Healthy Lifestyle 24/7

The Wall Street Journal had a fascinating, to me, article on A Simple Fix for Drunken Driving called Sobriety 24/7 now implemented in North and South Dakota, and Montana.

(DUI) Offenders in 24/7 Sobriety can drive all they want to, but they are under a court order not to drink. Every morning and evening, for an average of five months, they visit a police facility to take a breathalyzer test. Unlike most consequences imposed by the criminal justice system, the penalties for noncompliance are swift, certain and modest. Drinking results in mandatory arrest, with a night or two in jail as the typical penalty.
The benefits of the program aren’t just confined to road safety; counties using 24/7 Sobriety experienced not only a 12% drop in repeat drunken-driving arrests but also a 9% drop in domestic-violence arrests. Unlike interventions that only constrain drinking while driving, the removal of alcohol from an offender’s life also reduces the incidence of other alcohol-related crimes.
Why do repeat offenders change their behavior in response to relatively modest incentives? Patients continue using cocaine in the face of great harm to their families, livelihoods and physical health, yet they could still be induced to refrain from it when promised a small reward, like $10 for a negative urine test. The reward was relatively trivial, but it was unlike other potential consequences because it was both certain and immediate.
It turns out that people with drug and alcohol problems are just like the rest of us. Their behavior is affected much more by what is definitely going to happen today than by what might or might not happen far in the future, even if the potential future consequences are more serious.

Today we were talking to a big data company that can extract enormous amounts of information from your cell phone and make even more incredible inferences about your life style. How long will it be before your wearable will have a bluetooth connection to your phone to transmit all kinds of information on your biologic state? Certainly within two decades, possibly less. It will be able to monitor your body function and relate it to the unhealthy lifestyle choices you made in the last 24 hours.

At least half of our medical costs are the result of behavior that will not happen today and might or might not happen far in the future. Let’s assume that insurance costs $5,000 per person, probably not far off. Would you sign up for a policy that cost only $2,500 but required you to wear the monitor system and took $10 from your checking account and told you what you did the day before to warrant it any time you engaged in sufficiently unhealthy life style? It’s coming within years to auto insurance. I can’t imagine living in that world. That’s why it’s good we are mortal. One can only take a limited amount of change. And progress requires change.

Somewhere Mary Baker Eddy and BF Skinner are smiling.

27 thoughts on “Healthy Lifestyle 24/7”

  1. Who will decide which acts are ‘unhealthy’. We’re seeing a reversal in the cholesterol protocols where dietary sources are now OK. Will the app get a request to download the latest set of dietary guidelines, or, like Topsy, will they ‘just grow’? Will a lynch mob show up on my doorstep when they find out, and, oh by God, they will find out, that I had bacon wrapped pork sausage for breakfast?

    I cannot recall the quote, but it goes something like this…The ruler will at last leave you alone through neglect or forgetfulness, but the person out to save your soul, for your own good, will never leave you alone.

    A great many people in the Progressive ranks fall into the later category.

  2. George Orwell was right. “If you want a picture of the future, imagine a boot stamping on a human face — forever.”

  3. Today, in an example of good timing, I got a “Drive Safe” letter from my State Farm agent. When you get over 75, you get paranoid about stuff like this. I’ll ask her what it is about.

  4. It probably means you have a good driving record. The insurance company will offer to lower your premiums in exchange for the installation of their black box in your car. Some people will take that deal.

  5. Speed, acceleration, deceleration, and sharp turns. Too much of any of those indicates reckless driving.

  6. Will the app get a request to download the latest set of dietary guidelines, or, like Topsy, will they ‘just grow’?

    Sticking with cholesterol, the sensor will detect a rise in blood cholesterol. The app will then note that you burned less than 2,000 calories through exercise, were at a bar from 5-7, Ruth’s Chris from 8-11 and didn’t get home till 3 am. $10 dinged from your checking account. It won’t know you ordered the salad without dressing at Ruth’s Chris, but something made your cholesterol go up and those are the likely suspects.

    The life style choices that impact our health aren’t mysteries. Weight, exercise, diet, stress. The problem is we only pay for them after 60 years of abuse and neglect. We currently pay for it with escalating medical costs incurred decades after the behaviour that caused them. Accelerating the penalty into real time could reduce the long run cost. But at the cost of a loss of privacy. I wouldn’t accept the loss of privacy, but my children have.

  7. The endless, sometimes downright misleading or dishonest, preaching about how our lifestyle sins will shorten our lives has been accompanied by a pronounced lengthening of our lives. Odd that. Surely it can’t all be caused by people stopping smoking?

  8. I am conflicted with this. The Libertarian in me says “buzz off”. However I have seen (as have most) how awful substance addiction can be and how it crushes lives and turns creative, productive people into societal drags. And that part of me says if it works to help people, at least try. Not saying that there isn’t hard work that still needs to be done by addicts to get off of the substance, but if an easy kick in the pants works, great.

  9. “Surely it can’t all be caused by people stopping smoking?”

    Aside from vaccination, most of it probably is. The dietary rules are all wrong. When I wrote my medical history book 12 years ago, I looked to see what the literature said about Atkins’ diet. Nothing. Americans have been told for 50 years to cut down on protein and fat (Ruth’s Chris’) and eat more carbs. The result has been an epidemic of obesity and type II diabetes.

    Certainly TV has added the childhood obesity epidemic through the loss of exercise. There is also the “helicopter parent” factor which keeps kids at home instead of “free range.” I walked five blocks to kindergarten and crossed a busy street. After four days and rap on the knuckles by a nun with a ruler, I quit going. Next door to the school was a florist shop owned by friends of my father. I walked over to help the old uncle in the nursery. When I heard the school bell ring at noon, I walked home. My mother never knew until I told her 40 years later. I just went to the nursery every day instead of school, which was next door. I was saved from exposure (in more ways than one) when my father bought a house a mile away and we moved in November before the cold would have driven me indoors.

    I remember hitch hiking to the Museum of Science and Industry with friends at the age of 12. Later, we rode our bikes. We were the bane of the museum guards.

    My kids were outdoors all the time but it was California. It’s like 350 days of summer here.

  10. User data already finds its way out to the open market and gets used for other things not related to the initial purposes. They’re starting to use your big data trail instead of traditional credit history to ascertain creditworthiness. Your ‘social rating’ will be more important than your credit score, determining whether and where you can get into certain schools, you can start a business, buy a house, etc. This is understandable and generally accepted as the cost of using social media and e-commerce. However, when data gets collected and aggregated from using everyday possessions that we personally own, then the line is getting crossed. These things and their outputs belong to the owner, including their information. Any data about the owners’ use should be extracted only with just compensation to the owner, otherwise it’s stealing. There needs to be a clear determination of value of the data in order to set the amount and nature of compensation and eliminate any potential damage or misuse by data brokers. Tech startups that allow you to take control of your data and sell it yourself like Datacoup are a start, but we have a long way to go.

  11. Don’t forget penicillin. Most of the reduction in heart disease has been due to the virtual elimination of rheumatic fever by prompt treatment with antibiotics.

  12. Yes, antibiotics have been a huge boon to civilized countries. Pneumococcal pneumonia in Britain in WWII had a 26% mortality. Churchill had pneumonia in 1943 and his life was saved by sulfa drugs that had just been created. Penicillin was a year away.

    The other great medical advance was the drugs for high blood pressure. They did not appear until 1950 or so. I have a chapter on them in my medical history book. Roosevelt died of hypertension complications at the age of 63. Of course he also was a smoker. Churchill who smoked cigars lived into his 90s and was PM at an age well past the one that Roosevelt did not survive.

    The cholesterol hysteria came from autopsies on Korean War KIAs which showed coronary atherosclerosis in young men. Experiments on rabbits fed meat convinced the medical world that cholesterol was the reason and not smoking. We are finally starting to emerge from that mistaken belief. Global warming is not the first destructive hysteria by any means.

  13. The insurance companies will begin lobbying to have the black box made mandatory on all new vehicles.

  14. Pretty sure I posted about this earlier in the summer, but what the heck, this dead horse can take some more licks…we rented a car to go up to visit the grandkids in June. 2015 Buick, from Enterprise. Fine and dandy, no problems. We get into the old stomping grounds, and we’re cruising around slowly looking to and fro and what’s changed, what’s still there. Back road, rural stuff. We stop the car and get out. When I get back in and start it up, a message comes on the in-dash screen warning me “not to take my eyes off the road” We were quite taken aback. When I returned the car to Enterprise, I inquired about this. The clerk pretended not to hear my question. Also, the thing interacted with my wife’s IPhone, when she was using it during the trip. Her name came up on screen, and she was delighted that she could play music she had on the phone, on the cars stereo. Who knows what else was accessed and by whom?

  15. “The insurance companies will begin lobbying to have the black box made mandatory on all new vehicles.”
    Another good reason to stick to driving used vehicles. I’ve been getting letters from my insurance agent about this, too.
    The local utility company has been sending me letters for a couple of years now, about installing one of those “smart” thermostats in my house. I’m more than a little suspicious about what it will record and report to the utility company.

  16. I am down on Enterprise after being an enthusiast. I rented a car for my daughter to drive to South Carolina last March so she did not take her own and which was bigger, not an SUV, but would hold her clothes. I got a $4,000 bill from Enterprise. Outrageous. A thousand was a drop off fee. Anyway, I am done with Enterprise as none of this was disclosed.

  17. Yeah, Mrs. D – I suspect that peak load hours in South Texas are in the late afternoon in summer, when it gets to 100 degrees or thereabouts. Reduce or cut off electricity during those hours?
    No. Not only no, but hell-on-a-biscuit-no.
    This is the utility company – it’s their job to figure out how to meet peak need.

  18. The Southern California Edison was pushing very hard for “smart meters” before I sold my house. I’m renting now until the housing bubble in California pops and don’t know what they are doing now.

    Totally OT. How many know John Kerry’s daughter married an Iranian doctor and the son of the Iran nuclear talks negotiator was best man at the wedding. I don’t know if she converted to Islam.

    Kerry and Mohammad Javad Zarif have been friends for ten years.

    The country is in the best of hands.

  19. Sgt. Mom, You are correct about peak load but I’ll bet, even in Texas the utility company’s job is to figure out how to reduce demand not meet it.

    Mike K, Kerry or Caligula?

  20. Quote:Would you sign up for a policy that cost only $2,500 but required you to wear the monitor system and took $10 from your checking account

    I think that is a ‘backwards’ penalty rather than a ‘forward’ reward.

    I think that people who want to quit drugs would have a positive reinforcement every time they tested negative and were given a crisp new $10 or $20 bill. Bird in hand is worth twice a bird in the bush, more or less.
    A negative ‘kick’ after you have done something is not as reinforcing as the positive for good behavior.
    Most readers do not get a reward, documented and presented, for doing well in their driving and other habits. I realize their premiums somewhat reflect rewarding good behavior, but a separate and ‘above the premium’ type award might make people think more about what they do.
    Many people who have problems with drug abuse cannot, are unable, to think more than ‘right now’, even though they know the results of responding to the ‘right now’ need are indeed negative. Were they able to think beyond right now, they might be able to quit drugs more readily. An incentive, even if it is minimal, might make a difference. A punishment afterward is like promising prison for theft, IF CAUGHT, and they *know* they are not going to get caught… or they’d not do the crime. Each and every.
    If we were rational about prisons and crime, we would make available housing, perhaps convict built, at a per-person cost significantly less than confinement. Obviously needs more thought…

  21. Actually Mrs. Davis, Texas utilities still try to figure out how to meet the demand. They know rebellion would be the result of trying to curtail usage at 3 PM. Enviro-morons in air conditioned offices have been trying to get them to do serious demand restriction for years without true success.

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