How the AMA Undermines Primary Care

[Passages]

Federal regulators, under Democrats and Republicans alike, help them do it.

by Robert Kuttner January 7, 2025

The American Medical Association is the professional association and political lobby of the nation’s physicians. Ever since President Harry Truman proposed national health insurance in 1945, the AMA has been an implacable enemy of a single-payer system, though today many harried doctors wish we had it.

It turns out that the AMA is also a prime driver of the gross imbalance between primary care doctors, who tend to be overworked and underpaid, and specialists who make a fine living and have more control over their schedules. The AMA does this via a secretive panel called the Relative Value Scale Update Committee (RUC).

The relative value scale was legislated by Congress in 1989 as a way to assign values to thousands of medical procedures and restrain Medicare costs. The RUC was created by the AMA in 1991 to make sure that that the AMA would dominate the process.

The Department of Health and Human Services then deputized the AMA’s RUC panel to determine how Medicare should compensate different forms of care. HHS accepts about 87 percent of the AMA committee’s recommendations. Medicare compensation in turn heavily influences other compensation.
https://prospect.org/health/2025-01-07-how-ama-undermines-primary-care/

[biophile]

1. The doctor union is a strong one

No matter how they spin it, it’s very much like a union. This system sucks.
My daughter pays $1100 per month for medical insurance -for a family of three. For that, many services - like the grandsons MRI for a broken bone- are cheaper if she asks for a cash price because the co-pay is so high. They won’t pay for her thyroid medication or birth control. So the only two medications she needs are not covered. Young people cannot be blamed if they decide to emigrate to a sensible country.