We have discussed this before, JLM. User fee will discourage patients from getting preventive care, pre and post natal care, cancer testing etc. That will result in sicker children; resulting in high infant mortality (USA has one of the highest infant mortalities in the developed countries). It will also make it difficult to detect cancer in early stages. A patient gets much sicker in the later stages, it is expensive to treat and many times the prognosis for success is poor.
User fee will definitely lead to a sicker society, as is evident from USA; they have one of the highest infant mortality and one of the lowest life expectancy in the developed world.