The Relative Value Scale Update Committee (RUC) of the American Medical Association (AMA) is back in the news, courtesy of the New York Times. It's more of the usual story, published by the WSJ less than 4 years ago: specialists are paid too much, primary care physicians are paid too little, and it's all because of an evil committee of doctors who are members of the evil medical trade union group known as the AMA who set payments. (Full disclosure, I'm a proud member of the AMA). A good perspective on the debate from Paul Levy, a former non-physician hospital CEO, is here.