Rob: The "vast research" on this topic only reveals that lowering user fees increases use. In Kenya, charging for bed-nets decreased their use, as we would expect for any commodity, such as apples. That people buy fewer apples when the price goes up is well-accepted and, in fact, the elasticities that these studies find with respect to price declines are well within the ranges for normal goods.
There is much less consensus about whether lowering user fees improves health outcomes, which is what we care about.
1. A 2009 RCT from Ghana shows that removing user fees increases use, but not outcomes (doi: 10.1371/journal.pmed.1000007.)
2. Alessandro Tarozzi and Aprajit Mahajan's work from Orissa shows that lowering prices of bednets increases their use (as in the original Cohen-Dupas study), but has no impact on either malaria or anemia (something that was not measured in Cohen-Dupas). Http://www.unc.edu/depts/econ/workshops/tarozzi.pdf
3. Dupas' own new work shows that once people learn about the efficacy of bednets, they are much more likely to purchase them. This argues for an introductory subsidy, which the private market would figure out (as it has for soap, for mosquito repellants etc.), if market distortions and poor policy didn't rule them out. Http://www.stanford.edu/~pdupas/subsidies&adoption.pdf
4. You may be interested in our own comments on price-declines and policy in the Boston Review (http://www.bostonreview.net/br36.2/devarajan_das_hammer_behavioral_economics_global_development.php )
We refer to a 30-year old study precisely to point out that good lessons were lost.
Finally, it’s important to conceptually separate financing and provision. Our post argued that there are no efficiency or equity rationales for provision of medicines in public clinics, and that financing should be means-tested. In fact, by coupling medication with advice, the quality of advice--which is in short supply--may actually suffer.
Bottom-line: It’s worth discussing provision versus financing and subsidies for better medical advice and subsidies for better medicines given the new literature over the last decade.