How to Solve Obamacare’s Youth Enrollment Problem

When the first Obamacare enrollment numbers were released, there was nervousness that only 24% of those signing up were in the important 18 to 34 age category. Those who initially signed up through the Affordable Care Act tended to be older and potentially less healthy, and that kind of population didn’t bode well for premiums—or the law’s economic viability. So the question at hand was this: How do we get more young people to enroll?

Currently Obamacare uses financial penalties to get people to sign up. The result is either resentment or just plain avoidance. Young people in particular are upset because they know they’re paying for their elders. But a new quantitative science, called social physics, shows us that the key isn’t just to make it in their economic self-interest, but to make doing so benefit their own circle of people.

Social physics is a new quantitative science that not only describes how networks of people behave, but also accurately predicts patterns of human behavior and influences those patterns. It harnesses big data to radically change our ideas about why people decide to change their behavior, and how new ideas reach them and move them.

For instance, in one community experiment, my MIT research group offered people financial rewards for healthier behavior. The result was a small improvement, but one that disappeared as soon as the experiment ended. However, in a second community, we gave people rewards only when their neighbors or members of their workgroup improved. The improvement was up to eight times greater, and, perhaps just as important, the pattern of healthier behavior continued even after the experiment’s money ran out.

What explains the difference? Social network incentives raise community awareness and create social pressure to work together. Individual incentives are just that: They engage only the individual and miss the power of community engagement. When people interact in small groups, the ability to punish or reward peers is effective at promoting trusted cooperative behavior.

The social physics approach to getting everyone to cooperate focuses on changing the connections between people rather than getting individual people to change their behavior. Social network incentives act by generating social pressure around the problem of finding cooperative behaviors; people experiment with new behaviors to find ones that are better. The social pressure generated is a function of the cost of the behavioral mismatch between the behavior of the individuals, the value of the relationship, and the amount of interaction. All this means that the most effective network incentives should be focused on the people who have the strongest social ties and the most interaction with others.

You can also use social physics in online environments. For instance, with colleagues at the Swiss Federal Institute of Technology, we encouraged  buddy groups within a digital social network around energy use: When someone saved energy, then gift points were given to his or her buddies. This social network incentive caused electricity consumption to drop by 17%, twice that seen in earlier energy conservation campaigns and more than four times more effective than the typical energy reduction campaign. Just as in the health experiment, behavior change was most effective when it leveraged the strength of the surrounding social ties.

So how can the Obama administration use social physics to increase outreach to young people ahead of National Youth Enrollment Day on Feb. 15?

The simplest example would be to offer discounts to young people in workgroups or in the local neighborhood—but only if everyone signs up. If you offered each person $5 a month if everyone were to sign up, it would be a real topic of conversation among young people. If you offered $50 up front, it would be something they would have to do, because otherwise they would be ostracized by their peers—even though $50 is less than $5 per month. Using social physics, rather than economics, could drive young people to sign up in droves.

Talking With Your Children About Stress

With all the natural disasters that have plagued our nation in recent months, I often pray and worry most about our little ones. They too are greatly affected by stress and PTSD. We don't want to forget about them ... here is a little information about how to talk to your kids about stress. I find that this is valuable information.

According to a recent survey by the American Psychological Association (APA), many Americans — both adults and youth — experience high levels of stress. Adults can more readily identify feelings and causes of stress, and consider ways to manage it. Young people, however, may not recognize signs of stress or know how to respond effectively. Parents can offer valuable assistance and provide empathy and understanding. By knowing what to listen to and watch for and by seeking out opportunities to engage in conversation with children of all ages, parents can help their children to better manage life challenges. APA offers the following tips on talking with your children about stress:

Be Available 

• Notice times when your kids are most likely to talk — for example, at bedtime, before dinner, in the car — and be fully available to just listen.
• Start the conversation; it lets your kids know you care about what’s happening in their lives.
  Find time each week for a one-on-one activity with each child, and avoid scheduling other activities during that time.
• Learn about your children's interests — for example, favorite music and activities — and show interest in them.
• Initiate conversations by sharing what you have been thinking about, or what other kids may be thinking about, rather than beginning a conversation with a question.

Listen Actively

• When your children are talking about concerns, stop whatever you are doing and listen.
• Express interest in what they are saying without being intrusive.
• Listen to their point of view, even if it’s difficult to hear.
• Let them complete their point before you respond.
• Repeat what you heard them say to ensure that you understand them correctly.
• Realize that your children may test you by telling you a small part of what is bothering them. Listen carefully to what they say, encourage them to talk and they may share the rest of the story.

Respond Thoughtfully

• Soften strong reactions — kids will tune you out if you appear angry or defensive.
• Express your opinion without minimizing theirs — acknowledge that it’s okay to disagree.
• Resist arguing about who is right. Instead say, “I know you disagree with me, but this is what I think.”
• Focus on your child’s feelings rather than your own during your conversation.
• Ask your children what they may want or need from you in a conversation, such as advice, help in dealing with feelings or assistance in solving a problem.

Consider 

• Kids learn by watching their parents. Most often, they will follow your lead in how they deal with anger, solve problems and work through difficult feelings. Help your kids to adopt healthy coping strategies by modeling positive behaviors.
• Engage the family in stress-reducing activities, such as taking a family walk, riding bikes or dancing together.
• Young children may express feeling of stress or worry in their play. Pay attention to themes in their conversations and activities to gain a good sense of their concerns. Teens and older children are often more involved with peers than family as part of developing their own identity. Significant avoidance of parents, however, may be a sign that a teen is distressed and may need assistance.
• Kids learn from their own choices. As long as the consequences are not dangerous to themselves or others, don’t feel you have to step in each time.
• Shielding children from possible causes of stress or anxiety, such as unemployment, a parent’s marital problems or an illness in the family, can worsen a child’s anxiety because children commonly assume a worse case scenario. Help by providing age-appropriate information.

Seek Additional Help

If you have concerns that your child is experiencing considerable stress and the ideas are not sufficiently helping, seek advice from a licensed mental health professional such as a psychologist. Psychologists have specific training that can help both you and your child successfully manage overwhelming stress. For additional information on stress and lifestyle and behaviors, visit APA Help Center, read APA’s Mind/Body Health campaign blog, and follow @apahelpcenter on Twitter.