Background: There has been considerable interest in using financial incentives to help people improve their health. However, paying people to improve their health touches on strongly held views about personal responsibility. Method: "The New York Times" printed two articles in June 2010 about patient financial incentives, which resulted in 394 comments from their online audience. The authors systematically analyzed those online responses to news media in order to understand the range of themes that were expressed regarding the use of financial incentives to improve health. Results: "The New York Times" online readers revealed a broad range of attitudes about paying individuals to be healthy. Many comments reflected disdain for financial incentives, describing them as "absurd" or "silly." Other comments reflected the notion that financial incentives reward individuals for being irresponsible toward their health. Many individuals communicated concerns that paying individuals for healthy behaviors may weaken their internal drive to be healthy. A smaller set of comments conveyed support for financial incentives, recognizing it as a small sum to pay to prevent or offset higher costs related to chronic diseases. Conclusions: Although a measurable group of individuals supported financial incentives, most readers revealed negative perceptions of these approaches and an appeal for greater personal responsibility for individual health. Despite experimental success of financial incentives, negative perceptions may limit their public acceptability and uptake. (Contains 2 tables.)