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extra-billing
DCHP-2 (Sep 2012)
Spelling variants:extra billing
1n. — also attributively
direct user charges for medical services beyond the compensation offered by the government health-insurance program.
Type: 3. Semantic Change — According to the Canada Health Act, extra-billing means "the billing for an insured health service rendered to an insured person by a medical practitioner or a dentist in an amount in addition to any amount paid or to be paid for that service by the health care insurance plan of a province." Fears that a private health care system might weaken the public system (see medicare) have been a recurring and much-debated issue since the installation of universal health care in the late 1960s and early 1970s. Until 1977, the federal government matched (approximately) dollar for dollar the health care expenses of the provinces, while since then bulk payments have replaced the matched contributions (transfer payments). The change in compensation has, amid a climate of increasing costs, intensified the debate over extra-billing (see Canadian Encyclopedia reference).
The term is used almost exclusively in Canada (see Chart 1).
See also Gage-5, s.v. "extra-billing", ITP Nelson, s.v. "extra billing", which is marked "Canadian".
See also Gage-5, s.v. "extra-billing", ITP Nelson, s.v. "extra billing", which is marked "Canadian".
Quotations
1962
The Government also is prepared to base eligibility on residence, rather than on premium payment, and to allow regions to use extra billing or some form of utilization fee, the letter said.
1979
But asking private insurers to provide coverage for extra billing charges by physicians, even if it was permitted by law, is a backward step.
1987
In each case, the efforts of lobbyists were rebuffed, including a bitter campaign by Ontario doctors to block a bill to end the practice of extra-billing.
1988
The province now has several choices: to ban all private profit-making clinics, including abortion clinics and any other entrepreneurial surgical services in private offices; to put the financial squeeze on private clinics by enforcing the extra-billing law (a move that would affect other doctors who extra-charge their patients for office costs); or to insist that abortions may only be performed in hospitals or in government-approved women's health centres that offer a wide range of services.
1996
While the bill is not needed to address an existing problem with privatized medicine, Romanow said it will ensure that any future private facilities must operate under medicare's principles of universality and no extra billing.
2008
Yesterday's Globe and Mail reported that Quebec, in violation of the Canada Health Act, refuses to give Ottawa its data on extra-billing or user fees.
2015
At a Regina press conference, Shrybman also concluded that charging private fees - even if half of them went to pay for a second MRI procedure - would still amount to a user fee and potentially extra billing if doctors are further asked to translate the results. Again, both are prohibited under the Canada Health Act.
2v. — present participle
See meaning 1.
Type: 3. Semantic Change —
Quotations
1979
A sample survey conducted by the Alberta Government shows that more than a third of the province's doctors are extra-billing patients.
1988
Some doctors in Ontario are still extra-billing their patients more than 18 months after the practice became illegal.
2008
The B.C. Supreme Court has given a big boost to a landmark lawsuit demanding that provincial authorities enforce medicare's ban on doctors extra-billing patients for necessary medical services.
2015
The two sides then spent four years arguing about the scope of the audit. Finally, in 2012, the Medical Services Commission concluded the clinics were extra billing patients and threatened an injunction, which is still up in the air.
References
- Gage-5
- ITP Nelson
- The Canadian Encyclopedia • Health Policy
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