A nudge for long-term care insurance

Included in the new health care legislation winding its way through Congress is a proposed government-run long-term care insurance program in which participating companies would automatically enroll their eligible employees. These employees would have the option to opt-out.

Long-term care insurance helps pay for nursing home care or other bills of aging people who need living and medical assistance. With most people saving too little for retirement, they are failing to budget enough for these twilight years expenses.

“No one thinks they need long-term care until two years after they need it,” says Richard Thaler, the other co-author of “Nudge.” ”The theme of our book is we should try to help people make decisions without telling them what they have to do.”

Facebook is the marshmallow for these teenagers

That’s psychologist Walter Mischel, originator of the famous marshmallow experiment on self-control, describing the addictive properties of Facebook for today’s adolescents. To resist the temptation, some have devised creative commitment strategies.

After several failed efforts at self-regulation, Neeka Salmasi, 15, a sophomore at Greenhills School in Ann Arbor, Mich., finally asked her sister, Negin, 25, to change her Facebook password every Sunday night and give it back to her the following Friday night.

Full story in NYT.

Richard Thaler on breast cancer screening recommendations

In his latest Economic View column, Richard Thaler uses a bit of probability theory to explain why the recent federal recommendation on delaying breast cancer screenings until age 50 is not such a terrible policy prescription.

Here is a quiz: Suppose that there is a one-in-1,000 chance that a woman in her 40s with no symptoms has breast cancer, and that 90 percent of the time a mammogram correctly classifies women as having cancer or not. If a woman in this group tests positive on her mammogram, what is the chance that she has cancer? The answer is not 90 percent. It is less than 1 percent, because of the large number of false positive results.

Thankfully, breast cancer is rare enough in this age group that a vast majority of positive hits are false positives. Do patients understand this while they are waiting for the results of the subsequent tests?

Full column is here.

Guys like to aim. Why at flies?

NPR reports on the fly-in-the-urinal phenomenon. Why flies?

Keiboom in Amsterdam says the original fly idea was proposed almost 20 years ago by Dutch maintenance man Jos Van Bedoff, who had served in the Dutch army in the 1960s. As a soldier he noticed that someone had put small, discrete red dots in the barracks urinals, which dramatically cut back on “misdirected flow.”

Two decades later, he proposed to the airport board of directors that the dots be turned into etched flies. According to Keiboom, Van Bedoff decided that guys want to directly aim at an animal they can immobilize. The ability to use one’s natural gifts and achieve victory over the foe while standing is the key, he explained. Guys, he felt, can always beat flies. That’s why flies are so satisfying.

Is that the answer?

Berenbaum, the entomologist, says she’s not convinced. More than a hundred years ago in Britain, bathroom bowls also sported insect images, she says. Back then, however, the favored target was not a fly, but a bee. And bees have stingers. It seems that men in the 1890s were willing to take more imaginative risks when peeing.

“Fly guy” Doug Kempel sells both flies and bulls eye targets, and says the flies are more popular.

Data driven CT scans

Nowhere are good nudges more needed than in medicine. Reader Chris Crittenden digs up a great one about CT scans, the x-rays that give doctors a nice three-dimensional picture of a patients’ organs or tissues. The risk with CT scans – also known as CAT scans – comes from the radiation doses they emit into patients’ bodies. Health experts warn that the repeated use of scans, which are intended to detect diseases, will actually end up causing thousands of new cancers. Until lower radiation emitting machines are developed, doctors will need to order them intelligently.

Dr. James Thrall, chairman of the American College of Radiology, agrees. He says at his institution, the Massachusetts General Hospital, doctors who order a CT scan or other imaging study must list the reason. A computer program feeds back an ”appropriateness score.” A low score indicates the test is unlikely to be necessary.

”Our experience over the last five years has been rather phenomenal,” Thrall says. Instead of an annual growth rate of 12 percent in CT scans, it’s now about 1 percent, lower than the hospital’s annual growth in patient load. ”That means we’re doing fewer scans per person,” he says.

To cut down on unnecessarily high radiation doses, Thrall says, the College of Radiology is also developing an ”alarm” system that will alert hospitals when their CT scan exceeds an acceptable dose. That will require hospitals to feed dose data to a central computer run by the radiology group.

Full story is here.

Design your own study environment

Reader and business school student Brendan Baker is in the middle of finals and has been trying to create an environment that’s likely to bring him good grades. No doubt, Brendan’s perfect learning environment is different from yours or anyone else’s, but for Brendan it means

1) Color-coded spreadsheets that give him satisfaction when he completes tasks.
2) Healthy snacks within arms reach.
3) Rotating study locations.
4) Looping a nine song soundtrack in the background.
5) Putting his facebook group in the second spot on his browser toolbar.

The last two are a bit puzzling. Care to explain Brendan?

Nudges in action

1) Vail Resorts, partnering with the National Forest Foundation, adds $1 to each Vail Resorts season pass or overnight stay at a Vail Resorts property, which guests can ask to have deducted from their total. (Hat tip: Brandon Hough)

2) Whole Foods has a similar donation program called One Dime at a Time where customers can have the 10 cent refund they receive for each renewable bag be given to a local charity. Unlike the more popular opt-in programs, One Dime at a Time operates along a mandated choice paradigm where customers are asked if they’d like to donate their refund to charity. Of course, the social pressure that comes with publicly asking a customer if she would like to keep or give $0.30 on her $50 grocery bill to a local and worthy cause probably plays a role in encouraging donations.

3) Target turns the self-service checkout register into a game in order to encourage faster scanning by its customers. (Hat tip: Inge Kuijper)

4) In order to see the top free apps at Apple’s App Store, you have to see the top paid apps too.

5) The Australian mobile phone company Optus charges customers who want paper bills and doesn’t provide a direct link to the electronic bill in the monthly billing email it sends customers. Instead, customers have to navigate through a series of ads promoting Optus services to reach their bill. (Hat tips for 4 and 5: Jeromy Anglim)

Menu design tricks to get you to spend more, part II

In a must read for foodies, New York Magazine points out eight menu design tricks in its current issue. Many of the tips aren’t new (see here), but it’s worth reminding diners to beware of the extravagant item. Not because diners will buy it, but because they’ll buy something next to it.

2. The Anchor
The main role of that $115 platter—the only three-digit thing on the menu—is to make everything else near it look like a relative bargain, Poundstone says.

3. Right Next Door
At a mere $70, the smaller seafood platter next to Le Balthazar seems like a deal, though there’s no sense of how much food you’re getting. It’s an indefinite comparison that also feels like an indulgence—a win-win for the restaurant.

4. In The Vicinity
The restaurant’s high-profit dishes tend to cluster near the anchor. Here, it’s more seafood at prices that seem comparatively modest.

Hat tip: Daniel Lee

Break the email addiction. For an hour, at least.

Is email snuffing out your productivity? Facebook? Twitter? You might consider this Mac application called SelfControl that blocks access to all three accounts (or just one) for a predetermined block of time of time. You can still surf the web though, since you might need that for some actual research. Most importantly, once you run the program, you can’t stop it – even by restarting your computer or deleting the application!

Hat tip: Magdalena Kala

Addendum: A new year’s resolution featuring SelfControl.