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.