OK, raise your hand if you were surprised to learn that physicians averted a major Medicare pay cut that was supposed to take place this week. Didn’t think so. I wasn’t either.

This month-long delay (reported on earlier this week by McKnight’s) is sure to be a precursor to yet another delay. In fact, top lawmakers and the White House have already publicly stated they want another 12-month delay after this one. If you’ve been paying attention at all in recent years, you already know that docs don’t take funding cuts, yet alone one of a 23% magnitude.

Lawmakers must have had some “silly gas” pumped into the Capitol when they voted that one through. In hindsight, it would be laughable had the measure’s passage happened in earnest. But of course, it didn’t. Someone needed to score political points or balance a spreadsheet, so the unrealistic fee cut was tossed to critics like fresh meat to hyenas.

Now, there’s no appetite to make it stick. Through at least a handful of “doc pay fix” extensions, it’s become obvious there is no real resolve to pull in the reins. Lots of big talk about doing it, sure. But never anything close to clipping physicians’ wings, for better or worse.

Whenever they have felt the slightest bit threatened—and it’s not often—they don white lab coats on the steps of some important building and threaten to take their black bags and go home. As many as two-thirds say they would consider not accepting new Medicare patients if funding were cut.

The rub for long-term care providers is a) you need physicians around, of course, and b) those doctors are being paid from the same finite trough that you dine from. The more the docs get, the less there is for everyone else. Take this one-month delay of the planned funding cuts for example. Changes in Medicare reimbursements for outpatient therapy services will pay for it. Now if that doesn’t hit close to home, I don’t know what does.

The way the political donations game has been going lately, it looks like the docs don’t have to worry about not getting their belly full. They’re the sixth biggest “corporate sponsor” of members of Congress nationwide.

Long-term care providers (the 62nd biggest donor) might know how to give until it hurts. But when it comes to politicians, physicians know how to give until it feels better.