THE GOOD CITIZEN

If you pay him, Nicholas Schoon will behave well

In his clinic at the medical centre of Johns Hopkins University, Kenneth
Silverman deals with some really hard cases. These patients from the
surrounding Baltimore neighbourhood inject cocaine, share needles and are
often involved in crime. Usually it's almost impossible to get them to stay
clean for a few weeks at a time, but many have now managed to stay off
cocaine for months. A few haven't touched the stuff for two years.

The secret of Silverman's success is not better education about the dangers
of drugs. Nor is it some new wonder cure from one of the giant
pharmaceuticals companies---it's greenbacks. His patients receive up to
$1100 over a 12-week period in return for an unbroken supply of weekly
cocaine-free urine samples. The money comes in the form of vouchers for
food and other goods.

In a way, Silverman and the dozen or so other addiction specialists in the
US who are trying out this scheme are paying people not to be antisocial.
And not everyone is comfortable with that idea. But raising convincing
moral objections to such payments is about to become a lot harder as the US
government is now using the same powerful incentive---cash---to help
drivers break their addiction to cars. Thanks to Al Gore's so-called
"commuter choice" programme, America's employers can pay their staff up to
$780 free from income tax in return for using public transport or a
car-sharing pool to get to work. Another measure offers cash incentives to
staff to give up their parking spaces at work. Such schemes represent an
interesting reversal of what governments normally do---tax activities such
as smoking, gambling and driving cars. Should we be concerned at this
departure from the norm? Not necessarily: after all, money may succeed in
making us change where education and exhortation fail because it talks a
language everybody can understand. But some problems must be faced head-on.

First, we have to recognise that some people are bound to try to cheat.
They may, for instance, establish a track record in being bad in order to
collect the incentive money for changing their ways. In the case of
addiction, taxpayers could end up short-changed if clinics paid people who
merely dabbled in drugs for clean urine samples, rather than bona fide
addicts. So reward schemes need to be policed.

A second problem is that they may encourage a dependency on the cash
without ending the harmful behaviour. In the now discredited "set aside"
scheme, designed to reduce food mountains, Europe's taxpayers paid farmers
not to farm some of their land. But many of them simply set aside their
least productive land, while improvements in farming techniques boost crop
yields on productive land. Result: the surpluses remain.

In other areas of life, tougher rules governing informed consent may be
needed. Take the activities of an American charity called CRACK, which is
currently offering drug addicts $200 if they consent to be sterilised. The
"harmful behaviour" it seeks to end is conceiving babies who could be born
addicted, to a parent incapable of looking after a child. In effect, people
who are desperate for cash and unable to take a longterm view of life are
being paid to give up their birthright of parenthood.

On balance, though, paying people for desisting from doing bad feels like
an idea whose time is coming. We have to recognise that there are limits on
people's public spiritedness and that carrots can have a more powerful
effect on behaviour than the sticks of taxes and other penalties.

How odd if money turned out not to be the root of all evil, but the
wellspring of public good.