{"id":106,"date":"2013-08-10T20:28:00","date_gmt":"2013-08-11T00:28:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=106"},"modified":"2013-08-10T20:28:00","modified_gmt":"2013-08-11T00:28:00","slug":"special-deal-by-haley-sweetland-edwards-the-washington-monthly","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=106","title":{"rendered":"Special Deal by Haley Sweetland Edwards | The Washington Monthly"},"content":{"rendered":"<p><em>Another piece on the RUC. Follow the tags to learn more\u2026<\/em><\/p>\n<blockquote>\n<p>Over the past few years, a few well-placed health care figures from both parties have spoken out\u2014at least once they\u2019ve left office\u2014about how crazy this system is. \u201cThe RUC is really just a giant cabal run by the AMA,\u201d Thomas Scully, former head of the CMS under George W. Bush, told me. \u201cA private trade association should not have that sort of control over the biggest spending account in the government. It\u2019s an outrageous travesty of democracy.\u201d Bruce Vladeck, former head of the CMS under Bill Clinton, agrees, calling the RUC \u201ca significant part of the problem.\u201d<\/p>\n<p>There have also been scathing reports issued by the Government Accountability Office, and by MedPAC, the agency that advises Congress on Medicare-related issues, as well as some hard-hitting investigative reporting by the <em>Wall Street Journal<\/em> and the Center for Public Integrity. In 2011, a bipartisan panel participated in a Senate roundtable, during which three former heads of the CMS took turns lamenting the RUC.<\/p>\n<p>Yet, for the most part, the RUC continues to operate exactly as it always has\u2014behind the scenes, without anyone, including actual doctors laboring in the clinics and hospitals across the country, even really knowing about it. (This spring, Scully told me that he went to lunch with a very high-ranking official at the CMS who had no idea how the RUC actually worked.)<\/p>\n<p>The Affordable Care Act, for its part, includes a few lines that could potentially, if incrementally, limit the RUC\u2019s power. But in general, it doesn\u2019t much change the way the reimbursement system works. Taking on the RUC would have \u201cstarted a nuclear war with the AMA,\u201d as Scully put it, and alienated other key political allies that the administration needed to pass the law to begin with. Fixing the RUC, however, is essential to fixing health care in this country.<\/p>\n<\/blockquote>\n<p><a href=\"http:\/\/www.washingtonmonthly.com\/magazine\/july_august_2013\/features\/special_deal045641.php?page=all\">Special Deal by Haley Sweetland Edwards | The Washington Monthly<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Another piece on the RUC. Follow the tags to learn more\u2026 Over the past few years, a few well-placed health care figures from both parties have spoken out\u2014at least once &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=106\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Special Deal by Haley Sweetland Edwards | The Washington Monthly&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[61,47,65],"tags":[],"class_list":["post-106","post","type-post","status-publish","format-standard","hentry","category-ipab","category-physician-income","category-ruc"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/106","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=106"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/106\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=106"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=106"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=106"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}