesar’s Casino’s, once a professor at Harvard, famously said that running an experiment without a control group was one of the three things that could get you fired from his company (the other two being stealing and sexual harassment).

The British government has recently been experimenting with new, and often more effective and less obviously annoying, ways of influencing people’s behaviour. British Prime Minister David Cameron set up the “behavioural insight team” inside the cabinet office shortly after being elected. It is nicknamed the “Nudge Unit,” after a book on behavioural economics called Nudge: Improving Decisions about Health, Wealth and Happiness by Cass Sunstein and David Thaler.

The “nudge” concept comes from the idea of gently steering people to do what is in their own best interests, but using clever and often invisible “nudges” rather than traditional nanny-state measures such as bans, taxes or publicity campaigns. Bans and taxes are heavy-handed and often surprisingly ineffective, while publicity campaigns can be both costly and of uncertain effectiveness.

Economist websites are now full of legends about the surprising success of the nudge approach. People in cafeterias often buy what is at eye-level, so why not put the salads and apples there instead of the burger menu? Many workers don’t sign up for voluntary retirement contributions when they start a new job, so why not make signing up the default option and let them opt-out if they choose?

The BBC reports that the Nudge Unit managed to increase organ donor volunteers in the U.K. by over 100,000 people just by subtle changes to the opt-in/opt-out choices and wording on the forms for driver licence renewal.

In another innovation, the Nudge Unit was recently partly privatized. It is now owned by its own employees, a charity called Nesta and the U.K. government. The idea is that it will sell its services to governments around the world, and also make enough money to attract and retain top talent.

It already has a big book of business, including looking at why Moldovan tuberculosis patients stop taking their medication when they leave the hospital. This is a major problem, since people who don’t finish their medication when they start to feel better inadvertently encourage the spread of drug-resistant tuberculosis.

The process the team took to tackle the problem is interesting. First they brainstormed hypotheses. One possibility was that people were forgetting, so a daily text message might help. Another was that people needed an extra incentive to finish their pills, so a reimbursement or payment could help. A third was that the Moldovan treatment process, which required patients to visit a doctor’s office and take the pills under observation, was too much hassle.

What they did next went farther than what many desk-bound government officials do when evaluating policy. They got out and did direct consumer research with patients, which revealed that the hassle factor was the major problem.

Now they are experimenting with “video observed treatment” with patients and health workers using the Moldovan equivalent of Skype, and another is home visits. They will test these two approaches versus the control group of patients and see which one works best.

This is what rational fact-based policy making looks like in practice. It is a lot more work than desk-based policy development, but can be remarkably more effective. The Nudge Unit is so confident that they can generate proof these approaches work for government clients that they have left their cozy home in the U.K. cabinet office to sell their wares worldwide.

Libertarians may object that the state is still trying to influence citizens, possibly for nefarious reasons. The Economist magazine pointed out that politicians are prone to fall for trendy policies and make decisions on the fly, and that the things they ask the Nudge Unit to nudge people about may not make sense.

Despite these objections, nudge policies have a lot going for them. In the end, the citizen still decides whether to sign up for organ donation or take their tuberculosis pills. And the cost and effectiveness of government interventions are much better understood, which bring accountability to officials spending tax dollars.

As for the Yukon government’s anti-salt program, I must be in the control group since (as far as I know) no government officials are monitoring my bacon and ketchup choices.

Keith Halliday is a Yukon economist and author of the MacBride Museum’s Aurore of the Yukon series of historical children’s adventure novels. You can follow him on Channel 9’s Yukonomist show or Twitter

@hallidaykeith

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