On 15 March 2019, the ‘Organ Donation (Deemed Consent) Bill’ was passed into law. (See the blog, Organ donations – Changing the default option vs active choice.) The government has just announced that this will come into force on 20 May this year. Under the scheme, ‘adults in England will be considered potential donors unless they chose to opt out or are excluded. The act is known as Max and Keira’s law in honour of a boy who received a heart transplant and the girl who donated it.’
This change from an ‘opt-in’ to an ‘opt-out’ system follows a similar a move in Wales in 2015. Since then, Wales has seen a significant increase in potential donors, with the consent rate rising from 58% to 77%. A similar move in Scotland will come into force in the autumn of this year. The government expects there to be an additional 700 transplant operations per year available for transplant by 2023.
These moves from an opt-in to an opt-out system are consistent with ‘nudge theory’. This maintains that positive reinforcement or making a decision easy for people can persuade them to make a particular choice. They are ‘nudged’ into so doing.
Opting out and nudge theory
In the case of having to opt in to a scheme such as organ donation, people have to make the decision to take part. Many, as a result, do not, partly because they never seem to find the time to do so, even though they might quite like to. With the busy lives people lead, it’s too easy to think, ‘Yes, I’ll do that some time’, but never actually get round to doing it: i.e. they have present bias and hence behave in a time-inconsistent manner.
With an opt-out system, people are automatically signed up to the scheme, but can freely choose to opt out. In the case of the new organ donor schemes in the UK, it is/will be assumed that organs from people killed in an accident who had not opted out could be used for transplants. If you do not want your organs to be used, you have to notify that you are opting out.
It could be the same with charitable giving. Some firms add a small charitable contribution to the price of their products (e.g. airline tickets or utility bills), unless people opt out.
Similarly, under UK pension arrangements introduced from 2012, firms automatically deduct pension contributions from employees’ wages unless they opt out of the scheme. Opt-out pension schemes like this retain between 90 and 95 per cent of employees. Opt-in pension schemes, by contrast, have much lower participation rates of around 60 per cent, even though they are otherwise identical.
This type of ‘nudging’ can improve the welfare of those who make systematic mistakes (i.e. operate in a time-inconsistent manner), while imposing very limited harm on those who act in a time-consistent manner. If it is in the interests of someone to opt out of the scheme, they can easily do so. Policies such as these are an example of what behavioural economists call ‘soft paternalism’.
- New opt-out model for organ donation to come into force in May
Pulse, Helen Quinn (25/2/20)
- Max and Keira’s law: New ‘opt-out’ organ donor system to be introduced on 20 May, government plans
Sky News, Greg Heffer (25/2/20)
- Adults to be automatically enrolled as organ donors under new law
Independent, Peter Stubley (26/2/20)
- Max and Keira’s law: New ‘opt-out’ organ donor system that presumes all adults agree to donate when they die will be introduced in May
Mail Online, Ben Spencer (25/2/20)
- Opt-out organ donation law: Your questions answered
New Scientist, Clare Wilson (27/2/20)
- Should organ donors be paid? The heavy toll of US kidney shortage
BBC News, US and Canada, Henri Astier (18/2/20)
- What Spain can teach Scotland about organ donation
BBC News, Scotland, Susie Forrest (18/10/19)
- A little nudge goes a long way in increasing organ donor registrations
The Conversation, Nicole Robitaille (2/5/19)
- How nudge theory is ageing well
Financial Times, Julian Baggini (19/4/19)
- Richard Thaler: ‘If you want people to do something, make it easy’
Financial Times, Tim Harford (2/8/19)
- Why a nudge from the state beats a slap
The Observer, Richard Reeves (30/7/08)
- Why do opt-out schemes have a higher take up than opt-in ones? Would this apply if people behaved in a time-consistent manner?
- What is present bias? How does it differ from simple impatience? Explain how present bias might help to explain the impact of changing the default option.
- What are the arguments for and against nudging people to make decisions that benefit them or are in the social interest?
- Give some example of nudges that are used in public policy or would be a good idea to use. Consider how effective they are likely to be. (You might refer to the work of the Behavioural Insights Team.)
- What are the possible drawbacks of presumed consent in organ donation?
- What are the arguments for and against paying live people to donate organs, such as a kidney?
- How might people be encouraged to behave in the right way during an epidemic, such as corona virus?
- To what extent was nudge theory used during the Brexit referendum campaign and in the two subsequent general elections?
Economists are often criticised for making inaccurate forecasts and for making false assumptions. Their analysis is frequently dismissed by politicians when it contradicts their own views.
But is this fair? Have economists responded to the realities of the global economy and to the behaviour of people, firms, institutions and government as they respond to economic circumstances? The answer is a qualified yes.
Behavioural economics is increasingly challenging the simple assumption that people are ‘rational’, in the sense that they maximise their self interest by weighing up the marginal costs and benefits of alternatives open to them. And macroeconomic models are evolving to take account of a range of drivers of global growth and the business cycle.
The linked article and podcast below look at the views of 2019 Nobel Prize-winning economist Esther Duflo. She has challenged some of the traditional assumptions of economics about the nature of rationality and what motivates people. But her work is still very much in the tradition of economists. She examines evidence and sees how people respond to incentives and then derives policy implications from the analysis.
Take the case of the mobility of labour. She examines why people who lose their jobs may not always move to a new one if it’s in a different town. Partly this is for financial reasons – moving is costly and housing may be more expensive where the new job is located. Partly, however, it is for reasons of identity. Many people are attached to where they currently live. They may be reluctant to leave family and friends and familiar surroundings and hope that a new job will turn up – even if it means a cut in wages. This is not irrational; it just means that people are driven by more than simply wages.
Duflo is doing what economists typically do – examining behaviour in the light of evidence. In her case, she is revisiting the concept of rationality to take account of evidence on what motivates people and the way they behave.
In the light of workers’ motivation, she considers the implications for the gains from trade. Is free trade policy necessarily desirable if people lose their jobs because of cheap imports from China and other developing countries where labour costs are low?
The answer is not a clear yes or no, as import-competing industries are only part of the story. If protectionist policies are pursued, other countries may retaliate with protectionist policies themselves. In such cases, people working in the export sector may lose their jobs.
She also looks at how people may respond to a rise or cut in tax rates. Again the answer is not clear cut and an examination of empirical evidence is necessary to devise appropriate policy. Not only is there an income and substitution effect from tax changes, but people are motivated to work by factors other than take-home pay. Likewise, firms are encouraged to invest by factors other than the simple post-tax profitability of investment.
- In traditional ‘neoclassical’ economics, what is meant by ‘rationality’ in terms of (a) consumer behaviour; (b) producer behaviour?
- How might the concept of rationality be expanded to take into account a whole range of factors other than the direct costs and benefits of a decision?
- What is meant by bounded rationality?
- What would be the effect on workers’ willingness to work more or fewer hours as a result of a cut in the marginal income tax rate if (a) the income effect was greater than the substitution effect; (b) the substitution effect was greater than the income effect? Would your answers to (a) and (b) be the opposite in the case of a rise in the marginal income tax rate?
- Give some arguments that you consider to be legitimate for imposing controls on imports in (a) the short run; (b) the long run. How might you counter these arguments from a free-trade perspective?
Many of you may have heard of nudge – the idea that governments can help people make better decisions by carefully designing the way a policy is structured and presented. Have you heard of sludge?
The most widely cited example of a nudge is changing a default option. The default option is what happens if you do nothing. For example, when you start a new job, are you automatically enrolled into the pension scheme or do you have to do something (i.e. fill-in an on-line form) to opt-in to the scheme. Changing the default option to one of being automatically enrolled in a scheme seems to have a big impact on the choices people make.
Recently, policy makers have started referring to ‘sludge’. Sludge is the opposite of nudge: i.e. characteristics about design and presentation that make it more difficult for people to make good decisions. Some businesses may use sludge to encourage consumers to spend more on their goods than they ever intended.
One interesting application of sludge is in the design of websites – referred to as Dark Patterns. The following are a number of different categories of dark pattern:
The last example, Forced Continuity, refers to the use of free trial periods and automatic renewal of contracts. Many people sign up for a free trial or special offer with the full intention of cancelling before the account automatically switches to the standard price.
How often do people simply forget or never quite get around to cancelling these deals when the time comes? Some recent evidence comes from a YouGov Survey. Forty-seven percent of respondents to this survey reported having accidently signed up for an annual subscription because they either forgot or were unable to cancel their account. The estimated total cost of unwanted subscriptions per year was £837 million. The same YouGov survey found that one in eight people kept paying for over four months before finally getting around to cancelling.
One business has recently seen an opportunity to help people deal with this problem. Free Trial Surfing is a new App developed by the company, Do Not Pay. It became available via Apple’s App store in September but is not yet compatible with Android devices. It works in the following way.
When customers download the app, they receive a new credit card number and a false name. Although Do Not Pay register the card details to their own business, the customer can use the information to sign up for a free trial of a good or service. In effect, Do Not Pay acts as an intermediary between the firm offering the promotion and the user. Once the free trial period ends, the app automatically cancels the subscription. Importantly, the new credit card details only work when someone signs up for a free trial. Consumers cannot use it to purchase any other products. Obviously one major drawback to the app is that a consumer would have to sign up again with their own personal credit card if they wanted to continue to use the service after the free trial ends. Businesses may also try to block the use of Do Not Pay credit card numbers for their services.
It will be interesting to see if other businesses come up with interesting ways of helping us to deal with sludge.
- Give three different examples of nudges.
- What policies do government typically use to change peoples’ behaviour? How do these traditional approaches differ from nudge?
- Identify some biases from behavioural economics that might help to explain why so many people fail to cancel subscriptions once a free trial period ends.
- Choose two other types of dark pattern and explain how they might prevent people from making decisions that maximise their own welfare.
The linked article below, by Evan Davis, assesses the state of economics. He argues that economics has had some major successes over the years in providing a framework for understanding how economies function and how to increase incomes and well-being more generally.
Over the last few decades, economists have …had an influence over every aspect of our lives. …And during this era in which economists have reigned, the world has notched up some marked successes. The reduction in the proportion of human beings living in abject poverty over the last thirty years has been extraordinary.
With the development of concepts such as opportunity cost, the prisoners’ dilemma, comparative advantage and the paradox of thrift, economics has helped to shape the way policymakers perceive economic issues and policies.
These concepts are ‘threshold concepts’. Understanding and being able to relate and apply these core economic concepts helps you to ‘think like an economist’ and to relate the different parts of the subject to each other. Both Economics (10th edition) and Essentials of Economics (8th edition) examine 15 of these threshold concepts. Each time a threshold concept is used in the text, a ‘TC’ icon appears in the margin with the appropriate number. By locating them in this way, you can see their use in a variety of contexts.
But despite the insights provided by traditional economics into the various problems that society faces, the discipline of economics has faced criticism, especially since the financial crisis, which most economists did not foresee.
Even Davis identifies two major shortcomings of the discipline – both beginning with ‘C’. ‘One is complexity, the other is community.’
In terms of complexity, the criticism is that economic models are often based on simplistic assumptions, such as ‘rational maximising behaviour’. This might make it easier to express the models mathematically, but mathematical elegance does not necessarily translate into predictive accuracy. Such models do not capture the ‘messiness’ of the real world.
These models have a certain theoretical elegance but there is now an increasing sense that economies do not evolve along a well-defined mathematical path, but in a far more messy way. The individual players within the economy face radical uncertainty; they adapt and learn as they go; they watch what everybody else does. The economy stumbles along in a process of slow discovery, full of feedback loops.
As far as ‘community’ is concerned, people do not just act as self-interested individuals. Their actions are often governed by how other people behave and also by how their own actions will affect other people, such as family, friends, colleagues or society more generally.
And the same applies to firms. They will be influenced by various other firms, such as competitors, trend setters and suppliers and also by a range of stakeholders – not just shareholders, but also workers, customers, local communities, etc. A firm’s aim is thus unlikely to be simple short-term profit maximisation.
And this broader set of interests translates into policy. The neoliberal free-market, laissez-faire approach to policy is challenged by the desire to take account of broader questions of equity, community and social justice. However privately efficient a free market is, it does not take account of the full social and environmental costs and benefits of firms’ and consumers’ actions or a fair distribution of income and wealth.
It would be wrong, however, to say that economics has not responded to these complexities and concerns. The analysis of externalities, income distribution, incentives, herd behaviour, uncertainty, speculation, cumulative causation and institutional values and biases are increasingly embedded in the economics curriculum and in economic research. What is more, behavioural economics is becoming increasingly mainstream in examining the behaviour of consumers, workers, firms and government. We have tried to reflect these developments in successive editions of our four textbooks.
- Write a brief defence of traditional economic analysis (i.e. that based on the assumption of ‘rational economic behaviour’).
- What are the shortcomings of traditional economic analysis?
- What is meant by ‘behavioural economics’ and how does it address the concerns raised in Evan Davis’ article?
- How is herd behaviour relevant to explaining macroeconomic fluctuations?
- Identify various stakeholder groups of an energy company. What influence are they likely to have on the company’s behaviour?
- In an era of social media, web-based information and e-commerce, why might it be necessary to rethink the concept of GDP and its measurement?
- What is meant by an efficient stock market? Why may the stock market not be efficient?
When making a decision, what happens if you do nothing: i.e. take no action? The answer is the default option. There is evidence that changing the default option for the same decision can sometimes have a big impact on the final choices people make. For example, when a person starts a new job, they often have to decide whether to contribute to the company’s pension scheme. The default option is typically for employees not to contribute. They have to do something actively (e.g. fill in an online form) to opt in to the scheme. An alternative is to change the default option so that employees are contributing to the pension. They now have to do something to opt out of the scheme.
Changing the default should have no impact on people who behave in ways that are consistent with the rational choice model in economics. However, research by Madrian and Shea (2001) found that it had a big effect. When employees had to opt-in, 49 per cent enrolled in a company pension. When they had to opt out, the figure increased to 86 per cent.
Other research suggests that defaults can influence the likelihood of getting a flu jab, making healthier food choices, receiving e-mail marketing and choosing certain types of car insurance.
One policy area where the choice of default has become a topical issue is organ donation. In 2017, over 400 people died in the UK because it was impossible to find an appropriate donor. Could changing the default increase the number of donors?
The scheme that operates in England requires people to sign-up to the organ donor register: i.e. they have to opt in. Although 80 per cent of the public support organ donation less than 50 per cent ever get around to signing this register.
Parliament recently approved the Organ Donation Bill and the new law will come into effect in 2020. The default position will change so that people are automatically signed-up for organ donation. If they do not want to donate their organs, they will have to opt out of the register.
In December 2015, the devolved Welsh government introduced a similar scheme. Although it is quite early to give a full assessment of the policy, its impact has been smaller than many people had hoped.
Why have the initial results been disappointing? One potential downside with an opt-out scheme is that it may create greater uncertainty about someone’s true wishes. With an opt-in scheme, a relative takes a deliberate action to indicate their preference to be an organ donor. In England, approximately 10 per cent of families overrule the wishes of a relative who has actively signed the register.
With an opt-out scheme, family members may worry that their relative did not want to donate their organs but never found the time to take their name off the register. In 2017/18, families in Wales overruled the presumed consent of their relatives in 33 per cent of cases.
Some countries, such as Singapore and Austria, operate a ‘hard opt-out’ policy. In these schemes, families cannot overrule and this leads to high organ donor rates. However, this type of policy is unpopular with large sections of the electorate who feel it is over paternalistic.
Forcing people to make a choice
Is it possible to force people to make a choice and so reveal their preferences to others? This is a policy of active choice. For example, the government could make the issuing of a driving licence conditional on a people making a choice about whether or not to sign the organ donor register.
This type of policy has been trialled in the USA with the take up of home delivered prescriptions. For the majority of people, there are clear advantages of choosing to have home delivered prescriptions rather than visiting a pharmacy – it is both cheaper and involves less time/hassle. However, the default option is to visit a pharmacy and one study found that only 6 per cent of people chose home delivered options. With the introduction of active choice, this figure increased to 42 per cent.
Some have argued that it is socially undesirable to force people to make a choice. An alternative is simplified active choice – people can either make a choice or accept the default option.
- Explain why changing the default option should have no impact on people who behave in ways that are consistent with the rational choice model in economics.
- What is present bias? How does it differ from simple impatience? Explain how present bias might help to explain the impact of changing the default option.
- What is loss aversion? How does it differ from diminishing marginal utility? Explain how loss aversion might help to explain the impact of changing the default option.
- What are some of the limitations of using defaults in policy-making?
- Is active choice less paternalistic than changing the default option?
- Think of some reasons why someone may not want to make a choice.