User charges (or fees) refer to charges levied on the users of public healthcare services. While this view limits its scope only to the fee charged in public health facilities, in a more general sense, it includes expenses incurred for availing health services in private centres too. An underlying distinction is also brought out by the nature of its (i.e. the user fees’) subsequent availability for improving the healthcare services. For instance, in the case of public healthcare services, the fees generated goes to the public exchequer and therefore may not necessarily get redirected for improving the services in the public facilities. But in the case of private health services, such collections may be invested in the improvement of health services. This reinvestment may take the form of stocking drugs, payment of bonus to medical personnel, etc.
In a much larger context, the various indirect expenses incurred by the people (e.g. cost of transportation to and from the hospitals, travel and staying expenses of accompanying relatives and friends, expenses on food purchase, opportunity costs lost by way of study time/wages/home duties, etc.) also constitute important components of expenses incurred on healthcare, even though not directly as user charges in the restricted sense.