Myth: user fees ensure better use of health services.

Tough economic times stir up anxiety over the affordability of public services—especially healthcare. As governments struggle to balance budgets, and healthcare spending continues to grow faster than the economy, conditions are ripe for old—and often discredited—policy ideas to make a comeback. User fees are no exception. At first blush, user fees appear to be an obvious solution. After all, any policy that promises to generate revenue1 and reduce costs by deterring unnecessary use is hard to ignore.1, 2 But as research has shown over the years, the silver bullet of user fees really is the stuff of fantasy.3