Special Deal: The Shadowy Cartel of Doctors Who Control Medicare
http://www.washingtonmonthly.com/magazine/july_august_2013/features/special_deal045641.php?page=1
On the last week of April earlier this year, a small committee of doctors met quietly in a midsized ballroom at the Renaissance Hotel in Chicago. There was an anesthesiologist, an ophthalmologist, a radiologist, and so onthirty-one in all, each representing their own medical specialty society, each a heavy hitter in his or her own field.
The meeting was convened, as always, by the American Medical Association. Since 1992, the AMA has summoned this same committee three times a year. Its called the Specialty Society Relative Value Scale Update Committee (or RUC, pronounced ruck), and its probably one of the most powerful committees in America that youve never heard of.
The purpose of each of these triannual RUC meetings is always the same: its the committee members job to decide what Medicare should pay them and their colleagues for the medical procedures they perform. How much should radiologists get for administering an MRI? How much should cardiologists be paid for inserting a heart stent?
While these doctors always discuss the value of each procedure in terms of the amount of time, work, and overhead required of them to perform it, the implication of that value is not lost on anyone in the room: they are, essentially, haggling over what their own salaries should be. No one ever says the word price, a doctor on the committee told me after the April meeting. But yeah, everyone knows were talking about money.