Sliding Scale: a Practice of Economic Justice at Mae Mind Body

Dec 1

What is Sliding Scale?

Sliding scale is a route to economic justice, or a means to increase access to products or services by offering a range of price points. Healthcare should be available to everyone, not just people with privilege. Sliding scale is a form of tangible community care.

How do we do this?

For sliding scale to function, there must be trust, respect, accountability, and the ability to hold complexity. I am not asking for proof of income or other verification as I trust you to be honest about where you fall on the sliding scale. Remember this is not a discount or sale; this is an opportunity to accurately assess where you hold power within systems of harm.

Economic Justice is…

Offering sliding scale to every patient is an experiment in Economic Justice and a way to dismantle traditional ideas of business, which hold that goods & services are available to anyone — that is, anyone who can afford it. I see sliding scale as a bridge between our current capitalistic system and the systems of interdependence we are dreaming and creating. It's also a practical action to implement my values in my business in meaningful ways.

Traditional Sliding Scale Structures

There are a few common sliding scale structures. One popular method offers three price points: full price, mutual aid price, and solidarity price with the “mutual aid” price essentially subsidizing the “solidarity” price. Other structures that are commonly seen are making a smaller set number of appointments available at a discounted rate, or offering discounted rates with proof of income. These systems work great for many places, though it also takes a lot of admin time in the form of wait lists or communication to maintain. I prefer to take a more hands-off approach where I trust you, the patient, to accurately assess where your needs are.

How It Works at Mae Mind Body

To take care of my needs and to work within the constraints of my payment-processing tools, I do things a little differently than the models outlined above. For my work, $200 is the full-price of an appointment with me - this price takes care of all business and personal needs. This price isn’t set according to ‘market value’ but is rather based on what I need.

Sliding Scale at Mae Mind Body

Inside of that, I offer sliding scale where you pay what you can honestly afford (accounting for your orientation to systems of power) in $10 increments from full price at $200 to $60. This low end of $60 is the bare minimum for me to cover just the costs of doing business. By offering this low price, I am not paying myself or covering all my costs. I offer this low price at a loss because it is important to me to make the care that I offer accessible. I believe that the work that I do with patients is actually building practices and skills that are needed in order to create new systems of interdependence and liberation.

A few notes to remember

Sliding Scale isn't how much you want to pay or even based on how much is currently in your bank account, though sometimes hourly or shift workers fall at different places on the sliding scale owing to fluctuation in income. Where you land on the sliding scale is about your access to privilege (education, race, sexual orientation, generational wealth, etc) and orientation within systems of harm. Sliding scale is to move us toward Economic Justice.

If you are unsure of where you fit on the sliding scale here are some prompts to consider:

Full price is for those that can say:

I am able to meet all of my basic* needs
I have access to or have benefited from generational wealth
I have access to multiple privileged identities **
I own my home or property OR I rent a higher-end property
I have easy access to transportation, I regularly use a car
I am employed or do not need to work to meet my needs
I have regular access to health care
I have a savings or investment account
I have an expendable*** income
I can always buy new items
I have access to sick leave and vacation time.

Middle of Sliding Scale is for those that can say:

I am able to meet all my basic* needs, though there may be occasional times where I hold off on a necessary purchase until next pay period.
I have access to or have benefited from generational wealth
I have one or more privileged identities **
I have easy access to transportation
I am employed
I have access to health care, though there may be hardship accessing care
I have access to savings though it may be less than needed
I have some expendable*** income
I am able to buy mostly new items
I can take a vacation annually or every few years.
I have the ability to take sick leave or time off

End of Sliding Scale is for those that can say:

I frequently can not meet my basic* needs
I do not have access to or have not benefited from generational wealth
I have one or more marginalized identity **
I have inconsistent access to transportation
I am employed at or near minimum wage, I am underemployed
Accessing healthcare is a challenge
I have no savings
I have no expendable income or limited expendable income ***
I rarely buy new items as I cannot afford them
I cannot afford a vacation or have the ability to take time off without financial burden
I do not have access to sick leave or paid vacation

* Basic Needs: includes food, housing, health care, and transportation.

** Privileged/Marginalized Identity: we all have multiple identities, some are visible and some are internalized. Some examples of identity are gender, sexual orientation, disability, education level, race, ethnicity, neurodiversity, and socioeconomic status. And within systems of harm (kyriarchy) some identities hold more power than others; this looks like white privilege, cis het privilege, or neurotypical privilege to name just a few.

*** Expendable Income: things that are not included in basic needs, i.e. you can buy an extra coffee at a shop without thinking, go out to dinner or drinks, go to the movies or a concert, buy new clothes, books, and similar items each month, etc.

If you have more questions they can be addressed in your initial free consult. You can schedule here.

Be well,

Dr. Kari