Comments on: RUC this

By: Publicola

Publicola — Wed, 04 Feb 2009 04:18:15 +0000

Bob, I generally agree with your take on the RUC, and support efforts to either tear it down or make it more transparent. But on the other hand, I am swayed to some extent by Atul Gawande’s argument in his New Yorker article from this week, to wit: Any viable solution is going to have to arise by building on existing, broken systems, and not chucking them out and hitting “reset.” We cannot take the system offline to redesign it. I hate the RUC and what they have done to American medicine, but it is hard to imagine any payment system that is divorced from it.

Matt is right. The RUC and their crazy broken system have benefited millions of physicians and their support systems. They will not sit idly by while a brave band of generalists stage our Lexington and Concord. I am afraid that incremental change in the payment structure is going to carry the day.

Publicola

By: Matt

Matt — Thu, 22 Jan 2009 13:27:47 +0000

“We have a preverted payment structure created without representation. That is the problem. I doubt that the RUC’s leaders want to discuss that problem.”

As long as the vast majority of physicians keep agreeing to be paid by it, it must not be too pressing a problem.

By: Health Care BS - TIME TO GET THE RUC OUT OF HERE

Health Care BS - TIME TO GET THE RUC OUT OF HERE — Thu, 22 Jan 2009 04:10:47 +0000

[...] of posts debating the pros and cons of RUC. The latest outbreak has manifested itself here, here and here. What amazes me is how consistently such discussions miss the real problem with a [...]

By: The Happy Hospitalist

The Happy Hospitalist — Thu, 22 Jan 2009 00:18:45 +0000

I had an xray of my leg at the hospital the other day. I went to review it with the doc as soon as it was up. He spent 15 seconds looking at it. About 30 seconds dictating it.

That was it. Less than 1 minute of time. How much did he get paid? Well he billed $35. My insurance paid $17.

$17 for one minute of care. Lets give him a minute to pull up the next xray. So 2 minutes for $17. That’s almost $600 an hour.

Medicare Pays $35 for a level one hospital follow up visits that it says should take 15 minutes. That’s $140 an hour.

Procedures pay more on a time based access that can’t be accounted for by extra education or malpractice. Period. End of story. The only explanation IS the RUC and their false economies.

By: pcb

pcb — Mon, 19 Jan 2009 22:49:33 +0000

let us know how the discussion goes with Bob Doherty.

By: Dr. Bob (FP)

Dr. Bob (FP) — Mon, 19 Jan 2009 15:09:23 +0000

Yeah, I think we’ve been getting RUC’d for years & hadn’t realized it. One of the tragedies of primary care docs is that many are well intentioned, but not that political or business savvy. We hadn’t realized how much we’d been RUC’d until it was too late. Now we’re clawing our way back.