Effect of removing user fees on attendance for curative and preventive primary health care services in rural South Africa

User fees are used to recover costs and discourage unnecessary attendance at primary care clinics in many developing countries. In South Africa, user fees for children aged under 6 yea rs and pregnant women were removed in 1994, and in 1997 all user fees at all primary health care clinics were abolished. The intention of these policy changes was to improve access to health services for previously disadvantaged communities. We investigated the impact of these changes on clinic attendance patterns in Hlabisa health district. Average quarterly new registrations and total attendances for preventive services (antenatal care, immunization, growth monitoring) and curative services (treatment of ailments) at a mobile primary health care unit were studied from 1992 to 1998. Regression analysis was undertaken to assess whether trends were statistically significant. There was a sustained increase in new registrations (P = 0.0001) and total attendances (P = 0.0001)for curative services, and a fall in new registrations (P = 0.01) and total attendances for immunization and growth monitoring (P = 0.0002) over the study period. The upturn in demand for curative services started at the time of the first policy change. The decreases in antenatal registrations (P = 0.07) and attendances (P = 0.09) were not statistically significant The number of new registrations for immunization and growth monitoring increased following the first policy change but declined thereafter. We found no evidence that the second policy change influenced underlying trends. The removal of user fees improved access to curative services but this may have happened at the expense of some preventive services. Governments should remain vigilant about the effects of new health policies in order to ensure that objectives are being met.

Attitudes to entry fees to National Parks: Results and policy implications from a Queensland case study

Examines visitor attitudes and whether visitors are willing to pay to enter Lamington National Park and under what circumstances they would do so. First a sample of visitors is asked a general (normative) question as to whether visitors should pay to visit Lamington National Park and in another question (positive) they are asked whether they would be more willing to pay if the money collected would be invested in the park to improve visitor facilities and for conservation work. The results show that visitors are more willing to accept the ‘user-pays’ principle if the money will be used for the benefit of the national park and its visitors. It was found that foreigners are more in support for a ‘user-pay’ fee than Australians, and among Australians, those visitors from Queensland are the least willing to accept the idea of a user-pay fee to enter the park. The results indicate that if visitors can be shown the benefits (both for visitors and for conservation) of charging an entry fee, then visitors are more likely to support such a concept than when they are unaware of the benefits of a user-fee. The study shows that on average foreigners are willing to pay more than Australians. Finally, the regression results identify significant factors influencing visitors’ attitudes and suggested amounts to visit the national park.

HSS (F)2004 04/04 - Revised Cost of Capital Rate in Fees and Charges Recovery Policy (PDF 51 KB)

HSS (F)2004 04/04 - Revised Cost of Capital Rate in Fees and Charges Recovery Policy

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report)

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report) In the context of the Government decision to end the arrangements whereby medical cards are issued automatically, without a means test, to all those aged 70 and over, a new income threshold was set and the Government decided to introduce a new single capitation rate payable in respect of patients aged 70 and over. I was asked to recommend a new rate for consideration by the Minister for Health & Children and the Government. Click here to download PDF 58kb

2005-2006 Academic Year Iowa Community Colleges Tuition and Fees Report, 2005

This document shows the tuition and fees charged by the 15 community colleges for the adacemic year 2005-2006. It includes comparisions to the regents institutions and to national data.

County Recorders Electronic Transaction Fees Under the Control of the State Treasurer and the Iowa County Recorders Association, Auditor of State's Report for the Period July 1, 2003 through September 30, 2005

County Recorders Electronic Transaction Fees Under the Control of the State Treasurer and the Iowa County Recorders Association, Auditor of State's Report for the Period July 1, 2003 through September 30, 2005

Investigation of County Treasurers' Tax-Sale Registration Fees, June 2007

On January 2, 2007, the Ombudsman received a complaint regarding the fee that county treasurers charge registrants at annual tax sales. The complainant said generally that many of the state’s counties, especially larger ones, appeared to be charging higher fees than was thought to be allowed by law. Investigation The investigation was conducted by Assistant Ombudsman Bert Dalmer. For purposes of this report, all investigative actions are ascribed to the Ombudsman. In early 2007, the Ombudsman surveyed tax-sale registration fees in 10 of the state’s 99 counties. Interviews of 10 county treasurers and/or some of their deputies were conducted. In addition, the Ombudsman researched the Iowa Code and relevant case law. The Ombudsman also consulted with the Iowa State Auditor and the president of the Iowa State County Treasurers Association.

Cashing by the hour: Why large law firms prefer hourly fees over contingent fees

Large law firms seem to prefer hourly fees over contingent fees. Thispaper provides a moral hazard explanation for this pattern of behavior.Contingent legal fees align the interests of the attorney with those ofthe client, but not necessarily with those of the partnership. We showthat the choice of hourly fees is a solution to an agency problem withmultiple principals, where the interests of one principal (law firm)collide with the interests of the other principal (client).

Retirement Investors' Club Plan Document; Fund Fees Comparison, 2005

The Retirement Investors’ Club (RIC) (also referred to as 457/401(a) deferred compensation) is a voluntary retirement savings program designed to help you meet your need for income at retirement and lower your current income taxes. Your contributions to RIC are automatically withdrawn from your paycheck and you are credited with an employer match. You may enroll*and make changes at any time. Other advantages are explained below…keep reading about this excellent employee benefit!

Report on a review of selected general and application controls over the Iowa State University of Science and Technology tuition and fees system for the period of April 11 through May 2, 2008

Report on a review of selected general and application controls over the Iowa State University of Science and Technology tuition and fees system for the period of April 11 through May 2, 2008

Report on a review of selected general and application controls over the University of Northern Iowa’s tuition and fees system for the period May 24, 2007 through July 3, 2007

Report on a review of selected general and application controls over the University of Northern Iowa’s tuition and fees system for the period May 24, 2007 through July 3, 2007

SF 2088 Convenience Fees Analysis and Recommendations, November 16, 2011

As an expansion of SF2088, the Department of Administrative Services-Information Technology Enterprise (DAS-ITE) was asked to further analyze the potential costs and savings if the current practice of charging credit card and overhead fees (“value-added fees���) were to be eliminated. Value-added fees reflect the costs an agency incurs while providing online services, and those costs will always exist.. DAS-ITE researched these costs and identified ways of making the associated fees less burdensome to the citizens of Iowa. The three alternatives provide different ways in which agencies can recover those costs; they could be borne by either an annual appropriation or adjustment of the online service “price” to include the fees within the cost of the online transaction. An additional alternative is presented to leave the current value-added fee practices in place. Recognition must also be made of the fact that traditional forms of conducting business with the State of Iowa, face-to-face and paper-based transactions, are inherently more costly. These delivery channels are effectively subsidized by the agency as a “cost of doing business” and the associated expense of the transactions is not passed on to the customer.

2007-2008 Academic Year Iowa Community Colleges Tuition and Fees Report, July 2007

This document shows the tuition and fees charged by the 15 community colleges. It includes comparisons to the regents institutions and to national data.