Want to Get Your Financial Life in Order? Pretend You’ve Had Bypass Surgery

Changing bad habits can be overwhelming, but heart patients undergoing major operations seem to do it. What can you learn?

Aug 24, 2014 at 8:45AM


Tackling a major life change can seem like an overwhelming proposition. Whether it's addressing credit card debt, budgeting, starting an exercise program, or quitting smoking, the immediate discomfort is high and the immediate benefits are low. After all, it takes a while to see the effects of good behavior, but you have to deal with the costs right now. 

So how can you convince yourself to take on the challenge? A recent study on heart patients and smoking habits suggests you might need to convince yourself that you're undergoing a major surgical procedure. 

Moral hazard: It's everywhere 
To understand how this works it's important to understand the concept of moral hazard. 

Moral hazard is essentially an adjustment of your behavior based on your perception of risk. If you don't think you'll bear the costs of a risky behavior, you're more likely to engage in it. Evidence from car safety regulations is a good example: Imposing seat belt laws didn't change the number of highway deaths, and there was actually an increase in the number of pedestrian deaths. Why? Because suddenly people no longer shouldered the costs of reckless driving. 

You could argue that many of our bad habits are the misapplication of moral hazard. We don't bear the costs of poor financial management, smoking, or a poor diet right now -- it's our future self who will have to deal with it. Of course, that person is us, but in the short run it can be easy to forget their pain and enjoy our little pleasures. 

Heart patient survival rates
Researchers have a hard time pinpointing the precise effects of moral hazard because the world is a complicated and strange place. So they tend to find interesting results in unlikely places, such as coronary artery disease patients who need medical intervention. 

There are two major surgical treatment options available to these patients. One is the less-invasive angioplasty, in which a balloon is inserted into the artery through a small incision, helping it to allow more blood flow through. This procedure takes about an hour and requires one night in the hospital.

The other option is bypass surgery. It includes, according to the study, "harvesting a section of vessel from a different area of the body (either vessels in the groin or chest wall), opening the chest cavity via sternectomy, and connecting one healthy part of the diseased artery to another, surgically bypassing the lesion." It takes about four hours and a weeklong hospital stay, leaves an enormous scar, and requires extensive recuperation.

While angioplasties have a higher immediate survival rate right after the procedure, people who undergo bypass surgery generally live longer, though there's no consensus as to why this is the case.

There is, however, a possible behavioral answer.  

The benefits of drastic action
This study's authors got the idea that maybe the enormous cost of the bypass surgery fuels a change in patients' perceived risk analysis, causing them to change their behavior for the better. So they looked at how many bypass and angioplasty patients quit smoking -- a nice proxy for better health behaviors -- and found something amazing. 

Bypass surgery patients are 12% more likely to quit smoking. That one seemingly small change could be indicative of a wealth of other lifestyle changes (this part wasn't studied).

By getting a taste of the enormous costs of an unhealthy lifestyle, bypass patients could perceive the cost of healthier habits as relatively low -- and the costs of an unhealthy lifestyle as very, very high. 

The universal applicability of moral hazard 
So the next time you roll your eyes at a credit card statement or put off enrolling in your company's 401(k), remind yourself of the bypass patient. Imagine -- really imagine -- the actual cost of letting bad habits continue: Do you want to carry a totally unmanageable debt burden? Do you want to be destitute in old age? 

Of course you don't: the costs are just too high. And that might help you to remember that the cost of taking a good action in the right direction is actually quite low. 

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