Wednesday, February 19, 2014

No More Free Rides

If you get something for free, you place less value on it than you would if you had to pay for it. This is just simple, common sense. So what makes anyone think that welfare and other entitlements is a good thing?

When I worked as a psychotherapist in New York City, a substantial number of the patients that came to the clinic were Medicaid recipients. They were seen once weekly and were given ongoing appointment schedules. If they had to cancel, they were asked to give the clinic at least 24 hour notice so that we could use their timeslots effectively. But cancelling appropriately was as rare as a liberal using facts to make decisions rather than feelings. Patients who paid out of pocket, or who had coverage through their employer (those with jobs often had coverage), were much more dependable when it came to showing up for session and for cancelling when necessary.

Fee for service therapists at the clinic only got paid when they actually had a patient session. There was no penalty for Medicaid patients not calling in to cancel--we call them "no shows," and this had become an ongoing problem. The situation became one in which the therapist was dependent upon the mental patient to do the right thing and allow a scheduling in the open timeslot. 

Entitlements like Medicaid, Food Stamps, and other programs that give away free stuff is fine and necessary, but it is all too easy to use these programs to create strong dependency and a nanny state. (I am not referring to Social Security--we've paid into that.) Moreover, in the case of psychotherapy, where clients pay nothing for treatment, there is a devaluing of treatment when it's free. I believe there should be a small penalty for being a "no show" and the patient must pay it by the following visit or be terminated from treatment.

The government has become too much like a rewarding parent, or Santa Claus. If you want to make people responsible adults, you need to hold them accountable for their actions. No more free rides. No more Obama phones. It's time for our nation to put on their big boy pants.

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