On Friday, the fees that Medicare pays to doctors dropped 21 percent because Congress hasn?t been able to pass legislation to prevent the cut. While the Senate passed a bill that day to postpone the rate cut for another 6 months, the House now must vote on the legislation. Reports are, Speaker Pelosi, is not impressed with this substantially shorter ?fix? than what the House had already approved.Medicare doctors and their patients are sick and tired of what?s become an annual Congressional ritual of passing short-term solutions to a problem created almost 15 years ago. Ezra Klein offers a great reminder of how we got here, because contrary to GOP mythology–the doc fixfiasco wasn?t caused by recently passed health care reform legislation–in fact, it could and should have been fixed in that bill:?You’re all probably as tired of reading this as I am of explaining it, but here, again, is the quick background. In 1997, the Republican Congress created a payment formula meant to govern Medicare called the Sustainable Growth Rate. The formula was supposed to be a little tweak that saved a couple billion dollars. But the formula was wrong, and it quickly proved a wrenching readjustment that would’ve driven physicians out of the program by sharply slashing their payments. But rather than undo it, Republicans in Congress, and then Democrats when they took over Congress, passed temporary fixes, because no one wanted to come up with the money to fix the thing permanently.When health-care reform started, Democrats made an admirable effort to end the shell game and just fix the system. But doing so cost almost $300 billion, and Republicans, who caused this mess in the first place, attacked the Democrats’ fix as if it was part of their health-care reform plan rather than part of the Balanced Budget Act that Republicans passed in 1997. So Democrats abandoned the effort and left the fix out of health-care reform.?So, doctors in Medicare are scheduled for pay cuts now or, if the House acts, temporary relief to pay cuts that will come back around again in just months. There?s no hope of a permanent fix because the same folks who created the flawed formula in the first place, won?t pay to fix it now. So, who really pays in all of this? America?s seniors who are already finding itharder to find and keep their doctors in Medicare.Remember starve the beast? This is what it looks like.