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Fixin' Healthcare

Friday, April 07, 2006

The Lifestyle Chronicles - A Little Discipline Will Help

Today's issue of the journal Science contains a study from the University of Erfurt in Germany involving 84 students in an investment game. Each player was given 20 tokens that at completion could be redeemed for real money. The players could join one of two groups and any player could change groups before each round.

One group could impose penalties within its membership and the other group could not. The players in the penalty group had the option to pay one token to dock another player three tokens. Otherwise, the two groups functioned under identical rules and conditions. Each round offered players the option to invest in a fund that returned guaranteed profit as a multiple of the tokens invested. The profit from an investment were distributed equally among all members of a group, including those who did not invest.

Initially, about one-third of the players chose to join the group that imposed penalties. Two-thirds of the players joined the no penalty group. Within each group everyone was aware of the contribution of each player, the profit generated by the group and their own return.

By the fifth round, about half of the no-penalty group had changed to the penalty group. A smaller number of players moved in the opposite direction. Round twenty found most of the players had joined the penalty group and the no-penalty group was deserted.

The conclusion drawn from the study is that a group (society) manages successfully when people with shared standards have the moral courage to informally sanction others to promote cooperation. Also, the results demonstrate how self-interest can over-ride aversion to punitive norms. Perhaps someone should introduce the investigators to the Survivor series on television.

There might be some lessons that pertain to community health. The self-interest of a community and its individual members dictates reduction of known health risk. How is the best way to do it? Penalties should not be excluded from consideration. An example is the current trend of communities to tax tobacco, prohibit smoking and restrict advertising by tobacco companies. Also, there is serious question about the need to limit advertising of junk food to children and advertising by pharmaceutical companies.

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