Comments on: That damn RUC http://www.kevinmd.com/blog/2008/01/that-damn-ruc.html Tue, 14 Feb 2012 17:14:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/01/that-damn-ruc.html#comment-82656 Anonymous Fri, 11 Jan 2008 23:35:00 +0000 http://clients.emmense.com/kevinmd/2008/01/that-damn-ruc.html#comment-82656 The existence of RVS puts paid to any plausible claim that even "private" care in the US operates as any kind of free market.<br/><br/>The committee is where the power struggles are carried out by the central planners deciding who "deserves" how much.<br/><br/>It's dissociation from underlying market forces shows itself as shortages: shortages of primary care physicians and psychiatrists (who will play the game) for example.<br/><br/>The only rational fee system for non-surgical services is time based. And it is a marketplace system only if the producer is free to set the fee and it is the customer who decides whether to accept it or not. <br/><br/>The thing with time based charges are that they give patients a much better metric to evaluate their docs charges by--he can decide whether he wants the 300$ an hour consultant or the 450$ an hour one. The existence of RVS puts paid to any plausible claim that even “private” care in the US operates as any kind of free market.

The committee is where the power struggles are carried out by the central planners deciding who “deserves” how much.

It’s dissociation from underlying market forces shows itself as shortages: shortages of primary care physicians and psychiatrists (who will play the game) for example.

The only rational fee system for non-surgical services is time based. And it is a marketplace system only if the producer is free to set the fee and it is the customer who decides whether to accept it or not.

The thing with time based charges are that they give patients a much better metric to evaluate their docs charges by–he can decide whether he wants the 300$ an hour consultant or the 450$ an hour one.

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