When President Obama signed the defense appropriations bill that also included a two-month delay to the 21% cut to Medicare payments to physicians, he enabled one of Congress’ long-standing healthcare tricks: pretending to do something about a problem while not actually addressing it. While most Medicare reimbursements are tied to inflation, physician reimbursement is based on the Sutainable Growth Formula (SGF) implemented in 1998. Most years, Congress intervenes and does not allow the forumula to be implemented because it would mean significant reimbursement cuts. Stopping a 21% cut makes sense; that’s a big hit.

But it’s also a little ridiculous that Congress never addresses the underlying problem with the SGR. The American College of Radiology announcement about the President signing the bill delaying the cuts mentions that the Congress hopes to address problems with the SGR during the delay. We’ll see. Maybe there may will be some movement to address the SGR as part of the pending health reform legislation, but there will have to be something done outside of that because the two-month delay of the cuts isn’t likely to be enough time to iron out the difference between the house and senate reform bills in reconciliation.

Some Republican opposition to healthcare reforms mentions this problem. Opponents have said the savings and cost of the healthcare bills include Medicare cuts some Republicans say Congress will never carry through on implementing—like SGR-driven cuts—when push comes to shove. History suggests Republicans are right about that.