Healthy Living Vouchers?

Blog, Healthcare & Welfare, Ben Eisen

A little while ago I posted here, arguing that public awareness campaigns will likely prove an ineffective strategy for reducing obesity in Canada. 

One alternative is using incentives to encourage people to lose weight or engage in healthy activities. One proposal for this sort of approach was recently put forward in this column in the National Post.

The proposal here is a “Healthy Living Voucher” (HLV). Neil Seeman from the University of Toronto describes his idea this way:

An HLV is an annual sum of money for every person 16 years and older — probably about $5,000 in Canada — to spend on healthy-living options that are agreed to by the person and his or her primary care provider. The money comes from a 2-4% slice off the provincial budget. The money can be applied only to options approved by a self-governing (non-state) regulatory college representing all members of qualified health professionals.

Starting to think through the challenges associated with implementing this sort of incentive scheme makes it clear how difficult it would be to develop any sort of efficient and effective anti-obesity public agenda. To note just one concern, a lot of the money spent on this sort of universal program would go to “free riders,” people already engaged in the sort of activities the government wants to encourage. The government agreeing to pick up the tab for the gym membership (for example) of a fit, healthy person who is currently paying for that membership himself seems like a real waste of money during tight fiscal times.

It’s the same problem that comes up when governments offer people money to insulate their homes – a lot of the time, you just wind up writing cheques to people who were going to do so anyway. When this happens, the government is out a chunk of money, but no behaviour has actually changed.

Seeman might be on the right track in terms of using incentives to discourage obesity, but giving $5, 000 to everybody to combat a disease that afflicts only a minority of Canadians seems like it would involve an awful lot of unproductive government spending that we just can’t afford.