For the past 20 years, the government has relied on recommendations from a secretive, powerful committee–convened by the American Medical Association and largely populated by specialists–to determine how much doctors should be paid by Medicare. Not only are physicians getting together to fix the prices of the medical services they perform, the resulting distortion in payments is exacerbating the national shortage of primary care physicians, contributing to dramatically rising health care costs, and creating perverse incentives that reward unnecessary procedures. The existence of the committee, known as the RUC (AMA/Specialty Society Relative Value Scale Update Committee), has been reported on by multiple media outlets. However, in 2011, a group of six activist primary care physicians challenged the government’s reliance on this American Medical Association committee in federal court. My story chronicles the fight of these primary care doctors, led by Dr. Paul Fischer, for a more equitable reimbursement system for physician services.
