BLOGSCAN - Irrational Reimbursement

On DB's Medical Rants, this post continues on the theme of the irrational, complex, opaque system that the US Medicare program uses to determine physician reimbursement. This system is a major driver of the increasing cost of health care, and the priority the US puts on procedures, devices, and high-tech care versus primary care and physicians' cognition. Yet the mind-bending complexity of the system has seemingly diverted attention elsewhere, so that the conventional wisdom about increasing health care costs rarely directly implicates it. Furthermore, until recently, almost no one noticed how the system is influenced, if not controlled, by the shadowy RBRVS Update Committee (RUC), privately run (by the AMA), and dominated by sub-specialists whose names are not public. (See our most recent posts on the RUC here and here.)