In this guest column, UTMB’s Dr. Howard Brody addresses the upcoming decision that Congress will have to make about the Medicare formula for physician payment. “Years ago, well intentioned policymakers designed a payment formula that made small adjustments every year toward long-term cost savings. The problem was that neither physicians nor Congress really agreed that the best way to save health care dollars was to cut physicians’ pay. Congress responded by passing short-term fixes that delayed the implementation of the pay cuts. The formula, however, kept churning away, so that each threatened cut in payment was bigger than the last, and now has reached a whopping 23 percent. Congress has to act by Dec. 1 to prevent that drastic cut from taking effect.” The column also appears in the Beaumont Enterprise and the Galveston County Daily News.