NYT Op-Ed: Obama’s Audience Speaks First

In yesterday’s New York Times, in advance of President Obama’s health care reform speech to Congress, Anna Deavere Smith compiles interviews about health that she conducted in preparation for a play. She spoke with Peter Orszag, the director of the White House Office of Management and Budget, who spoke about a public health success story:

A key question is how do we move towards a different norm both for providers and for beneficiaries so that when you go to the doctor you’re not just asking for more of everything, if that’s not going to make you better. It’s not just incentives. Norms sound fuzzy, but I think they’re crucial.

How do you adjust norms? … Take seat belts versus speeding. You get a ticket if you don’t use your seat belt or if you’re speeding, and so the pure Econ 101 approach would suggest the penalty for not obeying is similar, and yet adherence to seat belt laws seems much higher, in part because at least for those in the front seat, the norm has changed. When you get in a car, if there’s a passenger in a car, you sort of, at least I do, I kind of look over if a passenger in the front seat doesn’t put on their seat belt. You don’t quite do the same thing if you are in the front seat and the driver is speeding.

And how does that develop? There was a concerted effort to try to encourage seat belt use. So similarly [in health care] part of what needs to happen is not just public policy … but an emphasis on healthy living, and helping people do what they say they want to do, which is eat better and exercise more and be healthier. That’s going to be gradual evolution too, but the norm setting I think is important.

Read the entire story on The New York Times’ Web site.

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