Nudge: Improving Decisions About Health, Wealth, and Happiness, Cass R., Sunstein
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Cass R.,Sunstein

Nudge: Improving Decisions About Health, Wealth, and Happiness

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collaborative filtering.” You use the judgments of other people who share your tastes to filter through the vast number of books or movies available in order to increase the likelihood of picking one you like. Collaborative filtering is an effort to solve a problem of choice architecture. If you know what people like you tend to like, you might well be comfortable in selecting products you don’t know, because people like you tend to like them. For many of us, collaborative filtering is making difficult choices easier.
A cautionary note: surprise
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The first is that seemingly small features of social situations can have massive effects on people’s behavior; nudges are everywhere, even if we do not see them. Choice architecture, both good and bad, is pervasive and unavoidable, and it greatly affects our decisions. The second claim is that libertarian paternalism is not an oxymoron. Choice architects can preserve freedom of choice while also nudging people in directions that will improve their lives
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See Berns et al. (2005). Conforming answers are associated with changes in the perceptual features of the brain rather than with changes in the prefrontal cortex, which is associated with conscious decision making. It turns out that people may not merely say that they see things as others do. If all others see things a certain way, we may actually see them that way.
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As we have seen, people are most likely to need nudges for decisions that are difficult, complex, and infrequent, and when they have poor feedback and few opportunities for learning
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For certain fundamental decisions, often made on impulse, a similar strategy might well be best. Some states impose a mandatory waiting period before a couple may get divorced.7 Asking people to pause and think before making a decision of that magnitude seems like a sensible idea, and we are hard-pressed to think of why anyone would need to divorce immediately. (True, spouses sometimes really don’t like each other, but is it really terrible to have to wait a short while before the deed is done?) We could easily imagine similar restrictions on the decision to marry, and some states have moved in this direction as well.8 Aware that people might act in a way that they will regret, regulators do not block their choices but do ensure a period for sober reflection. Note in this regard that mandatory cooling-off periods make best sense, and tend to be imposed, when two conditions are met: (a) people make the relevant decisions infrequently and therefore lack a great deal of experience, and (b) emotions are likely to be running high. These are the circumstances in which people are especially prone to making choices that they will regret.
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But forced choosing is not always best. When the choices are hard and the options are numerous, requiring people to choose for themselves might be preferred and might not lead to the best decisions. Given that people would often choose not to choose, it is hard to see why freedom lovers should compel choice even though people (freely and voluntarily) resist it. If we ask the waiter to select a good bottle of wine to go with our dinner, we will not be happy if he says that we should just choose for ourselves!
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To approach these problems we once again rely on one of our guiding principles: transparency. In this context we endorse what the philosopher John Rawls (1971) called the publicity principle. In its simplest form, the publicity principle bans government from selecting a policy that it would not be able or willing to defend publicly to its own citizens. We like this principle on two grounds. The first is practical. If a government adopts a policy that it could not defend publicly, it stands to face considerable embarrassment, and perhaps much worse, if the policy and its grounds are disclosed. (Those who participated in, or sanctioned, the cruel and degrading actions in the Abu Ghraib prison might have benefited from using this principle.) The second and more important ground involves the idea of respect. The government should respect the people whom it governs, and if it adopts policies that it could not defend in public, it fails to manifest that respect. Instead, it treats its citizens as tools for its own manipulation. In this sense, the publicity principle is connected with the prohibition on lying. Someone who lies treats people as means, not as ends.
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Most of the time, nudging helps those who need help while imposing minimal costs on those who do not. If people are already saving for retirement, offering the Save More Tomorrow program will cause them no problems. If people are not smoking, or are naturally (or unnaturally) thin, campaigns to help smokers and the obese will do them little harm.
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But how much learning do you think is good for people? We do not believe that children should learn the dangers of swimming pools by falling in and hoping for the best. Should pedestrians in London get hit by a double-decker bus to teach them to “look right”? Isn’t a reminder on the sidewalk better?
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In the areas that concern us, these critics would disapprove of policies that explicitly benefit the weak, poor, uneducated, or unsophisticated. They would object to these policies not because they lack sympathy for these groups but because they think that any help for them should come voluntarily from the private sector, such as from charities, and that government policies would come at the expense of other groups (often the strong, rich, educated, and sophisticated). They don’t like any government policy that takes resources from some in order to assist others.
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The third point is one that we have emphasized throughout: In many cases, some kind of nudge is inevitable, and so it is pointless to ask government simply to stand aside. Choice architects, whether private or public, must do something. If the government is going to adopt a prescription drug plan, some sort of choice architecture must be put in place. With respect to pollution, rules have to be established, even if only to say that polluters face no liability and may pollute with impunity. Even if states dispensed with both marriage and civil unions, contract law would have to be available to say what disbanding couples owe each other (if anything).

Often life turns up problems that people did not anticipate. Both private and public institutions need rules to determine how such situations are handled. When those rules seem invisible, it is because people find them so obvious and so sensible that they do not see them as rules at all. But the rules are nonetheless there, and sometimes they are not so sensible.
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We would love to see similar principles used to monitor governments. Require government officials to put all their votes, earmarks, and contributions from lobbyists on their Web sites. Require those determining the future of energy policy (to cite a random example) to reveal which profit-maximizing firms were invited to lend their all-too-invisible hands to the process of designing the rules. Require those determining the future of educational policy to reveal which interest groups, and which unions, gave them money in the most recent campaign. Require government agencies, not merely the private sector, to disclose their contributions to air and water pollution, and their greenhouse gas emissions. Supreme Court Justice Louis Brandeis urged that “sunlight is the best of disinfectants.” Democratic governments, as well as authoritarian ones, could use a lot more sunlight.
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Dollar a day. Teenage pregnancy is a serious problem for many girls, and those who have one child, at (say) eighteen, often become pregnant again within a year or two. Several cities, including Greensboro, North Carolina, have experimented with a “dollar a day” program, by which teenage girls with a baby receive a dollar for each day in which they are not pregnant.3 Thus far the results have been extremely promising. A dollar a day is a trivial cost to the city, even for a year or two, so the plan’s total cost is extremely low, but the small recurring payment is salient enough to encourage teenage mothers to take steps to avoid getting pregnant again. And because taxpayers end up paying a significant amount for many children born to teenagers, the costs appear to be far less than the benefits. Many people are touting “dollar a day” as a model program for helping reduce teenage pregnancies. (Surely there are more such programs to be invented. Consider that a nudge to think of one.)
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If the goal is to increase charitable giving, here’s an easy way to do it. In fact it would not be at all surprising if the Give More Tomorrow program produced far more money for those who need it—while also pleasing the well-meaning but absentminded donors who want to give but never get around to it
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Quit smoking without a patch. Organizations already exist to help people make commitments and achieve goals. CARES (Committed Action to Reduce and End Smoking) is a savings program offered by the Green Bank of Caraga in Mindanao, Philippines. A would-be nonsmoker opens an account with a minimum balance of one dollar. For six months, she deposits the amount of money she would otherwise spend on cigarettes into the account. (In some cases, a representative of the bank visits every week to collect the deposits.) After six months, the client takes a urine test to confirm that she has not smoked recently. If she passes the test, she gets her money back. If she fails the test, the account is closed and the money is donated to a charity.

The early results from this program have been evaluated by MIT’s Poverty Action Lab and look very good. Opening up an account makes those who want to quit 53 percent more likely to achieve their goal.2 No other antismoking tactic, not even the nicotine patch, appears to have been so successful
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The state does not simply permit people to marry within their religions; it does not merely enforce people’s agreements. It also creates a monopoly on the legal form of marriage; imposes sharp limits on who may enter and how; and accompanies the legal form with material and symbolic benefits that it alone confers.
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Insofar as it operated through government, the marital institution was originally a means of government licensing of both sexual activities and child rearing. If you wanted to have sex or to have children, you were in a much better position if you had a license from the state. In fact you might well have needed that license, no less than you now need a license to drive. A state license was a way of ensuring that sexual activity would not be a crime; and it was difficult to adopt children outside of the marital relationship. But official marriage no longer has this role. Indeed, people now have a constitutional right to have sexual relationships even if they are not married—and people become parents, including adoptive parents, without the benefit of marriage. Now that marriage is not a legal precondition for having either sex or children, the state’s licensing role seems less important.
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As a matter of history, a primary reason for the official institution of marriage has been not to limit entry but to police exit—to make it difficult for people to abandon their commitments to one another. Of course, there are good reasons for this form of policing, which can operate as a nudge or as much more. Marriage might be seen, in part, as a solution to a self-control problem, in which people take steps to increase the likelihood that their relationship will endure. If divorce is difficult, then marriages are more likely to be stable. Marital stability is usually good for children (though children can also benefit from the end of a bad marriage). Marital stability can also be good for spouses, who may benefit from protection against impulsive or destructive decisions that are detrimental both to their relationships and to their long-term welfare.
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Why do courts block such deals? The answer is nonlibertarian paternalism, pure and simple. Courts appear to think that sensible patients would not waive their right to sue, and that doctors should not be treating patients without the threat of malpractice liability to deter negligent treatment. We are glad to acknowledge that patients are Human and may make bad decisions. But we wonder whether mandates and bans are sensible in this context—and whether freedom of contract, alongside a few nudges, might not be better.
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Fortunately, few of us are going to be treated negligently; and few of those who are will end up suing. If you can save something by waiving your right to sue, you might well elect to do that. The point is especially important for people without a lot of money. Since it is impossible to buy medical treatment without implicitly buying the right to sue, sick people who can afford treatment but not the package of treatment plus suit option will drop out of the market. So even if the risk of liability for negligence actually does reduce the frequency of injuries caused by doctors, these gains could easily be offset by the losses of those who are unable to afford treatment at all.6
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