Creating a RUCkus

The outing of the RUC (RBRVS Update Committee), the secretive committee that has so much influence over how Medicare reimburses physicians, and hence bears much blame for the decline in US primary care, continues. (Our most recent post on this subject is here.)

First, on the Movin' Meat blog, Shadowfax, an emergency department physician, took up the issue. He emphasized how poorly the RUC represents the overall population of US physicians. Most seats on the RUC go to particular medical societies, regardless of their size. So there is a one seat for the 6,000 member American Society of Plastic Surgeons, and one seat for the 124,000 member American College of Physicians. Furthermore, Shadowfax charged that an informal alliance of sub-specialty surgeons and procedurally oriented medical sub-specialists dominates the agenda.

Also, DB's Medical Rants takes up the subject again, noting that the way the RUC works seems to reflect an American bias to reward doers more than thinkers.

In my humble opinion, the government needs to rethink how Medicare reimburses physicians before primary care vanishes entirely. Furthermore, someone ought to investigate how federal policy, in this case, Medicare reimbursement became so beholden to a single private committee, and why such policy has been set in such an opaque manner. Not only are the proceedings of the RUC confidential as Medical Rants noted but the AMA does not see fit to disclose the identities of the people who sit on the RUC. (This appears to be as close as the general public, or the general AMA membership is going to get.)