We have described a lot of nudges, but we are confident that there are countless others. Here are a dozen more—mininudges, if you will.
Readers are warmly encouraged to add to the list by sending them to ourWeb site: www.Nudges.org.
1. Give More Tomorrow. Many people have strong charitable impulses, and we suspect that because of inertia they give far less than they actuallywant to give. Their Reflective System wants to be charitable, but their Au-tomatic System doesn’t get around to it. How many times have youthought that you ought to provide some help but failed to do so becausethe moment passed and you focused on other things? A simple nudge would be a Give More Tomorrow program. The basic idea, modeled on Save More Tomorrow, is to ask people whether theywould like to give a small amount to their favorite charities starting some-time soon, then commit to increasing their donations every year. (It wouldprobably be impractical to link the increases to pay increases.) If people de-cided to opt out of Give More Tomorrow, they need only make a quickphone call or send a brief email at any time. We suspect that many peoplewould gladly join such a program.
Anna Breman (2006) has conducted a pilot experiment using this idea in collaboration with a large charity. Donors already making monthly do-nations were asked to increase their donations either immediately orstarting in two months. The latter group increased their donations by 32percent. We are involved with some additional experiments in collabora- tion with our own university, and the initial results look promising. If thegoal is to increase charitable giving, here’s an easy way to do it. In fact itwould not be at all surprising if the Give More Tomorrow program pro-duced far more money for those who need it—while also pleasing thewell-meaning but absentminded donors who want to give but never getaround to it.
2. The Charity Debit Card and tax deductions. A related nudge would make it easier for people to deduct their charitable contributions. Keepingtrack of donations and listing them on a tax return is burdensome for someHumans, who end up donating less than they would if the tax savings wereautomatic. An obvious solution is the Charity Debit Card—a special debitcard that would be issued by banks and accepted only by charities. Withthe Charity Debit Card, any charitable donations are deducted from yournormal account, and your bank sends you a statement at the end of theyear with your donations itemized and totaled. You could also use the cardto keep a record of when you donate nonmonetary items like furniture orcars, ensuring that your bank would know the value of what you donatedand add it to your end-of-year statement. The statement could even besent straight to the irs so that the government could automatically processthe appropriate deduction for you. By making donations salient, such acard could make charity simpler and more attractive.
3. The Automatic Tax Return. Speaking of taxes and automatic process- ing, no sensible choice architect would design the current income tax sys-tem, which is famous for its complexity. Withholding was a major advancethat simplified life for everyone. Ordinary people and the Internal Rev-enue Service would benefit even more if the process could be made moreautomatic. A simple step, suggested by the economist Austan Goolsbee(2006), is the Automatic Tax Return. Under this approach, anyone whodoes not itemize deductions and has no income (such as tips) that is notreported to the irs would receive a tax return that is already filled out. Tofile, the taxpayer would need only to sign it and mail it (or, even better, goto a secure irs Web site, sign in and click). (Of course, the taxpayer wouldbe required to make changes if her status changed, or if she started receiv-ing unreported income.) Goolsbee estimates that this proposal would save taxpayers up to 225 million hours of tax preparation time and more than $2 billion a year in tax preparation fees. True, many people don’t trust the irs, so here’s one wayto assure them that our tax collectors are honest: if there’s an error, you getthe money back, plus a bonus (say, $100).
4. Stickk.com. Many people need help in achieving their goals and aspi- rations. Committing oneself to a specific action is one way to improve theodds of success. Sometimes it is easy to make a commitment, as, for exam-ple, by cutting up your credit cards, refusing to stock your kitchen withbrownies and cashews, or having your significant other hide the TV re-mote until those leaves get raked. Other times it is hard. Remember theweight-loss bet we described between two graduate students in Chapter 2?Well, one of them, Dean Karlan, now a Yale economics professor, hasteamed up with his Yale colleague Ian Ayres to propose a Web-basedbusiness based on the same concept. Ayres and Karlan call the businessStickk.com.1 Stickk offers two ways to make commitments: financial and nonfinan- cial. With financial commitments, an individual puts up money and agreesto accomplish a goal by a certain date. He also specifies how to verify thathe has met his goal. For example, he might agree to a weigh-in at a doc-tor’s office or a friend’s house; a urine test for nicotine at a clinic; or anhonor-system verification. If the person reaches his goal, he gets his moneyback. If he fails, the money goes to charity. He also has the option to enterinto a group financial commitment, in which the group’s pooled money isdivided among those members of the group who reach their goals. (Atougher, more mischievous, and perhaps even more effective option is togive the money to people the would-be committer hates, such as an op-posing political party, or the fan club of the home team’s arch-rival—thinkYankees and Red Sox.) The nonfinancial commitments include peer pres-sure (emails to family or friends announcing your successes or failures) andmonitoring one’s own goal via a group blog.
A committer’s goal might be to lose weight, quit smoking, exercise more frequently, improve grades, or the like. There is even a creative sec-tion for people with idiosyncratic goals: climb Mount Kilimanjaro whilethere is still ice at the summit (verification by photograph), travel to Mon-golia (verification by passport stamp), learn to juggle seven oranges and awatermelon (verification by video), run a marathon, save more money(less creative, to be sure), use less gas and electricity (not so creative but admirable), or whatever self-improvement people can conjure up and poston the Web site.
5. Quit smoking without a patch. Organizations already exist to help people make commitments and achieve goals. Cares (Committed Actionto Reduce and End Smoking) is a savings program offered by the GreenBank of Caraga in Mindanao, Philippines. A would-be nonsmoker opensan account with a minimum balance of one dollar. For six months, she de-posits the amount of money she would otherwise spend on cigarettes intothe account. (In some cases, a representative of the bank visits every weekto collect the deposits.) After six months, the client takes a urine test toconfirm that she has not smoked recently. If she passes the test, she gets hermoney back. If she fails the test, the account is closed and the money is do-nated 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 makesthose who want to quit 53 percent more likely to achieve their goal.2 Noother antismoking tactic, not even the nicotine patch, appears to havebeen so successful.
6. Motorcycle helmets. Many states ban people from riding motorcycles without helmets. To libertarians, these bans are questionable. They ask: Ifpeople want to take risks, shouldn’t they be allowed to do so? To date, anintense debate has separated the hardcore paternalists, who emphasize thedangers and support bans, from the fans of laissez-faire, who insist that thegovernment should let people do what they want. The columnist JohnTierney (2006) has suggested a nudge-like way that states might promotesafety while maintaining freedom. The basic idea is that riders who do notwant to use the helmet have to get special licenses. To qualify for the li-cense, a rider would have to take an extra driving course and submit proofof health insurance.* Tierney’s approach imposes some costs on those who want to feel the wind in their hair; an extra driving course and proof of insurance are not *One reader of Tierney’s column suggested in a letter to the editor that a rider with this special license should also have to display a decal certifying that he has signed up tobe an organ donor.
exactly trivial. But requirements of this kind are less intrusive than a ban—and might do a lot of good to boot.
7. Gambling self-bans. Gambling raises complex issues, to say the least, and we will not explore in any detail what a libertarian paternalist might doin this area. (Suffice it to say that if we were in charge, we would not givestate governments a monopoly on gambling—especially if they choose tospecialize in gambles that offer the worst odds for customers, namely statelotteries, which pay off roughly fifty cents on the dollar. Hint: if you wantto gamble with decent odds, start a football pool with your friends.) How-ever, it is clear that gambling addicts are among us, and they need realhelp.
Here’s an ingenious solution. Over the past decade, several states, in- cluding Illinois, Indiana, and Missouri, have enacted laws enabling gam-bling addicts to put themselves on a list that bans them from entering casi-nos or collecting gambling winnings. The underlying thought is thatsomeone who has self-control problems is aware of her shortcomings andwants to put her Reflective System in control of her Automatic System.
Sometimes recreational gamblers can do this on their own or with theirfriends; sometimes private institutions can help them. But addicted gam-blers might do best if they have a way to enlist the support of the state. Wethink that self-bans are a great idea and suggest that research be done toexplore ways to use this concept in other domains.
8. Destiny Health Plan. Insurance companies don’t like paying large medical bills any more than patients do. There is room for some creativeefforts on the part of such companies to work with their customers to im-prove people’s health while reducing medical bills for all. Consider herethe Destiny Health Plan now offered in four states (Illinois, Wisconsin,Michigan, and Colorado). The plan features a Health Vitality Program ex-plicitly designed to give people an incentive to make healthy choices. Aparticipant is able to earn “Vitality Bucks” if he works out at a health clubin a particular week, has a child join a soccer league, or completes a blood-pressure check with normal results. Vitality Bucks can be used to obtainairline tickets, hotel rooms, magazine subscriptions, and electronics. TheDestiny Health Plan is a clever effort to combine health insurance withnudges designed to get people to live healthier lives.
9. Dollar a day. Teenage pregnancy is a serious problem for many girls, and those who have one child, at (say) eighteen, often become pregnantagain within a year or two. Several cities, including Greensboro, NorthCarolina, have experimented with a “dollar a day” program, by whichteenage girls with a baby receive a dollar for each day in which they are notpregnant.3 Thus far the results have been extremely promising. A dollar aday is a trivial cost to the city, even for a year or two, so the plan’s total costis extremely low, but the small recurring payment is salient enough to en-courage teenage mothers to take steps to avoid getting pregnant again.
And because taxpayers end up paying a significant amount for many chil-dren 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 re-duce teenage pregnancies. (Surely there are more such programs to be in-vented. Consider that a nudge to think of one.) 10. Filters for air conditioners; the helpful red light. In hot weather, peo- ple depend on air conditioners, and many central air-conditioning systemsneed their filters changed regularly. If the filter isn’t changed, bad thingscan happen; for example, the system can freeze and break down. Unfor-tunately, it is not easy to remember when to change the filter, and not surprisingly, many people are left with huge repair bills. The solution issimple: people should be informed via a red light in a relevant and con-spicuous place that the filter needs to be changed. Many contemporarycars notify people when the oil needs to be changed, and many new refrig-erators have a warning light for their built-in water filters. The same can bedone with air conditioners.
11. No-bite nail polish and Disulfiram. People who hope to change cer- tain bad habits might want to buy products that make it unpleasant, orpainful, to continue to indulge those habits. Through this route, theReflective System can choose to discipline the Automatic System throughproducts that tell the Automatic System: Stop! Several products now accomplish exactly this task. Those who want to stop biting their nails can buy bitter nail polishes such as Mavala and OrlyNo Bite. A more extreme version of this concept is Disulfiram (antabuse),which is given to some alcoholics. Disulfiram causes alcohol drinkers tothrow up and suffer a hangover as soon as they start to drink. For some people suffering from chronic alcoholism, Disulfiram has had a strong andpositive effect as part of a treatment program.
12. The Civility Check. We have saved our favorite proposal for last. The modern world suffers from insufficient civility. Every hour of every day,people send angry emails they soon regret, cursing people they barelyknow (or even worse, their friends and loved ones). A few of us havelearned a simple rule: don’t send an angry email in the heat of the moment.
File it, and wait a day before you send it. (In fact, the next day you mayhave calmed down so much that you forget even to look at it. So much thebetter.) But many people either haven’t learned the rule or don’t alwaysfollow it. Technology could easily help. In fact, we have no doubt thattechnologically savvy types could design a helpful program by next month.
We propose a Civility Check that can accurately tell whether the email you’re about to send is angry and caution you, “warning: this appears to be an uncivil email. do you really and truly want to send it?” (Software already exists to detect foul language. What we are proposing ismore subtle, because it is easy to send a really awful email message thatdoes not contain any four-letter words.) A stronger version, which peoplecould choose or which might be the default, would say, “warning: this appears to be an uncivil email. this will not be sent unless you ask to resend in twenty-four hours.” With the stronger version, you might be able to bypass the delay with some work (by inputting, say, yourSocial Security number and your grandfather’s birth date, or maybe bysolving some irritating math problem!).* The Reflective System can be nicer as well as smarter than the Automatic System. Sometimes it’s even smart to be nice. We think that Humanswould be better off if they gave a boost to what Abraham Lincoln called“the better angels of our nature.” *While we are waiting for this program to be invented, we have adopted a self-con- trol device of our own as a substitute. When one of us gets really angry, he drafts the an-gry email, and sends it to the other one to edit. Of course, this won’t work if we get an-gry with each other, so we are hoping the program gets invented soon.

Source: http://nudges.files.wordpress.com/2008/04/our-dozen-nudges1.pdf

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CURRICULUM VITAE General information : Name: Ali Last Name : Taghizadieh Address: Emergency Department, Tabriz University of Medical Sciences, Daneshgah Street, Imam Reza Hospital , I.R IRAN. Phone: +984113330066 Fax: +984113352078 Cell phone:+989144126103 Email: [email protected] Date of Birth: 7/4/1971 Place of Birth: Tabriz-Iran Marital Status: Married Citizenship:


Global Health Care Declaration Physical inactivity is the biggest global public health problem of the 21st century. “Physical inactivity is the fourth leading risk factor for all global deaths, with 31% of the world’s population not physically active,” according to the World Health Organization (2010). A 2009 study that directly measured physical activity levels rather than relying on

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