Good intentions are often just not good enough. We try our best to help our community and the families we serve by providing free services and bending over backwards to be accommodating and do as much as we can to assist them. But at what point is our help simply creating dependency and contributing to the long-term problems our community faces? Are free services taken for granted and unappreciated simply because they are offered for free? If the people we are trying to help had to pay for the services in some way, whether monetarily or in a different way, would the services be more effective? I don’t have the answers, but I sure do think that it’s a discussion worth having and that a better way, though perhaps yet undiscovered, must exist.
Many of the classes and programs that we offer consist of a series of sessions. Almost without fail, there will be individuals who arrive to the classes late, miss sessions or ultimately stop attending after some point. Not only do they not fully benefit from what the classes have to offer, but they also take a spot in the class away from someone else who may have attended with more regularity. If the same individuals had to pay for the class, even a nominal fee, would they assign more value to the class and therefore increase their commitment to attending and participating? Or perhaps something could be set up so that their registration fee would be returned to them at the end of the series of classes if they attended each session and participated fully. Would that lead to better outcomes or simply breed discontent and create a chasm between the community and our organization?
We often come across individuals who come to us seeking medical assistance for health problems like diabetes, heart disease and other maladies. We connect them with health professionals, at no cost to the individuals seeking help, who recommend dietary or lifestyle changes needed to improve the patients’ health outcomes. Weeks or months later, we hear from some of these same individuals, asking us to cover the cost of another medical visit. When we ask if they followed the original doctor’s recommendation, we learn that they opted not to make the needed changes. Again, with our limited resources, should we pay for another doctor’s visit for the same person or save our resources to help those who are willing to do the work and make the changes necessary to get better? Would asking the individual to pay for part of the visit increase their adherence to the physician’s recommendations or help decrease missed appointments?
I know many of the individuals and families we serve are in need of assistance because they don’t have the financial means to pay for the services themselves, so I’m not suggesting we ask them to bear the brunt of the financial costs. I’m not even advocating that their contribution need be financial. What if community members could volunteer in the community and earn credits that could be used toward services? Volunteer at one of our health fairs or help clean a community park for an hour or two and get a couple of credits that can be used toward physician visits, parenting classes, transportation vouchers or any other service they need. Would having to work to earn these services make them more valuable to the families who seek them? Would it also instill a positive sense of pride that they earned services? Might they pick up some additional marketable skills in the process, which could be used to improve their financial outlook? Would volunteering in this way also actually allow us to reach and help more people since there would be more of us in the community helping others? Or would it simply lead to families not getting the services and help they need because they are unwilling or unable to put in the necessary work? How can we avoid creating an entitlement attitude in our community and instead help foster a mentality of ownership and responsibility?
These are just a couple of examples of the issues our organization faces in providing free services and perhaps contributing to a culture of dependence. Are other organizations facing similar issues? If so, are they looking for alternatives and how are those working so far? We would love to learn from others’ experiences and share our own in an effort to find a better way to help the communities we serve.
As I stated earlier, we are so committed to helping our communities that it may be difficult to have an honest discussion of any negative, unintended consequences we may be creating in the process; but it is a discussion that must take place if we want to effect long-term improvements in our communities and in the lives of the families we help.
What do you think? Let’s start that conversation.