Since 1992, the AMA has summoned this same committee three times a year. It's called the Specialty Society Relative Value Scale Update Committee (or RUC, pronounced "ruck"), and it's probably one of the most powerful committees in America that you've never heard of. The purpose of each of these triannual RUC meetings is always the same: it's the committee members' job to decide what Medicare should pay them and their colleagues for the medical procedures they perform. While these doctors always discuss the "value" of each procedure in terms of the amount of time, work, and overhead required of them to perform it, the implication of that "value" is not lost on anyone in the room: they are, essentially, haggling over what their own salaries should be.
