The threatened Medicare doctor pay cut has once again been narrowly averted thanks to lawmakers in Washington. By unanimous vote, the Senate has decided to put off making any of the tough choices facing our debt-laden nation by extending the “doctor fix” for another year.

The source of the problem is a 1997 law that established the rate at which Medicare spending could increase, the “sustainable growth rate,” which was designed to help Medicare remain viable. However, the health care industry wasn’t listening, and costs increased at several times the overall rate of inflation with doctors and hospitals left holding the bag.

In order to protect lawmakers from political fallout, the legislation, like many new laws passed these days, was designed to have a minimal effect in the early years. But in 2002, it dictated an automatic, 4.8 percent, across-the-board cut in Medicare spending. Medical professionals and seniors complained loudly and threatened action, and a frightened Congress passed a temporary stay.

Every year since then, health care costs have continued to balloon while Congress has continued to avoid making cuts, worsening the financial well-being of a program upon which millions of seniors depend. Repeatedly postponing the cuts has meant if Congress were to bring payments in line with the law next year, doctors would face a 23 percent cut in reimbursements.

To make matters worse, the Obama administration was counting on that 23 percent reduction, which would have saved Medicare $15 billion to help offset the cost of health care reform. The solution according to lawmakers in Washington? To cut subsidies under the Affordable Care Act in 2014, far enough off that no one need fear the wrath of special interest groups in the next election.