The Wall Street Journal (10/27, A1, Mathews, McGinty) reported a committee of doctors called the Relative Value Scale Update Committee (RUC) decides how much Medicare pays for various medical procedures. This committee wields considerable power over how Medicare dollars are spent.
It is good to have doctors deciding this? Who would be better? Government regulators? In private insurance plans, the insurer and the doctor contract for what those prices should be.
We now have a health care system that largely removes from patients the direct responsibility of paying for care. So if patients aren’t going to decide how much they will pay, it’s left to someone else — either the insurer or the government. It may seem that leaving this in the hands of doctors may not be a great idea, but the RUC can’t pay doctors whatever it wants. It just sets the relative amount that one procedure gets paid vs. another. It’s a zero-sum game, so that if one procedure is paid more, another is paid less.
So while the RUC is controlled by physicians, those physicians don’t change Medicare’s overall costs.