[00:00:00] Jordan Heath-Rawlings: For a moment last week, a whole bunch of Albertans who had done the right thing, had a chance to second guess themselves.
News Clip: We need everyone who’s on the fence or those who want to get a shot, but have just been putting it off for awhile, uh, to, to get their dose.
News Clip 2: Vaccinated Albertans now are eligible for three, $1 million draws the goal to have 70% of those eligible vaccinated this week. And if that happens, the real prize is a full reopening of the province.
Jordan Heath-Rawlings: Alberta’s government has joined a growing list of states and provinces and companies offering the chance of amazing life-changing prizes to lucky citizens who get vaccinated against COVID-19. Sometimes these vaccine lotteries are open to everyone. Who’s had a shot. Sometimes they’re only open to people who get their shot now, but that doesn’t really matter. What matters is that they appear to work. [00:01:00] They work well enough to make me someone who desperately sought out and took the first vaccine. I could get feel a little bit of FOMO, and that means there’s something weird going on here because I have no chance at winning a vaccine lottery. Like none, neither do you, even if you live in Alberta and even if you get your shot right now.
I mean, technically of course you have one single minuscule chance, but realistically you have none yet. After early experiments with guaranteed small rewards, you might remember these as a free beer or a baseball ticket for Americans who got vaccinated. Most states in America with vaccine, hesitant citizens have moved away from those and towards the big price. Why does that work better than say paying everybody who gets vaccinated a guaranteed 50 bucks, what’s happening in our heads that makes us get this calculation so wrong. And if governments continue to [00:02:00] see that a mere hint of a bundle of cash can alter our medical decisions, what could they manipulate us into doing next?
I’m Jordan Heath-Rawlings. This is The Big Story. Adam Rogers is a senior correspondent at WIRED, where he writes about science and miscellaneous geekery. And today he joins us to talk about vaccine lotteries. Hey Adam.
Adam Rogers: Hello there.
Jordan Heath-Rawlings: Why don’t you start by telling us because it’s, it’s such a neat idea that kind of showcases both sides of this. Tell us about what United Airlines is doing.
Adam Rogers: Yeah. This is a fascinating example and it’s especially interesting to me because it’s, it’s, uh, I’m not sure how to say this in the right way. It’s a non-state actor, right? It’s not a, it’s not a government, uh, using this approach.
Jordan Heath-Rawlings: Right.
Adam Rogers: So United Airlines out of a desire, both to encourage people to get vaccinated against COVID-19 and also a great deal of [00:03:00] self-interest after a lot of conversations internally, what they adopted was this idea that if anybody who flew and who signed up for. Mileage Plus, which is their frequent flyer loyalty program. You know, you get miles or points for every time you fly, um, and uploaded their vaccination card in the US you get a little card that says, like, you know, people sign the pharmacist, whoever signed says, yes, you got your shots.
Jordan Heath-Rawlings: Right.
Adam Rogers: Would be entered into a sweepstakes, a lottery. And the prize, there were a bunch of different prizes, but the big one, the grand prize was a year of travel for two. Anywhere that United flies, in United’s, like super first-class up in the front of the plane that nobody ever gets to see. Cause they close the curtain where there’s good food and. I dunno, really nice stuff. It’s really nice.
Jordan Heath-Rawlings: I wouldn’t know.
Adam Rogers: Yeah. I don’t know. I’ve only heard rumours, apparently. It’s pretty great. And so that, that became the inducement. What United wanted to do was say, yes, we want people to fly again. We want people to get vaccinated. We want people to fly United here’s the [00:04:00] reward that you might win these fabulous prizes. Now there’s a, that that might has like italics and is underlined because you’re not going to win.
Jordan Heath-Rawlings: Yeah.
Adam Rogers: Because nobody’s going to one, person’s going to win thousands of tens of a hundred thousand. However many are going to enter and in fact, they’ll be able to tell from their data, like, okay, we can look and see how many new people signed up for Mileage Plus, or how many new people flew with us and what were the dates on their vaccination card, which would be a way to tell, okay, did they get vaccinated after we announced that this was going. The prize, which will be a pretty good proxy to tell if somebody had actually gone out and done what they hoped. Got, wasn’t going to get vaccinated or hadn’t been vaccinated and then went out and got it. They haven’t seen whether that actually worked yet, but they certainly seem to feel like it would, if we’re having trouble getting people to get vaccinated.
We got that the first group of people who were highly motivated to get a vaccine, like I was like, you know, yes, put it into my arm. Let’s do it. Give me the shot, please. Right. And, and that group of people got their vaccinations as soon as they possibly could. [00:05:00] And they had access, they knew how to use the internet in the US so they could get signed up all that stuff. And then the people who were like anti-vaccine who were just like, no, I don’t believe it. It’s a 5G chip that turns you into a werewolf, it’s none of those things, but whatever, they’re not going to do it. You can’t convince them, but there’s people in the middle. And so how do you motivate them? If they’re not getting their shots?
I would have thought like, okay, you give them all 20 bucks, give them all 50 bucks, show up, get your vaccine. Here’s a $20. Here’s $50 bill. Here’s a gift card to a supermarket, whatever. But yeah. That’s not what the behavioural science, what the behavioural economics and what the research shows, what it shows is what the marketing people at United seem to understand. Um, and, and governments start starting to try to figure out too, which is that there are some group of people who will move off the dime with the, the barest possibility of a life-changing prize, much more so than if you guarantee them a $20 gift.
Jordan Heath-Rawlings: Well, and that’s the fascinating thing is how this has evolved, because I remember, uh, obviously in the United States, you guys were a couple of months ahead of us in terms of ramping up mass [00:06:00] vaccination. And one of the things I remember most from those. Is seeing a free beer. If you show us your vaccination card or for some of the baseball stadiums that we’re reopening, you know, a free ticket. If you come and get your vaccine before you see the game. And those were the kind of things that I was expecting to see whenever we got to the level that we’re approaching now in Canada, where, where we’ve done most of the easy pickings in terms of people who want it. But we actually haven’t seen that up here. What we’ve seen instead in the one province that’s done it is that typical. Vaccine lottery, uh, that some states and in your neck of the woods have been doing right. And, and what kind of results have we seen from that in the United States?
Adam Rogers: Not everybody has released data. So what, what data has come out. So the state of Ohio was the kind of the first place that did a big splashy. Lottery program. And they saw increases of like overall increases of close to [00:07:00] 50% and their vaccination rates in the first, like couple of weeks after the, um, they announced the lottery. Um, and that, that got all sort of confused because you had to say like, okay, well, which age groups was it? Because the, the, the, the minimum age also got lowered. So the teenagers all came in, um, as well. But even if you accounted for that, Ohio saw like a 28% increase or something like that.
California instituted a lottery as well, about half a dozen states. Maybe, maybe it’s more now instituted in California. The numbers for vaccinations kind of stabilized, I think, but they didn’t, they didn’t spike back up. You didn’t see like an N shaped curve. Um, which is what people were hoping where it like went up and then it went way down and then it would come up again. But I think it’s sort of stabilized. Um, what you do see is, uh, Another proxy measure for success that the Ohio folks talked about was they spent about, um, like five and a half million dollars US essentially on the program because it was like $5 million prizes initially. And then by half a million dollars in scholarships for the kids. And, [00:08:00] um, they, by their count. The equivalent $28 million of earned media, which is to say that they would have had to spend $28 million to get the same amount of airtime on a, on a CNN or an ABC as they got for free. I’m putting that in air quotes, wasn’t free.
I’ve said is they got just for doing kind of a splashy thing. And that makes a lot of sense because the, the point of the money, a lot of the money that the states are using for this came from the federal, from the federal government. To encourage people to get vaccinated. So how do you spend that money? This is a way to spend it on these lotteries and the economics of these giveaways are part of the reason that they’re appealing to the people, doing them. This is a different sort of behavioural economics than somebody like you or me who were like, well, should I go get vaccinated? Oh, there’s a lottery. I’ll go do it. The people who were putting them on, you know, they want, they get, it looks like they get more bang for the buck, essentially for like, oh, if we put on a lottery, we’re going to spend less than we would if we had given $50 to each person or as United chose not to do give them two thousand mileage points or however many mileage points to everybody because that has a cost for them.
Jordan Heath-Rawlings: Can you [00:09:00] explain maybe the economics of it before we get into the behavioural science. And I mean that, from the point of view of what a rational economist would think, if you were offering them a choice of taking 50 bucks, guaranteed, if you get your vaccine versus being entered into a million dollar lottery. I assume they would say that the $50 is what you should grab.
Adam Rogers: Yeah. The hyper rational economists that like a classic Chicago school economist thinks that you’re insane for going for a lottery. Right. They would say, well, look, here’s the difference. A crisp new $50 bill or a, a lottery ticket that is essentially not worth the paper it’s printed on because the, by the odds you’re not gonna win. So, you know, to them, it’s nuts.
Jordan Heath-Rawlings: But to behavioural economists.
Adam Rogers: Right. To a behavioural economist, they understand that human beings are. A little dumb and [00:10:00] they overvalue the possibility of a big win, um, because it’s fun because they get to dream about it. And because it’s entertaining and because they, they are bad at predicting the future. We are bad. I’m talking like I’m an AI or an alien, sorry, we are bad at predicting what the future is going to be. We tend to not think bad things are going to happen to us, and we tend to think good things are gonna happen to us. Um, so the, so the idea, this, the possibility of, um, Of a big win becomes more compelling.
Whereas, you know, the, and the converse of that is that if the, if we get told, uh, oh, come get a vaccination and you get a free beer or a baseball ticket or, uh, or $20 gift card or whatever, then we, we think that’s the value that somebody else has put a value on getting vaccinated. And so we don’t think of them. Of not getting sick and dying and not getting someone else sick who then might die and not putting it into a global pandemic that in the United States alone was hypothesized would cost in the end, $16 trillion. [00:11:00] All those things are abstract to us, but the right, but the concrete thing. Okay. Oh, this vaccination is worth the $20 gift certificate. And my time is worth more than that. And it’s hard for me to access a vaccine site and I don’t want to risk the possibility of two days of side-effects, which many the vaccines come with because I have finals coming up or because I have stuff to do because I don’t have childcare because I, I, you know, I don’t have a ride to a vaccination site.
All those things that, that make it difficult, not impossible, but difficult to get vaccinated, become the barrier. And now if it’s, if it’s only worth. If, if some government entities says it’s worth 50 bucks to us that it’s the, it’s the inverse of a, of a famous paper called A Fine is a Price where if you tell a person or a government, or if you tell a corporation, like if you pollute the oceans, it’ll, we’ll, we’ll find you $2 million. Then that corporation says, oh, now I know it costs me $2 million to cough toxic waste into the ocean. And so I’ll just price that into my product and then I can do it. And then [00:12:00] when the government says you put toxic waste into the ocean, I just give them the $2 million in all as well. It’s the cost of doing business.
So this is the inverse. So we say, oh, the cost of doing business is like, I get $20. That’s not worth it to me. I’m not going to go get vaccinated. But if the cost of doing businesses, a million dollar prize, like, oh, wow. Getting vaccinated is worth a million dollars suddenly in my head as a dopey human being.
Jordan Heath-Rawlings: How does that leap happen? And do we know why we value something, uh, that we have no chance to win that highly? To your point it seems really stupid.
Adam Rogers: I mean, it does and it doesn’t, I mean, we, we, we think that the good things are gonna happen to us and the bad things aren’t. It’s the reason that what an economist, sometimes calls, calls a nudge works and what some other, what other things, whatever behaviourists and, and, um, and some marketers and folks might call gamification slightly different. But the idea that if you turn something into a game where you can win or lose, and you can get points for doing something that, that encourages people to do stuff. [00:13:00] So for example, the person who was. Kind of the main, um, consultant on the Oregon vaccine lottery had come out of the world of finance, where he was a co-founder of a, of a bank, basically that, that gamified that gave people a rewards game-like rewards, even financial ones, just for like saving money. Or for getting a retirement account, um, because they found that they could increase by, by vast number of what, like, like by 50%, the number of people who would just, you know, have a bigger savings account. If they made that into a game, if they made it something you could win or lose.
That has some, some ethical and behavioural implications in itself. And there’s reasons to be very concerned about gamification and reasons to be concerned about nudge. Um, type, uh, policies like these vaccine lotteries, but like in the, from the behavioural economic side, there’s a, there’s a famous book called Nudge. There’s actually a new version of it. A revision coming out in August by a, um, a couple of behavioural economists, Richard Thaler and Cass [00:14:00] Sunstein. Sunstein is now an advisor in the Biden administration, Thaler’s a Nobel prize winning economist. And what they said is that you could make, you could make people do this is the ethical thing. Cause it’s weird to make people do stuff, but you can essentially induce people to do things that were policy net benefits, policy wins, population scale wins that they themselves might not be likely to do or even wins for themselves. They’re not likely to do by doing things like making the thing fun, making it easy, making it more possible to do. And the, and the fun part. It seems to be the critical thing about the lottery is that it’s so good. Enjoy gambling is enjoyable. You know, people don’t go to Las Vegas because they’re going to win.
You know, you sit down on a blackjack table, really fundamentally the economics. There are you sit down the blackjack table and lose for six hours because it’s fun to sit at a blackjack table for six hours.
Jordan Heath-Rawlings: I had it explained to me once that people don’t buy a lottery ticket to win the lottery, they are paying that money to dream about winning the lottery. And that is actually the value they get in return. And they value that at more than the two or three bucks it costs.
Adam Rogers: Yeah, exactly. I think that’s exactly right. And, and I could, I could be [00:15:00] even more. Neuropsychiatric least cynical about it and say, you’re paying for a little squirt of dopamine. You know, you go in and you pay your $3 and you get the little jolt of like, whew, this could be great. It’s like, you know, it was fun to scratch that off. Like, did I win? Nah. All right. Well, but I had, I had those moments and they, that, that fun is real. Uh, you know, it’s, it’s, I think it’s a mistake to dismiss the fun. It’s clearly a mistake here, because if you can move some subpopulation, there’s a lot of different just thinking about the vaccine thing.
There’s a lot of different reasons. People don’t get vaccinated. And if you can cross one or two of those off that list, that increases the number of people who get vaccinated. And that’s a net benefit for everybody. Cause even the anti-vaxxers in this case become free-riders, you know, who get the benefits of a larger population and the people who were vaccinated around them.
Jordan Heath-Rawlings: So here’s my, my logical followup to that. Okay. You know, let’s use the vaccines as an example, but just to state, these vaccines are incredibly safe. They’re incredibly efficacious. Everybody should get vaccinated. These vaccines work, however, it feels [00:16:00] kind of icky to have governments. Psychologically manipulating people into making a healthy choice. Do you know what I mean?
Adam Rogers: Yeah, no, that’s the, that’s one of the ethical concerns that I was alluding to a second ago. And as you say, these vaccines are extraordinarily safe and it’s really good to get vaccinated for a bunch of different reasons. There are very, very rare, very, very rare, but occasional outcomes that are bad. Um, there’s some association it’s not totally clear, which some people would think it’s clearer than other with like significant, severe side effects. Very, very rare. But that happens, which in a way is like a negative lottery weirdly, right? Is that you, you know, you, that’s probably, it’s almost certainly not going to happen to you, but some people it happened to and you, you know, you don’t want to hit that, that lottery.
So like, Is it ethical then to make someone or try to make someone do something they weren’t going to do. Otherwise, it’s a very good question and different, different, you know, that that becomes a cultural value. Of whether that’s, whether it’s okay to do that. And you, so you begin to weigh things like the public health benefit, the population benefit [00:17:00] versus the cost, the ethical cost and the potential risk to the individual. We make those calculations, especially with biomedical interventions, with drugs and surgeries and all that kind of stuff. We make those evaluations all the time, both as policy matters and also as individuals and as physicians.
Um, one way to potentially circumvent that. And I talked to some folks about this a little bit is that you, you, you might overweight the, make it easy side of the nudge instead of the, make it fun. Um, cause the, the make it fun begins to feel like, well, isn’t that a mandate in a way it’s a sneaky mandate and it’s like a, it’s a sub Rosa mandate. And what we’re trying to avoid here. In a way is just saying like, look, you’re not allowed in the building, unless you prove you got vaccinated, you’re not allowed on the airplane. Unless you prove you got vaccinated, you can’t come back to work. You can’t go to university.
Jordan Heath-Rawlings: That makes it a negative thing again.
Adam Rogers: Exactly. And, and certainly in the United States, there’s a whole set of politics that makes that untenable. People really a certain segment of people really freak out at that stuff. Even with public health, [00:18:00] I would say like another digressions. This is a little bit weird, but in, in, in the last 200 years, public health catastrophes, similar to the one that we were experiencing that we’ve been through the last year would lead to increases in the powers of public health to mandate people’s behaviour.
This time around, there are states in the US that are actually decreasing the powers, the legal powers of public health authorities in response to what’s happened with the pandemic, which strikes me as like that’s a really wild shift politically and culturally in response to a public health catastrophe.
So if you, if you instead choose the, make it easy side, if you just said, we’ll look instead of, um, vaccines being only available at certain sites, and you have to have, you know, a doctor, you can go to a pharmacy, you know, maybe like there should be. Um, vaccine vaccine stands, you know, pop-up vaccination centers at every supermarket at every mall at every school. Every school nurse should have access to this. If you can figure out the technology of preserving the vaccines, every, you know, make it so that you basically can’t go anywhere without someone walking up to you and saying like, Hey, you’ve vaccinated. You get, you [00:19:00] want a vaccine? I got it right here.
It has become clear. Um, in the US that it’s not the gross dichotomy of, um, I will take any medical intervention offered to me, to, you know, for whatever my values are either because I, uh, because I’m a communitarian or because I don’t, I’m scared of getting sick or because whatever, versus absolutely not, I don’t believe in vaccinations, you know, there’s a lot going on in the middle and there are different people in different groups in that middle, with different reasons. And so you want to try to figure out how to reach all of them in different ways.
Jordan Heath-Rawlings: Here’s the last thing I want to ask you, because this is really the question that I keep coming back to in the days since Alberta announced their vaccine lottery. And you know, it certainly seems like this has been catching on and to your point is effective, does it stop with vaccine lotteries? Like why, what is preventing and why wouldn’t governments do this say in certain places where they know that there are a lot of votes for their party as we [00:20:00] head into an election, or even just for voting in general or any sort of like bribing people to behave like good citizens with the chance that a prize? Like this could set a real precedent, no?
Adam Rogers: Yeah. I think that’s absolutely right. Why not lotterize everything. Yeah. You know, um, I want to see data first. This is a fascinating natural experiment. If you can actually correlate, increases in vaccine uptake with this kind of lottery move, then yeah. You could start to imagine this. And in fact, the whole, the nudge philosophy behind behavioural economics and, and policymaking, I don’t think they have it anymore, but the yeah, United King- England had a nudge unit, had a whole, like a policy unit set up to try to encourage these sorts of policy net benefit behaviours from people. Um, so you can imagine what sorts of things could you put a lottery behind? You could say like, okay, if you, um, you like voting is a good one, I guess like everybody who actually votes you can’t reward people for voting. Oh, this is one of the reasons it’s hard to test by the way, is that if you tell people, we’ll give you a hundred [00:21:00] dollars. If you, um, come in and get a flu vaccination, or we’ll put into you into a lottery, there’s some question about whether that’s an ethical trial, like, even testing it is, is might not be ethical because technically giving people money to participate in a clinical trial is also itself unethical.
So it’s even hard to test this stuff, but now there’s an actual experiment. Let’s see if the states who had vaccine lotteries or the provinces that had vaccine lotteries have more vaccination uptake than the places that don’t. And then if you know it works, then yeah. You know, how about like, uh, everybody who, um, you know, rides the bus is entered into, I don’t know how you’d keep track of it or everybody who-
Jordan Heath-Rawlings: Get a bike license and be entered into a lottery.
Adam Rogers: Yeah. Bike license, any of that stuff, you know, that you want individuals to do? Like if it works. Maybe.
Jordan Heath-Rawlings: I look forward to my future of being psychologically manipulated by governments more so than I already am, I’m sure.
[00:22:00] Adam Rogers: Well, and that’s the thing is how much, you know, you already, there’s some there’s distrust in how governments operate and work with us as it is. Do you want to encourage that there’s a policy-making cost here? You know, how much do you want to be perceived as being tricksy versus, um, you know, being transparent with the people who you’re governing.
Jordan Heath-Rawlings: Thanks so much, Adam, for this it’s fascinating article and really appreciate you taking the time.
Adam Rogers: Oh, it’s my pleasure. Thanks for having me.
Jordan Heath-Rawlings: Adam Rogers, senior correspondent at Wired. That was The Big Story for more from us head to thebigstorypodcast.ca. Find us on Twitter at @TheBigStoryFPN. Tell all your friends that you can listen to us every day and any podcast player you want. Our episodes drop at 4:00 AM eastern time, perfect for early risers. You can also email us, firstname.lastname@example.org. Please do. We would love to hear from you.
I’m Jordan Heath-Rawlings, thanks for listening. We’ll talk tomorrow. [00:23:00]
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