The Economic Survey 2019 says that health insurance plans need to be simplified to make it easier for individuals to buy them. 

The survey says that there is asymmetrical information such as high variability of health care expenditures which often leads people to making health-related decisions which are not in their best interests. These harmful decisions range from not buying health insurance or engaging behaviour such as smoking and drug abuse. 

To change such behaviour, the Economic Survey has suggested the following seven behavioural tools. 

1. Leverage default rules 

• Giving individuals default flu shot appointment time can increase influenza vaccination rates.
• Providing smart insurance plan defaults can significantly simplify health insurance choice.

• Asking consumers the factors that are most important to them while choosing a health insurance plan and restricting the plan to these factors can make decision making easier and can in turn increase the number of people buying health insurance.
• Minor behavioural alterations in school and college canteen menus (giving interesting names to healthy options, putting them near the cash counter, making the process of buying unhealthy options more time taking) can increase uptake of nutritious food.

• Adolescents often overestimate how much alcohol or drugs their peers take making heavier consumption to be perceived as a socially desirable behaviour. Campaigns focusing on number of people who don't drink or take drugs may be more effective.
• Youth may be more responsive to a drug prevention program after the death of a celebrity from drug overdose.
• Giving out messages in information campaigns such as "90 per cent of doctors agree that vaccines are safe" can significantly reduce public concern about childhood vaccine, establish the social norm that vaccinations are safe and enhance vaccination.
• Presenting information on how many people in the neighbourhood have chosen to take up the health insurance plan and the benefits it has offered to families with similar disease in that area can increase enrolment rates.

• Disclosing to people about the realised benefits of hand-washing and, or family planning practices experienced by other people in their community, can enable them to take up these health practices.

• Sending messages to patients that asked the patient to write down the day and time they planned to get their next vaccination can boost uptake of vaccines.
• Doctors asking patients coming to hospitals for a signed pledge or a verbal commitment, preferably in the presence of someone the signee respects, called "accountability partner" to take up Yoga and walks can encourage such healthy lifestyle practices. A monthly appreciation (joint coupon rewards) for following the pledge, after being certified by the "accountability partner", can sustain such behaviour.
• Many people suffering from critical diseases do not take their medicines regularly. Use of simple text messages and pill bottles that light up if not opened at the right time can increase drug adherence. Delivering an appreciation certificate at the end of the month for following their prescription schedule can sustain adherence

• People often find it difficult to achieve goals like weight loss or ceasing to smoke. People voluntarily made to post bonds (deposit contracts) or lottery tickets on a website that will be returned to them if they achieve their goals, but are forfeited otherwise, can help them achieve these difficult goals.

• 7. Make messages match mental models
• Control of diarrhoea suffers from a flawed mental model: the perception that the solution is to decrease the child's fluid intake and to keep the child 'dry', implying less use of Oral Rehydration Solution. Information campaigns on adoption of ORS can overturn this flawed mental model.
• Message boards in public hospitals and medical advertisements on media must emphasize gains from smoke cessation and breastfeeding to foster preventive action. Similarly, messages for sexually transmitted diseases and breast cancer must focus on the loss to deter and encourage early diagnosis respectively.
• The Mother's Absolute Affection (MAA) Programme campaign leverages role of influencers (the relationship between mother-in-law and the daughter-in-law) and the idea of commitment devices ("Vaada" i.e., promise) to reinforce the idea of breastfeeding the child within one hour of birth. Cultural tailoring of health messages in this area can nudge them to adopt breastfeeding.

• The Economic Times
• 04/07/2019