What money shouldn’t buy? Measuring aversion to monetary incentives for health behaviors

We study attitudes toward offering monetary payments for vaccination. We develop the Policy Lab, an experimental paradigm to characterize policy preferences in which participants decide whether to implement actual interventions to influence others’ real-world behavior. In two studies with representative samples of the Swedish population (N=2,010) and one with Swedish policymakers (N=2,008), participants decide whether to provide others (N=1,529) with monetary incentives for vaccination. A majority of participants oppose using monetary incentives. Despite the widespread perception that such incentives are an effective policy instrument, which is supported in our data, opposition to their use is driven by perceptions that they are coercive and unethical. Policymakers exhibit, if anything, greater opposition to the use of monetary incentives. We also document that opposition to incentives extends beyond vaccination to other health domains. Our study provides evidence that the public opposes policies that they correctly perceive as effective, potentially creating barriers to their adoption. We further introduce a novel method to elicit policy preferences, widely applicable whenever researchers conduct randomized trials.