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.