Is Opower the model for getting us to wellness and health?

This is a post about nudges. And optimism.

There’s a story I read a long time ago by David Brin. It’s called “The Giving Plague,” and the protagonist is a virologist and epidemiologist who describes his life working on viruses and vectors. The Plague of the title is a virus that has evolved the ability to make infected people enjoy donating blood. Recipients keep giving blood, leading to an exponentially expanding network of people who find themselves giving blood regularly and even circumventing age and other restrictions to make sure they can give their pint every eight weeks.

The central twist of the story is that the protagonist’s mentor, who discovers this virus, realizes people who donate blood also perform other altruistic acts–that the act of giving blood changes their own self image. Makes them behave as better people. And so he suppresses the discovery, for the greater good of society. The protagonist, a rampant careerist, begins plotting murder to allow him to take credit. But before he can act, more diseases strike, the Giving Plague moves through the population, and the protagonist forgets about it in his efforts to cure newer diseases.

And if anyone thinks something like this is too outlandish, I encourage you to read this piece about Toxoplasma gondii and how it makes infected mice charge at cats, the better to be eaten so that T. gondii can spread. Yeah.

But what does this story have to do with the future of wellness and health?

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Trying to figure the way through a 401(k) life

Thomas Friedman’s thoughts on how we’re becoming a 401(k) nation have been kicking around the back of my mind for about a year. His Op-Ed piece described the shift in how retirement plans in the US have largely shifted from pensions to 401(k)s and used that transition to make a point about the changing nature of work.

In a pension plan, a defined input (so many year of work) leads to a defined output (a regular payment that starts upon retirement until the day you die) with the risk assumed by the employer. In a 401(k), there’s still a defined input (regular deposits into a managed investment account) but how much a person gets at the end carries no guarantees and the risk sits squarely with the employee.

Friedman’s insight was that work itself is following that same path. Where once the defined achievements of education and learned skills were enough to guarantee continued employment and a good, middle-class career (at least), that’s not really the case anymore.

The news a some months back that Amgen will be closing its Seattle site this year really drove that point home. It was a reminder that biopharma, like so many other industries, isn’t immune to the implications  of the 401(k) life.

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