April 12, 2025
How Elon Musk Could Fix Medicare
By James A. Betti, M.D.
Elon Musk’s DOGE has a unique opportunity to standardize Medicare billing and fulfill the promise of nationwide Electronic Medical Records (EMR) health care information–sharing. Better yet, EMRs could become the vehicle Musk needs to root out fraudulent Medicare billing, saving the taxpayers billions and stabilizing Medicare’s future.
But first, a basic primer on how Medicare reimburses health care providers is needed. Here it is.
American society has entrusted physicians and health care workers (now collectively referred to as “providers”) with a sacred trust, and these providers are compensated through a “fee for service” system. To reduce costs and maximize profits, the government and private health care payers have attempted to manipulate this sacred trust and its compensation. This piece will focus on government Medicare reimbursement.
In the 1980s and early 1990s, Washington, D.C. think-tanks developed the concept of a Relative Value Unit (RVU). One RVU was assigned a dollar value (presently $33.28), and all health care services provided by physicians and other providers have been assigned Relative Values. A didactic example of how the system works is the calculation of a surgeon’s compensation for an appendectomy. The system has assigned 10.6 RVUs as the value for an appendectomy; therefore, a surgeon’s compensation is calculated by multiplying the assigned RVU value (10.6) by the value of 1 RVU (33.28), totaling $352.68. All “fee for service” compensation is calculated in this manner.
morehttps://www.americanthinker.com/articles/2025/04/how_elon_musk_could_fix_medicare.html
