Saturday, May 14, 2022

Do You Qualify For A Discount? And Are Discounts Racist? Talking About Mental Health Costs And Discounting Frameworks


Pile of money

Remember how last October I decided not to increase my rates? Well, it seems to be causing some confusion. It also caused a fight, and therefore I'm doing some thinking.

Let me explain, and tell me what you think.

In my therapy work, I am based at home and online, so I pass on these savings to clients. As I'm in Malaysia where living is cheaper than in Europe, I'm very affordable, charging just US$35 per session.  

In addition, I offer a discount rate to clients in Malaysia. Why? Because Malaysia is a developing nation, and a lot of the people, especially young people, are quite poor.

As I've said before, I'm okay with working a little harder in order to give the people in my community a little bit of a break.

So I charge a local rate of RM110. (correct in Nov 2022)

From time to time I've had people living in first world nations asking for discounts and saying they can get third parties to pay the local rate.  The answer is no.

I'm willing to work a little harder to help my community, but there's a limit. Even my top rate, US$35, makes me significantly cheaper than my peers. 

I also need to earn my living, pay back for the 7 years tuition that is needed to enter work as a therapist, and prepare to look after myself in old age when I can no longer work. 

Some four or five years ago, before I had two separate rates, clients picked the payment method that worked for them. But my pricing structure has changed, so that no longer applies. I now have a two-tier system.

It is also true that some of my younger local clients who started with me while in college in Malaysia and then moved abroad kept the low rate. I closed one eye and let them stay on this as a courtesy because emigration is expensive and mentally challenging. 

And yes, I've also let a few families overseas in trouble in cheap.

Most people are okay with this. However, others misunderstand or resent this flexibility. I got some very nasty responses from one individual recently.

Hence the thinking.

Discounting is always controversial because it's natural to love a discount and to feel bad when you don't get one. Even so, charging different rates is common in mental health practice, mainly because so many can't afford the service but need it.

Typically, practitioners use means testing, where they offer a discount depending on your income. Mostly, they ask to see wage slips. 

I refuse to do this for several reasons. 

I find it intrusive. I don't need to know what you make, and I certainly don't want to get into how you spend your money. For all I know, you're making peanuts and have a rich relative who pays your bills. Or you earn a bomb, and are keeping your huge family. It's none of my business.

Also, as many people link income and personal worth, it may hurt or worry to discuss this topic. I won't do that to my clients. 

As for asking to see wages slips - OMG, that says you don't even trust people to be honest! I'm so not going there. I actually make a point of invoicing after the session, to show I trust my clients.  

I don't say means testing is wrong. But given the issues, it's not for me.

So, is my system of discounting based on geographical location racist? 

It's not racist because I don't ask people about race, but it's probably something 'ist'. Locationist, maybe? My thinking is based on local salaries and local purchasing power. I think that's practical, and although it's not foolproof or ideal, it's the best I can come up with. 

No, I don't want to apply special rates to various countries based on average income. I'm happy to help my community but I'm not a saint. I am running a business, not an NGO. Also, practically speaking, I'm not going to research other economies every time I get a client from a country that's new to me, either.

So there you go. That's my thinking. If I'm wrong, tell me how and why, and I will reconsider.

As for now, I love what I do, but I don't want to fight about money. So here are my rules, clearly and concisely.  

If you're living in Malaysia, you get the local rate. If you're not, you don't. No exceptions.

I'm putting my foot down, establishing my boundaries 😊

Will I adjust my rates for the clients abroad who get a low rate out of courtesy? 

I'm in several minds about this. 

Part of me says that they should not be affected because I'm annoyed by the rantings of some entitled twit. 

But another part of me says that really, if they're now established in first world countries, they should move to the other structure. Maybe I'm a bit too soft there?

I won't make a hasty decision. I'm going to sleep on it. And if you have an opinion, please do share. I'd like the insight.

Update: when people migrate, I'm taking it case by case. As there are no universal moral rules, I'm not going to break my head trying to make them. 25th November 2022