Syndicate content  User fees and abuser fees  Shanta Devarajan's
picture    Raising the price of a good or service has two
effects: it reduces demand and increases supply.  In the case of
user fees for health, it was thought that paying for a service
also makes people use it more appropriately (you don’t go to the
doctor for minor ailments) and value it more than if they
obtained it for free. The new empirical evidence shows that this
reasoning is incorrect [people use bed-nets just as much, even
if they get it for free].  On the supply side, though, the
evidence is consistent with the view that payments to providers
generate incentives for better performance. Unfortunately, in
many African countries, user fees were not paid directly to
health facilities or frontline providers.  They went into the
central-government’s coffers and therefore played no role in
incentivizing providers.  And since we now know that they didn’t
help people use health services better, user fees helped no
one.  Removing them was a goo