Only 15% of the doctors on the RUC (reimbursement update committee) of the AMA are primary care physicians. This secretive committee decides how doctors are reimbursed through Medicare and Medicaid. And surprise surprise specialists get reimbursed at much higher rates than primary care physicians. Fewer and fewer people are going into primary care. It just doesn’t pay. And our whole system suffers because of this.
Dr. Paul Hochfeld of the Mad as Hell Doctors returns to The Edge Talk Radio in Bozeman, Montana to continue the discussion on the many ways that health care must be reformed. He is back in Corvallis, Oregon after traveling to Washington DC and meeting up with doctors at a rally on September 30. When he found out on October 1st that there was going to be a doctors news conference on Monday, October 5, he changed his plane ticket. Although not invited he made it into the photo op and was seated alone between two very burly guys where he could watch the brief event. He then talked to the doctors who had come at their own expense to support the president’s efforts on health care.
Get Dr. Paul’s perspective on where do we go from here by listening to the 40 minute interview over at Montanamaven.com
About 20 minutes into the interview he talks about the fishy way that doctors are reimbursed under Medicare and Medicaid. And the AMA gets $100 million to come up with these CPT codes.
I found an article by health analyst Brian Klepper who quotes Dr. Roy Poses on the RUC over at healthcommentary.org
The RUC ostensibly is just an advocacy group sponsored by the American Medical Association, yet it seems to be the only source of outside input about physicians’ reimbursement used by the US Center for Medicare and Medicaid Services (CMS). Given this influence, it is dismaying that it is secretive, unrepresentative, and unaccountable. Neither its membership nor proceedings are public. It is dominated by proceduralists and sub-specialists. It is unaccountable to US physicians, much less the general public.
About.com has a warning to folks thinking of investigating this.
What are CPT Codes and how do they effect healthcare?
Because these particular codes mean so much income for the AMA, it is difficult to find lists of them that are accessible to the public. In fact, groups that have tried to make them public have been cited for violations and fines by the AMA and have been forced to remove them from the Internet. Many groups license the lists of codes from the AMA, however, and then publish them online or in books. They are allowed to charge for access since they are also paying that licensing fee.
Because of practices like this, Dr. Paul Hochfeld really believes that we need some sort of national health care system like improved Medicare for All. Then we can address the crisis in primary care, unfair practices, medical malpractice, rising costs, and a host of other problems with the clout of an entity that represents 300 million Americans. The helter skelter and corrupt system that now operates is just plain mean and stupid.



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I have to go to bed. I have to drive up North tomorrow for a Montana Democratic County Chairs Meetings. We have received all kinds of praise for Max in our e mails, so I expect that the party loyalists will not be pleased with me. But that’s on Saturday. Tomorrow night a group of renegades will be meeting to plot and plan against our lords. Here’s some of the praise for Max:
Barf.
What happened to those who were demanding a public option from Max? I’m sure the reviews will still be glowing when Montanans are taken to the cleaners by the insurance companies.
That’s why the separate meeting tonight of those who had formed a coalition asking Max to have some kind of public insurance with no trigger and universality. A couple of the larger or more politically connected counties were upset that we were “embarrassing” our senator. Suddenly our latest letter only went to Max’s chief of staff rather than as a public statement.
Many heated e-mail exchanges occurred. The word “emotional” was thrown in for good measure. So a face to face meeting was requested. Montana is a big state. the 4th largest. It will take me over 3 hours to get there and others will take up to 7, so we won’t have a big group, but it looks like the single payer/public option advocates will not be outnumbered. I hope.
What is more likely is that the mind numbers will hijack the meeting. They will talk about election judges and how to get more accurate call sheets. I will, as always, try to steer the conversation from “How” to “Why” and “For What?” The Democratic brand is tainted like bad pet food. Why hear some guy explain to use “the legislative process” when the process is corrupt?
This should really be a different diary.
give them hell montanamaven! am looking forward to hearing your report of the meeting.
and thanks for your diary and radio interview of mad as hell doc (i just down loaded the podcast). you rock!
We need to redefine the common notions associated with healthcare. Obviously, healthcare is not just being treated by a doctor. Good nutrition and physical exercise are forms of healthcare. National defense is also a form of healthcare. We need to protect our bodies from harmful bacteria, viruses, terrorists, and invading armies. If we, as a nation, are willing to fund national defense initiatives to protect American lives than we should also be willing to federally fund decent healthcare for all Americans to protect their lives.
As a nation, we are obviously willing to spend tremendous human and monetary resources to defend us from external forces. Just considering the ongoing wars in Iraq and Afghanistan — we have lost many lives; many more have been physically and mentally injured; we have spent billions of dollars on waging the wars; and we have diverted precious human and physical resources away from more economically productive endeavors. In the Iraq war alone, over 4,000 soldiers have died and over 30,000 American soldiers have been injured. The military expenditure of human resources and monetary capital has been terribly expensive.
By a conservative estimate, the United States military operations in Iraq and Afghanistan have cost our nation well over $900 billion and the cost is steadily increasing. However, the actual cost is largely a secondary consideration mainly because our nation has been galvanized to defend ourselves from terrorist attacks. We are very motivated in our battle to save American lives from external forces. And because lives are at stake, our national defense has been performed without any notion of budget deficit neutrality.
National defense is a form of national healthcare. We are quite willing to spend whatever is needed to protect us from external threats. Unfortunately, as a nation, we’re unwilling to protect all of our citizens by providing healthcare for them. Each year many people in this country die because they don’t have healthcare coverage at all or because they don’t have adequate healthcare coverage. Two reputable studies report we currently have either 20,000 or 45,000 people in the US dying each year because of a lack of healthcare coverage (Institute of Medicine study – “Analysis on the Impact of Uninsurance on Mortality” at http://www.urban.org/UploadedPDF/411588_uninsured_dying.pdf and Harvard study – “Health Insurance and Mortality in U.S. Adults” at http://www.ncpa.org/pdfs/2009_harvard_health_study.pdf). If we average the total deaths per year from the 2 studies, that’s 32,500 people dying each year just because they don’t have healthcare coverage.
To many of us, the fact that 32,500 people needlessly die each year is a flat statistic. Please allow me to animate it. The number of people in the US dying each year for lack of healthcare coverage is approximately the same as the number of students enrolled at one of our large universities. If this degree of mortality occurred at universities over 8 years, it’s like all University of Iowa students died one year; all University of Utah students died the next year; all Boston University students died the next year; all University of Tennessee students died the next year; all George Mason University students died the next year; all Colorado State University students died the next year; all University of Kansas students died the next year; and all San Diego State University students died the next year. This represents more than 230,000 people dying in 8 years simply because they didn’t have healthcare coverage. This is a disaster and it is preventable!
President Obama and many other elected representatives have stated they want a healthcare reform bill that will not increase the federal deficit. Given the annual death toll from insufficient healthcare coverage, how can we ever begin to consider that this problem should only be solved in a manner that doesn’t increase government spending?!? Have we as a people and our democratically-elected representatives lost our minds? I’m outraged at this type of mean-spirited solution. We need to stop the needless suffering and dying in this country by supporting decent healthcare coverage for all – even if we have to spend some money to do it. It’s worth it.