In 2002 the Legislative Tuan promulgated the ¡§Charges Law.¡¨ Undoubtedly this has empowered county and city governments to levy charges/fees. Kaohsiung City Government has thus commissioned us to reexamine the reasonableness of the charges system of Kaohsiung city and study how to enhance the levy of charges, through investigating user charges/user fees, Activity Based Costing, and the charges system of counties and cities. This would increase the revenues of Kaohsiung city and comply with the Charges Law requiring local governments to periodically examine and adjust the regulations on charges. The study has found: (1) The fees charged by Kaohsiung City government agencies for city service can be increased. (2) Fewer than 30% of agencies of Kaohsiung City government as well as other county and city governments charge fees that are permitted by local ordinances and regulations. (3) Kaohsiung City has less revenues derived from levying charges than does Taipei City, primarily because the latter has more high rate, more people using public services and facilities and charges new fees. (4) As indicated by questionnaire survey, government agencies for citizen service of Kaohsiung City are not eager to adjust charges or levy new fees in the future. This study suggests Kaohsiung City to adjust charges and levy new fees in consideration of the distinctive conditions of city, by abiding by the ¡§equal, fair¡¨ principle, and by referring to other county and city governments in this regard.

This paper examines the market adaptation of Swedish public libraries from a critical theory perspective, to see which forms of market-based funding and activities have been incorporated in the Göteborg, Malmö and Stockholm city libraries. The thesis uses an ideal type analysis, creating a theoretical construct of the archetypical marketized library against which the three libraries can be compared. The funding of a marketized library (1) is not public; and relies on (2) user fees; and (3) private grants and sponsorship. Regarding the activities of a marketized library, (4) the objectives are to maximize the quantity of output, regardless of its content (5) users are approached as “customers” and (6) collections are determined by market criteria and user demand. Library plans, annual programs and annual reports are the material for analysis. The results give a mixed picture. The libraries are all primarily publicly funded. Only the Stockholm library used private sponsorship as a source of funding. However, all three libraries relied rather heavily on user fees and service charges, and they all received private grants in 2006. In terms of the activities, none of the libraries expressed their goals purely in quantitative terms (although the Göteborg library vision was close). The goal assessments indicate libraries preoccupied primarily with numbers, however, trying to increase the quantity of visits and loans much like a book store. Users were in practice often approached as “customers,” but they were not expressly called that in the documents. There were also some market elements in the determination of collections. / Uppsatsnivå: D

Through a case study methodology this research explores the decision-making process regarding financing services provided by the Canadian federal government to individual citizens. From a transparency and accountability perspective, for those services that benefit individuals versus society as whole, it is important to understand why some services are provided through general taxation while others are financed through user fees. The study utilizes public choice theory as developed in The Calculus of Consent: Logical Foundations of Constitutional Democracy which is the initial attempt to illustrate how the tools of economics may be applied to political institutions using a rational choice approach with an emphasis on rules about how choices are made. Rather than focusing on ‘what’ government spends funds on, the study focuses on ‘how’ government generates funds by examining three major actors: government, citizen-voters and pressure groups. This study furthers scientific knowledge as there has been prior research on distinguishing between public versus private goods, and deciding on how to publicly fund such goods, but there has been limited research undertaken on the actual decision-making process in financing public goods and services. From an academic perspective, this study is the first time that The Calculus of Consent: Logical Foundations of Constitutional Democracy model has been adapted and applied to the Canadian federal government. The study concludes that it depends on what elected officials decide to do to appeal to citizen-voters in order to win votes: appear fiscally prudent thus charge user fees; advance its political agenda with decisions to sometimes charge user fees or other times not; or limit costs to private sector organizations by deciding to not charge user fees. While elected officials make the decisions whether or not to charge user fees, it is the bureaucracy that implements these decisions.

Masters in Public Administration - MPA / Red Cross War Memorial Children’s Hospital (RCWMCH), located in Cape Town, South Africa, is the only hospital in sub-Saharan Africa dedicated to children. It renders world–class public health-care services to sick children; 95% of which come from the poor, local and distant communities and require specialised treatment to recover. This case study aims to explore the factors associated with debt management and revenue-enhancing strategies in the Hospital Fees Department (HFD). The primary objective of the study is to examine the way in which the hospital manages outstanding debt and identify different empirical methods to improve revenue collection. In order to ensure the cost recovery of services, members of the public are billed and the expectation is, of course, for the bills to be paid. The hospital has a Hospital Information System (HIS) in place that consists of Clinicom and the Accounts Receivable System (ARS). The business design of Clinicom ensures that patient information is recorded and billed correctly. The ARS, on the other hand, ensures the collection of debt and reconciliation of state funds. The reason for choosing the HFD is that this component influences service delivery and funding. The importance of cost recovery to improve service delivery coincides with the Constitution of the Republic of South Africa and it is for this reason that people have the right to basic services. By making for sure revenues are collected, it ensures that the improved health-care services, to which they are entitled, are delivered to members of the public at the RCWMCH. The primary approach employed to collect information is made using structured questions and interviews with the members of the public and the RCWMCH management. The secondary approach is through the use of books in the field of finance, the HFD annual reports and policies. The study concludes with findings and makes recommendations to the RCWMCH management, the South African government and the academic arena at large. The researched information can be used as a tool to manage outstanding debt and improve revenue collection for the RCWMCH and other hospitals that face similar circumstances.

Background: Iraq is a higher middle-income country with a GDP of $223.5 billion (as of 2014). In the 1970s and 1980s, an extensive network of primary, secondary and tertiary health facilities was built, and the country recorded some of the best health indicators in the Middle East. However, two decades of conflict (both inter- and intra-state), sanctions and poor planning have reversed many of the previous gains. In the aftermath of the 2003 war, the government of Iraq introduced a Basic Health Services Package (BHSP) with a user fee component. International actors often advocate BHSPs as a means of rapidly scaling-up services in health systems that are devastated by conflict. User fees have also been promoted as a way of raising revenue to enhance the financial sustainability of healthcare systems in such contexts. While Iraq is a conflict-affected state, it has retained an extensive healthcare infrastructure and has a ministry of health with considerable financial and administrative capacity. In such a context, the introduction of a BHSP is a notable and distinctive feature of health policy in this setting, and the process through which this occurred have not yet been examined. Aim: To explore the processes through which the BHSP was conceived and designed in Iraq. It compares Iraq’s BHSP with similar policies in other post-conflict settings. It examines the roles of domestic and external actors and models in the policy’s conception and design. It explores the preferences of internal and external actors about the financing of service delivery through user fees. The study also examines the extent of policy transfer in the formulation of Iraq’s BHSP. Methodology: The thesis utilises a qualitative case study approach, incorporating analysis of semi-structured elite interviews and documents. Twenty Skype, phone, and face-to- face interviews were conducted between January 2013 and August 2014. Interviewees included former ministers of health, directors of departments of health, academics and officials at donor agencies, bilateral and multi-lateral bodies and consultancies. Documents included 47 official government publications, evaluations, reports, policy briefs and assessments. Literature review: A search of the literature on health policy making in post-conflict and fragile settings identified three key gaps in existing evidence; first, there is a dearth of published work examining health policy in post-conflict Iraq. Second, the literature focuses mainly on the impact of policy action in post-conflict contexts, largely neglecting the processes through which those policies are introduced. Third, while the literature concentrates on the roles of external actors, it pays limited attention to the role of domestic actors and politics. Results: Iraq’s BHSP shares commonalities with the other selected countries (Uganda, Afghanistan, and Liberia) in its primary aims, influential actors, interventions included or excluded, and financing principles. However, Iraq’s BHSP also aims at broader, and longer-term, structural reform, while the BHSP in other countries is often motivated by short-term objectives. The MoH in Iraq also appears to assume a prominent role in this case relative to others. Also, Iraq’s BHSP includes a greater number of interventions compared to the other countries. The Iraq war of 2003 offered the opportunity for wide-ranging structural change in the healthcare system. External actors, especially the WHO, were influential in advocating for a BHSP drawing on the recent experience of a similar initiative in what was in some ways the similar context of Afghanistan. However, the removal of former politicians and the emergence of internal policy actors with considerable technical and financial capacity allowed the domestic authorities to debate, dispute and challenge the recommendations of external actors. Relatedly, some of the internationally distinctive features of the BHSP in Iraq, including user fees, are similar to those that exist elsewhere in the health system. Most interviewees agreed that the BHSP was a means of enhancing financial sustainability and that it would help to enhance efficiency by targeting resources at population health need. The BHSP, according to some, represented the categories of healthcare that the government should finance, while allowing the private sector to meet demand for other services. However, many domestic actors supported the introduction of user fees as part of the BHSP. Several external actors either distanced themselves from this decision or declared no position, claiming that this was properly a matter for the government of Iraq. Discussion: While the BHSP’s ‘label’ is new in the context of Iraq, its substantive content is not. The BHSP can be seen as the outcome of the combination of old (existing) technologies and instruments presented in new (and introduced) ways. The existing health system offered ideas, techniques and processes that were maintained and reproduced even if these were packaged in new ways, to create a policy framework which is genuinely novel. External experts highlighted the idea of the BHSP and provided models (such as Afghanistan) on which the policy could be based. Internal decision-makers, however, were active players in policy formulation, not passive recipients who did not question or modify the policy during the process of transfer. On the contrary, it seems that the latter exerted considerable influence. User fees represent one aspect of that continuity. Ownership of policies by ministries of health in post-conflict is often advocated. However, such involvement introduces the potential for replicating old structures and policies, and may result in a degree of policy incoherence. Policy ideas are likely to change significantly where there is considerable local engagement in policy design and implementation.

Problématique : Dans les pays africains où les soins de santé sont encore payants au point de service, la barrière financière est un des obstacles majeurs au recours aux soins. Les indigents, qui sont les plus démunis, en sont les plus affectés. Pour faire face à ce défi, certains pays ont entrepris l’élaboration de programmes de santé ciblant les indigents pour leur permettre d’avoir un meilleur recours aux soins de santé par l’intermédiaire d’une exemption du paiement. Mais il existe un réel défi à identifier les indigents. De plus, peu d’études ont évalué l’impact de programmes d’exemption du paiement sur leur recours aux soins. Les indigents sont en majorité des personnes âgées avec des besoins importants en santé. Les personnes âgées en Afrique consultent très peu les professionnels de santé et les déterminants de leur recours aux soins sont peu connus. Pourtant, leur proportion est en augmentation dans les pays à faibles et moyens revenus. Ils sont en perte d’autonomie, ont de faibles revenus et présentent une prévalence élevée de maladies chroniques et d’incapacités fonctionnelles. Ces affections surviennent de façon précoce surtout chez les femmes. Objectifs : Cette thèse a pour objectifs : i) de déterminer le caractère équitable d’un processus de sélection communautaire des indigents au Burkina Faso qui vise à les faire bénéficier d’une exemption du paiement des soins; ii) de mesurer l’impact de ce programme d’exemption sur le recours aux soins de santé des indigents ; iii) d’analyser les facteurs associés au recours aux soins de santé par les personnes âgées au Nigéria. Méthode : Le cadre conceptuel de cette étude est le modèle d’Andersen et Newman qui regroupe les déterminants de l’utilisation des soins de santé en facteurs prédisposants (âge, sexe, état matrimonial, occupation), en facteurs facilitants (revenu, existence d’un recours à une aide financière, alimentaire ou instrumentale, cohabitation) et en besoins (présence de maladies chroniques et de limites de la vision, de la force musculaire et de la mobilité). Dans un premier temps, pour déterminer le caractère équitable d’une sélection communautaire des indigents, nous avons réalisé une étude transversale en 2010 dans le district de Ouargaye au Burkina Faso. Au cours de cette enquête, 1687 indigents ont été interrogés. La variable dépendante est la possession de la carte d’exemption du paiement des soins. Des analyses bivariées et une régression logistique ont été réalisées. Dans un deuxième temps, à partir d’un devis quasi expérimental pré/post, nous avons évalué les effets de ce programme d’exemption du paiement des soins sur le recours aux soins de santé des personnes en situation d’indigence au Burkina Faso. Au cours de cette recherche, 1224 indigents ont été interrogés en 2010 sur leur recours aux soins de santé. Parmi eux, 540 ont été sélectionnés et ont reçu une carte d’exemption du paiement des soins. Un an plus tard, un suivi a été réalisé avec un taux de rétention de 55,3%. Des analyses bivariées et une régression logistique ont été réalisées. Dans un troisième temps, à partir des données d’une étude transversale nationale, le General Household Survey de 2012-2013 du Nigéria qui couvre toutes les régions du pays, nous avons étudié le recours aux soins de 3587 personnes âgées dont 850 ont déclaré avoir été malades. Nous avons tenté d’identifier les facteurs qui y sont associés. Des analyses pondérées bivariées et une regression de Poisson pondérée ont été effectuées. Résultats : Au Burkina Faso, l’exemption du paiement des soins a été accordée en majorité aux veufs (ves) (OR=1,40 IC 95% [1,10-1,78]), à ceux qui ne bénéficient pas d’aide financière de leur ménage pour recourir aux soins de santé (OR=1,58 IC 95% [1,26-1,97], qui vivent seuls (OR=1,28 IC 95% [1,01-1,63]), qui vivent avec leurs époux/se (OR=2,00 IC 95% [1,35-2,96], qui ont des troubles de la vision (OR=1,45 IC 95% [1,14-1,84]), qui ont une faible force musculaire et une bonne mobilité (OR=1,73 IC 95% [1,28-2,33]). Le processus de sélection communautaire des indigents n’est pas parfaitement équitable, car très restrictif, bien qu’il ait permis de sélectionner les plus démunis. Il existe des différences de genre concernant les déterminants du recours aux soins chez les indigents. Être veufs (OR=0,53 IC 95% [0,33-0,81]) et avoir des troubles de la vision (OR=0,42 IC 95% [0,28-0,63]) freinent le recours aux soins chez les hommes, mais pas chez les femmes. Les maladies chroniques demeurent un obstacle commun aux hommes (OR=4,05 IC 95% [2,84-5,77]) et aux femmes (OR=2,14 IC 95% [1,54 – 2,97]). Le fait d’être exempté du paiement des soins n’est pas associé à l’augmentation de l’utilisation des services de santé (OR=1,1 IC 95% [0,80-1,51]). Qu’ils aient bénéficié ou pas de l’exemption du paiement des soins, les indigents qui ont un âge supérieur à 69 ans (OR=1,66 IC 95% [1,05-2,64]), qui appartiennent au genre masculin (OR=1,44 IC 95% [0,99-2,08]), qui appartiennent à un ménage à faible revenu (OR=1,71 IC 95% [1,15-2,54]) et ceux qui ont recours à l’aide financière familiale pour accéder aux soins de santé (OR=1,59 IC 95% [1,1-2,28]), sont les plus susceptibles d’augmenter leur utilisation des soins de santé. Au Nigéria, seulement 53% des personnes âgées ont consulté un agent de santé suite à un épisode de maladie. L’absence de scolarisation (PR = 0.73, 95% CI [0.6 0–0.8]), la faiblesse du revenu de ménage (PR = 0.75, 95% CI [0.5–0.9]), et le fait de résider dans les zones du Sud-Sud (PR = 0.59 95% CI [0.4–0.7]) et du Sud-Ouest (PR = 0.60 95% CI [0.4–0.7]), constituent des freins à la consultation d’un agent de santé. Conclusion La sélection communautaire est une des méthodes qui semble avoir permis de sélectionner les indigents avec une prévalence élevée de besoins en santé et d’obstacles économiques au recours aux soins. Cependant, l’exemption du paiement des soins n’est pas suffisante pour améliorer leur recours aux soins. Les déterminants de leur recours aux soins différent selon le genre, mais les maladies chroniques constituent un motif commun. Les personnes âgées et les indigents ont des caractéristiques communes telles que l’âge avancé, mais certains facteurs qui déterminent leurs recours aux soins diffèrent. Le déterminant commun est le facteur financier, soit la capacité contributive de ces personnes dans un contexte où l’utilisateur des services de santé est le payeur. En attendant la couverture universelle de soins, il serait approprié que les interventions pour améliorer le recours aux soins ciblent en premier lieu les populations ayant des besoins importants telles que les indigents et les personnes âgées en ôtant la barrière financière. Pour les indigents par contre, il faudrait y ajouter des mesures additionnelles comme, par exemple l’accompagnement, le transport et les frais d’hébergement. Enfin, les interventions doivent aussi considérer les différences de genre qui existent dans les facteurs qui déterminent leur recours aux soins. / Problem In African countries with point-of-service healthcare user fees, financial barriers are one of the major obstacles to healthcare-seeking behaviour, and the indigent, the poorest members of society, are the most affected. To address this issue, some countries have begun developing health programs targeting indigent people to help them gain better access to healthcare by waiving healthcare fees. Unfortunately, it is a genuine challenge to identify those who are indigent. In addition, few studies have assessed the impact of user fees exemption programs on healthcare-seeking behaviour. The majority of indigent people are older with significant health needs. Older people in Africa do not often consult health professionals. The determinants regarding healthcare-seeking behaviour by older people is little-known, although proportionately, their numbers are increasing in low- and middle- income countries. They are losing their autonomy, have little income and have a high prevalence of chronic diseases and functional disabilities. These problems occur early on, especially among women. Objectives The objectives of this thesis are as follows: (i) to determine the equitable nature of a community-based selection process for indigent people in Burkina Faso that aims to exempt them from paying healthcare user fees; (ii) to measure the impact of this user fees exemption program on healthcare-seeking behaviour among indigent people; (iii) to analyze the factors associated with healthcare-seeking behaviour by older people in Nigeria. Method The conceptual framework of this study is based on the model developed by Andersen and Newman, which groups healthcare use determinants into predisposing factors (age, gender, marital status, occupation), enabling factors (income, means and know-how to access financial, food or instrumental assistance, social relationships), and needs (presence of chronic disease and vision, muscle strength and mobility limitations). To determine the equitable nature of a community-based selection of indigent people, we carried out a cross-sectional study in 2010 in the Ouargaye District of Burkina Faso, in which 1687 indigent people were interviewed. The dependent variable was possession of an exemption card. Bivariate analyses and logistic regression were performed. Next, using a quasi-experimental before/after approach, we assessed the effects of this user fees exemption program on healthcare-seeking behaviour by indigent people in Burkina Faso. To that end, 1224 indigent people were interviewed in 2010 about their healthcare-seeking behaviour. Among them, 540 were selected and received an exemption card. One year later, a follow-up was conducted, with a 55.3% retention rate. Bivariate analyses and logistic regression were performed. Finally, using data from a national cross-sectional study, the Nigerian 2012–2013 General Household Survey, which covers all the country’s regions, we studied healthcare-seeking behaviour by 3587 older people, of whom 850 stated that they were ill. We attempted to identify the associated factors. Weighted bivariate analyses and a weighted Poisson regression were performed. Results In Burkina Faso, healthcare payment waivers were mainly granted to widows or widowers (OR=1.40 IC 95% [1.10–1.78]), to those who do not receive financial support from their household for healthcare (OR=1.58 IC 95% [1.26–1.97], or those who live alone (OR=1.28 IC 95% [1.01–1.63]), or with their spouse (OR=2.00 IC 95% [1.35-2.96], who have vision impairment (OR=1.45 IC 95% [1.14–1.84]), who have limited muscle strength and good mobility (OR=1.73 IC 95% [1.28–2.33]). The community-based selection process of indigent people is not completely equitable, although it did enable the most needy to be selected. There are gender differences concerning healthcare-seeking behaviour determinants among indigent people. Being a widower (OR=0.53 IC 95% [0.33–0.81]), and having vision impairment (OR=0.42 IC 95% [0.28–0.63]) were factors limiting healthcare-seeking behaviour among men but not among women. Chronic diseases remain a common obstacle among men (OR=4.05 IC 95% [2.84–5.77]) and women (OR=2.14 IC 95% [1.54–2.97]). User fees exemption is not associated with an increased use of healthcare services (OR=1.1 IC 95% [0.80–1.51]). Whether they received or did not receive exemption cards, indigent people over the age of 69 (OR=1.66 IC 95% [1.05–2.64]), who were male (OR=1.44 IC 95% [0.99–2.08]), who belong to a low-income household (OR=1.71 IC 95% [1.15–2.54]), and those who had financial assistance from family to access healthcare (OR=1.59 IC 95% [1.1–2.28]), are more likely to increase their use of healthcare. In Nigeria, only 53% of older people consulted a health practitioner after an episode of illness. Lack of education (PR = 0.73, 95% CI [0.60–0.8]), low household income (PR = 0.75, 95% CI [0.5–0.9]), and residence in Nigeria’s South South (PR = 0.59 95% CI [0.4–0.7]) and South West zones (PR = 0.60 95% CI [0.4–0.7]) constituted limitations to consulting a health practitioner. Conclusion Community-based selection is one method that appears to have made it possible to select indigent people with a high prevalence of health needs and obstacles to seeking healthcare. Healthcare payment waivers are not sufficient to increase their healthcare-seeking behaviour. Healthcare use determinants differ according to gender, but chronic disease constitutes a common theme. Elderly and indigent people have common characteristics, such as advanced age, but some factors that determine their healthcare-seeking behaviour differ. The common determinant is the financial factor, i.e., the contributory capacity of these people in a context where the user pays. Until there is universal healthcare coverage, it would be appropriate to ensure that activities to improve healthcare-seeking behaviour primarily target populations with significant needs, such as indigent and elderly people, by removing financial barriers. For indigent people, however, additional measures must be included, such as accompaniment, transportation and accommodation expenses. And activities must also take existing gender differences into account among the factors determining their healthcare-seeking behaviour.

Motor fuel taxes have been collected as a principal source of highway funding for close to a century. They account for approximately two thirds of all the highway user fees and about half of all highway expenditures. Federal fuel taxes have not kept pace with the inflation in general and increasing traffic demand and resulting construction, maintenance and operation costs of the transportation assets in particular. Lack of political will, combined with rising anti-tax sentiment among the populace, has kept the federal tax level not only well below its initial intents, but also at a unsustainable level in future. Mileage based user fees are possibly an alternative to the fuel taxes, which have been the main mechanism for funding the transportation system. Mileage based user fees have been successfully utilized in many parts of the world with glowing results. Germany‟s “TollCollect”, a quasi government enterprise has utilized GPS technology in collecting the users‟ fee from the truck operators. The system has been a financial engine providing much needed funding for many major transportation projects. Oregon Department of Transportation, in a federally co-funded pilot project, examined the practicality of the mileage based user fee collection at the fuel pumps. According to the Oregon study, there are not any major technical difficulties in mileage based user fee collection at the pump. Study participants (general motorist) did not express any objection to the mileage based user fee collection. This dissertation evaluates revenue impacts of several pricing policies including: Current per gallon fuel taxes, conversion to a mileage based user fee, time of day user fee application, iv area type user fee and congestion priced user fees. State of Florida‟s years 2015-2035 fuel revenue forecast is used as a case study. A model is constructed to estimate annual vehicle miles travelled for the analyses period. Fuel efficiencies, current per gallon fuel taxes and their corresponding mileage-based user fee equivalents are the input to a financial model developed for comparisons. Results demonstrate that decrease in fuel revenues due to vehicles fuel efficiency improvements can be offset by replacing current per gallon fuel taxes with a mileage-based user fee. Pricing the user fee according to area type, roadway classification, time of day and congestion level can not only generate more revenues but also assist in demand management.

Made available in DSpace on 2016-04-26T20:26:12Z (GMT). No. of bitstreams: 1 TESE - CESAR AUGUSTO GUIMARAES PEREIRA.pdf: 3312958 bytes, checksum: 11ed29eece76f5772f1b5c564754f54a (MD5) Previous issue date: 2005-11-30 / This work is based on a certain conception of users of public services, defined here as participants in a specific legal relationship binding them to the service provider. This idea stems from the Celso Antonio Bandeira de Mello's proposition of 2002 that public utility services are only those apt to be used individually by specific users. Chapter 2 examines the legal system and deepens the theoretical consequences of this proposition. It compares the user to similar individual positions. Chapter 3 is dedicated to the legal situation of the user vis-a-vis the service provider. They are linked by a predominately statutory bound that allows however certain spaces of freedom to be filled by consensus. This is an important condition for Chapter 4, which analyzes the relationship between consumer law - under the Consumer Protection Code - and the public utility services. It intends to clear certain mistakes by identifying boundaries and grounds for the limited application of consumer law. These three chapters form the part of the work dedicated to the legal position of the user. The following chapters deal with certain economic aspects of the service and their implications. Chapter 5 examines the creation of utility services as linked to the coming-of-life of constitutional fundamental rights and values. It examines the economic constraints to the provision of services. It establishes the rights of (hypothetical or potential) users with regard to the creation and organization of utility services. This is a supply-based analysis. Chapter 6 proposes a demand-oriented approach: it examines the position of the users and the remuneration of utility services (by taxes or user fees). The work reviews deeply entrenched opinions and proposes pragmatic and flexible criteria for the creation of user fees unlike those applicable under tax regulations. By proposing that the user should be placed in the center of any analysis of public utility services, this dissertation aims at abandoning a view of mere protection of the user and enhances the idea of individual responsibility. The first step towards that goal is to acknowledge that the service is provided always to a certain specific user. This person is entitled to individual rights and can claim his satisfaction. It proposes that the user be seen as a citizen, not a subject. He should not be guarded, but entitled and encouraged to exercise individually or collectively his rights with regard to public utility services / O estudo baseia-se na caracterização do usuário do serviço público como participante de uma relação jurídica concreta que o liga ao prestador. A idéia deriva da restrição do conceito de serviço público às utilidades fruíveis singularmente pelos usuários, proposta por Celso Antônio Bandeira de Mello em 2002. O Capítulo 2 examina o direito positivo e aprofunda as conseqüências teóricas dessa redução, comparando o usuário com figuras próximas. O Capítulo 3 é dedicado ao exame da situação jurídica do usuário em face do prestador do serviço. Conclui-se pela existência de um vínculo predominantemente estatutário, embora com espaços de liberdade para preenchimento consensual. Essa constatação é importante como pressuposto para o Capítulo 4, no qual se analisam os termos em que o direito do consumidor tal como veiculado pelo CDC pode ser aplicado ao serviço público. Pretende-se desfazer equívocos, identificando os limites e fundamentos dessa aplicação. Esses três capítulos compõem a parte do estudo dedicada à posição jurídica do usuário. Os capítulos seguintes relacionam-se com os aspectos econômicos do serviço e suas relações com essa posição jurídica. O Capítulo 5 examina as condições para a criação dos serviços públicos, a partir de sua vinculação à realização dos direitos fundamentais e demais valores constitucionais. Analisa-se a chamada reserva econômica do possível e se estabelecem os direitos dos usuários (hipotéticos ou potenciais) em face da criação e organização do serviço. Faz-se aí a análise de aspectos econômicos do serviço sob o prisma da oferta. O Capítulo 6 tem um enfoque de demanda: examina-se a posição do usuário frente à remuneração do serviço (taxa ou tarifa). São revistas posições consolidadas sobre o tema, propondo-se critérios pragmáticos e flexíveis para a instituição de tarifas, apartados dos critérios próprios do regime tributário. Ao defender-se que o usuário deve ser posto no centro da análise do serviço público, busca-se abandonar uma visão de tutela do usuário e reforçar a idéia de sua responsabilidade individual. O primeiro passo para esse objetivo é reconhecer que o serviço é prestado sempre em favor de um usuário determinado, que detém direitos subjetivos e pode reclamar sua satisfação. Pretende-se que o usuário seja cidadão, não súdito; que não seja tutelado, mas que tenha condições formais e materiais para exercer individual ou coletivamente seus direitos subjetivos em relação ao serviço público