What People Need Versus What They Get (the "Queen for a Day" Story)

Derrick Dufresne has been involved in the development of innovative service models throughout the country for the past few decades. He shared some of his collected insights with a group of program administrators in 2006.

Derrick Dufresne: To engage in what I call Queen for a Day mentality. I've been around long enough that, some of you might remember this too. If you remember the show "Queen for a Day," a rather bizarre concept.

These three women, and it was always women, came on Queen for a Day every single day of the show, and they sat at a table and they told increasingly woeful stories. And so the first one would say something like, haven't got a husband. And the second one would say, what's a husband? (Laughter) And the third woman would say, why would you want one? (Laughter)

And so then after they told these woe-is-me stories, the host, if you remember the story this is really what happened. The host would come over and he would put his hand over the woman's head, each woman's head, and they had this thing called the clap-o-meter. And the more woeful the story, the louder the people clapped. And the louder the people clapped, the further down the meter went. And whoever got the most applause, they came up and the woman stood up and they put a robe around her, a crown on her head, marched her down a runway, and they gave her a Maytag washer, which is the sponsor of the show. (Laughter)

They never once asked her, do you have someplace to plug this in? Is this like your dream given everything in your life? It was kind of the first issue program. We gave people what we thought they needed rather than what they wanted. So it's like this woe-is-me thing.

And I mean, how long have we known that Medicaid is under fire? David Stockman in 1982 proposed to block grant Medicaid. Medicaid was never supposed to serve people with disabilities, it was supposed to serve the working poor. It was supposed to be an insurance program. It was supposed to provide safety net health insurance to people.

We took that program and we tried to make it into something. Now what it has become is like being married to one of your distant relatives that you got a dispensation for and you're staying together for the sake of the kids. (Laughter)

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