Reading today’s paper on the subway to work this morning I learned about a clever new way to cut health-care costs: pay people to take their medication.
In a Philadelphia program people prescribed warfarin, an anti-blood-clot medication, can win $10 or $100 each day they take the drug — a kind of lottery using a computerized pillbox to record if they took the medicine and whether they won that day.
Before the program, Chiquita Parker, a 25-year-old single mother with lupus, too ill to continue her job with special needs children, repeatedly made medication mistakes, although she knows she depends on warfarin to prevent clots than can cause strokes, paralysis, or death.
“I would forget to take it,” and feel “like I couldn’t breathe,” she said. Or she would “take two in a day,” and develop bruises from uncontrolled internal bleeding.
But in the six-month lottery program, she pocketed about $300. “You got something for taking it,” Ms. Parker said. Suddenly, she said, “I was taking it regularly, I was doing so good.”
Suddenly, she was taking it regularly! Turns out she’s a capable woman after all; all she needed was a little “incentivizing”. Of course, she already had a few incentives that might done the trick for some of us: inability to breathe, internal bleeding, and the imminent prospect of “strokes, paralysis, or death”.
Vague abstractions all, I guess. Nothing focuses the mind like cash.
You know, come to think of it, I’ve got some pills I’m supposed to take tomorrow morning, too. Somebody make me an offer.