Unknown to most, a single committee of the AMA, the chief lobbying group for physicians, meets confidentially every year to come up with values for most of the services a doctor performs.
Pointer from a reader, who requested that I comment. Actually, I had seen the article, but I thought it was too depressing/frustrating to even begin to comment.
The truly fundamental error is the belief that there is any objective way to measure cost. See my essay on subjective value. If you really want to see the fundamental nature of the error, see James Buchanan’s Cost and Choice. And, speaking of Buchanan, would he have been the least bit surprised that when the government is deciding how doctors get paid, a trade group representing doctors takes over?
This all began around 1989 with the government mandated RBRVS, or resource based relative value system. This system is a ham-handed way of mixing together effort, risk, liability, and overhead. Each procedure in the AMA’s CPT manual, which we all have to follow if we are contracted with either Medicare or private insurance, is issued an RBRVS. What we then get is the “multiplier”, which is set by CMS. Basically, the RBRVS times the multiplier equals reimbursement. My average multiplier has gone down every year since 1989. The AMA dances on a string, controlled by CMS. Some trade group.