Every politician in Washington claims to want to cure what ails Medicare. Yet facing an imminent Medicare crisis that threatens elderly Americans' access to doctors, neither Congress nor the White House seems willing to act.

Under rules established by Congress, Medicare payments to doctors are about to be cut again, this time by 4.4 percent for a two-year reduction of nearly 10 percent. The medical community is warning that such cuts will force doctors to reduce the number of Medicare recipients they treat. And the cutbacks are a particular threat to Florida with its high percentage of elderly patients. Some young doctors looking to set up practices are reportedly ruling out Florida because of the impact declining Medicare fees would have on their income.

Everyone admits that the reduction in doctor's fees is an unintended consequence of a flawed formula that grew out of earlier efforts to keep government costs under control. So why has Congress been unable to fix the problem?

The answer gets at how Medicare reform has become the Gordian knot of politics and why no Washington version of Alexander the Great has stepped forward to cut through the complexities. In the last session of Congress, the House passed a Medicare reform bill that provided $30-billion in "give-backs" to doctors that would have made up for some of the lost fees. The bill's focus was a prescription-drug benefit that was rightly criticized by Democrats as too limited to help those most in need. The Senate, meanwhile, couldn't muster enough cooperation to back any one Medicare bill, in some measure because Democrats tried to include additional give-backs for hospitals and nursing homes, making the cost prohibitively high.

The Bush administration, for its part, has hardly taken a clear stand on the issue. It is reportedly considering broad reform of Medicare as well as cutbacks in funding to help pay for further tax cuts. Both issues would be controversial, casting the issue deeper into stalemate.

In short, Medicare problems get lip service from politicians but little action. The program is increasingly seen as a bargaining chip in fights over other political priorities.

When the latest cuts in doctor's fees take effect in March, fewer doctors will be taking new Medicare patients. That will put further stain on a system that is already struggling to provide many American with quality health care.

Congress isn't going to reform Medicare any time soon. But there is no excuse for delaying action on the fee issue. Both parties should find a way to fairly reimburse doctors while an accurate formula to fix fees is devised.

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