So You Want To Win $10 Million Dollars?

How do you save $120 million dollars in health care costs over three years for a community of 10K?  That's what some people are willing to pay big bucks to find out in a grand health care experiment.  Read the blurb below from The Health Care Blog.  

This belief is founded in the idea that aligned incentives can be a powerful way to spur innovation and seek breakthrough ideas from the most unlikely sources. Many of the reform ideas being put forward may not include some of the best thinking, the collective experience, and the most meaningful ways to truly implement change. To address this issue, the X PRIZE Foundation, along with WellPoint Inc and WellPoint Foundation as sponsor, has introduced a $10MM prize for health care innovators to implement a new model of health. The focus of the prize is to increase health care value by 50% in a 10,000 person community over a three year period.

Here's my solution.  Keep it simple stupid.   A high stakes game of chance which can only be won with strong personal commitment and responsibility to ones own health.   Let's use the national average of about $8,000 per person per year in health care costs.  That's $24,000 per person in health care costs over a three year period.  Multiply that by 10,000 people and the baseline cost to care for the community in question would be $240,000,000.  So the goal is to reduce health care costs by $120,000,000 over three years for this community of 10K folks.

How do you do that?  Here's my theory.  You can do more to affect health care costs by getting 10,000 people to change their lifestyle habits than you can by getting a few hundred docs to change how they document and collect data and prescribe some pills.

So here's what you do.  You bribe the public.  People are inherently lazy, but they respond well to piles of money. 

1. Pick three healthy lifestyle parameters.  I would chose nonsmoking status, achieved age appropriate exercise tolerance testing, and  lack of central obesity as my criteria.  
2. In your community of 10K, anyone who meets all three criteria of excellence will be entered into drawing for 3 million dollars at the end of the three year experiment.  One million for meeting each criteria.  There will be 10 random winners at a cost of 30 million dollars.    If you meet two criteria at the end of the three year experiment, you have five chances to win 2 million dollars  for a cost of 10 million dollars to the program.  If you meet one criteria at the end of the three year gig, you have just one chance to win 1 million dollars.   Total cost of the bribery?  41 million dollars.   
3. But here's the kicker, if you are picked as a random winner, in  order to collect on your winnings, everyone in your immediate household must also achieve the same number (or more) of defined lifestyle parameters  as you did for you to collect your millions.  So you're in it together.  For the long haul.
4. I am willing to bet the farm that $41 million dollars in bribes and a little peer pressure could potentially cut health care expenditures by 2/3 or $160 million dollars from a $240 million dollar starting pot.

Now.  Where's my 10 million bucks.