First of all, I agree with the folks who reacted to this query with the thought "Oh no, here we go again, Health Promotion defined as Prevention". I think we're talking here about prevention fee for service. I think perhaps the issue of fee for service is about who offers the service. If my colleague offers a stress reduction program at a community health centre ( i.e. an organization funded by our taxes) then there should be no fee for service. However, when she offers this same course privately I don't have a problem with her charging. However, in order to leverage funds to be able to offer even more of a limited service that is in high demand, is there anything wrong with asking for donations? For example, it's something clients of our stress reduction program at the community health centre I worked at formerly, used to ask about -" I can afford to pay for this - you have a long waiting list - can we contribute to increase the pot of money available so you can offer this course more often?" What do you think? Is this still the slippery slope? I also think of this question in terms of use of resources. If we have funding for health promoters who can offer prevention/health ed programs and can also do work on the broader determinants of health, we can't increase our funding by asking people to pay for our advocacy work, community devt work, etc. So does charging for health ed/prevention programs give us the leverage to free up resources to work on the other aspects of HP? This IS the slippery slope in my opinion. But it's a tough one in times of cutbacks when you want to maintain existing initiatives and instigate new ones.