Another fiscal thought and an observation.
Is the UK Treasury using tax breaks and credits in a health promoting way.
as well as taxing as a disincentive/sanction?
Also I remember Clark justifying >inflation tax on tobacco on health
grounds, and later rejecting any increase in taxation to try to discourage
criminal smuggling. Subsequent chancellors returned his earlier policy.
Mike
----- Original Message -----
From: "John Appleby" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, June 20, 2005 10:03 AM
Subject: Re: incentives and sanctions to promote healthy behaviour
Karen
Of course, in the UK successive chancellors (since Kenneth Clark) have
justified higher than inflation increases in taxes/duties on tobacco on
health grounds. Also, as far as I am aware, French primary schools wont
let children attend unless they have had their requiste vaccinations.
This might be the case in some other euro countries. I have also heard
that in the Netherlands (I think - could be Germany) (social) insurance
organisations started or are thinking of offering a discount on premiums
for keeping visits to GPs low...hard to see how any government could
justify restricting access to health care services on the basis of
non-compliance with some public health direction.
john
-----Original Message-----
From: The Health Equity Network (HEN)
[mailto:[log in to unmask]] On Behalf Of Thompson,
Kenneth
Sent: 19 June 2005 18:23
To: [log in to unmask]
Subject: Re: incentives and sanctions to promote healthy behaviour
hi all,
assuming the eventual demise of the health insurance industry in favor
of a single payer here in the us..(we can dream)... is it wrong for
government to use monetary or other incentives to discourage risky
health behaviors?
at the same time, what to make of the repeal of helmet laws for
motorcycles here in the States? one would think that insurance costs
would have climbed for motorcycle riders, but if so, there is no
evidence that it has discouraged riders from leaving their helmets
behind..
ken
-----Original Message-----
From: The Health Equity Network (HEN) on behalf of Alex Scott-Samuel
Sent: Sun 6/19/2005 12:01 PM
To: [log in to unmask]
Subject: Re: incentives and sanctions to promote healthy behaviour
it would be interesting to know what you discover Karen.
This kind of idea is - as you imply - inequitable and morally
questionable. I do seem to recall that some immunisations are required
before children can attend school in some parts of the US
Best wishes, Alex
Karen Jochelson wrote:
> I am hoping someone on the network may be able to point > me in the
right direction for a scoping project I am > working on. Insurance
companies already penalise some > behaviours with higher premiums and
reward healthier > behaviour with lower ones. I am interested in
whether any > governments are thinking or actually doing something >
along these lines ie using incentives or sanctions to > 'encourage'
people to adopt healthier behaviours, > especially those in lower
socio-economic groups. The > incentives could be financial eg an extra
benefit payment > for breastfeeding, or vouchers to attractive events
and > the sanctions similarly financial, or restricting access > to
healthcare or welfare services.
>
> On the sanctions side I thought the US might be a good > place to
look: are there any efforts to tie social > security to health
behaviour. I have heard of states > getting payments to reduce births
outside marriage and > that teenage mothers were getting squeezed out
of cash > welfare payments. I also wondered whether there were >
sanctions around smoking or drinking during pregnancy. Is > there a US
social security/health expert on the network > whose brains I could
pick?
>
> Are there any incentives/sanctions schemes anyone is > aware of in
Europe?
>
> I am aware that some of this may be morally and ethically >
problematic - for the moment though, I am trying to find > out if any
schemes operate.
>
> Any leads are gratefully accepted!
>
> Dr Karen Jochelson Research Fellow in Health Policy - > Public
Health The King's Fund 11-13 Cavendish Square > London W1G 0AN > >
Tel: 020 7307 2663 Email: [log in to unmask] >
<mailto:[log in to unmask]> Web:
> www.kingsfund.org.uk <http://www.kingsfund.org.uk/> > > > Dr Karen
Jochelson Research Fellow in Health Policy - > Public Health The King's
Fund 11-13 Cavendish Square > London W1G 0AN > > Tel: 020 7307 2663
Email: [log in to unmask] > Web: www.kingsfund.org.uk
<http://www.kingsfund.org.uk/> >
******************************************************************
Alex Scott-Samuel
EQUAL (Equity in Health Research and Development Unit) Division of
Public Health University of Liverpool Whelan Building Quadrangle
Liverpool
L69 3GB
Tel (+44)151-794-5569
Fax (+44)151-794-5588
http://pcwww.liv.ac.uk/~alexss
e-mail [log in to unmask]
******************************************************************
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