Here comes one of Washington’s least favorite rituals: the “doc fix.”

Every year, and sometimes more often, Congress passes a bill to make sure that doctors don’t absorb a big pay cut from Medicare. The many, many “doc fix” patches are meant to counteract a law passed in the 1990s that sought to restrain costs by tying doctors’ pay to a formula. Everyone agrees that the formula makes little sense, so lawmakers continually pass a short-term doc fix that keeps the doctors’ payments stable, and occasionally gives them a small raise.

Everyone grumbles about the doc fix: deficit hawks who call it a budget gimmick; doctors; and lawmakers and journalists who have to endure all the scaremongering news releases and congressional hearings, which started up again two weeks ago. (Though I’ve heard people express the opposite sentiment, too: Some call the problem the “full lobbyist employment act.”)

This year, as with several recent years, there is a movement in Congress to pass a “permanent doc fix.” It would erase the law’s inaptly named “sustainable growth rate.” The proposal, while a long shot because of its expense, has bipartisan support. But here’s the thing: The pressure on Congress to find a way to finance doctors’ pay every year has actually reduced federal health spending in general and the Medicare budget in particular.

Even though Congress doesn’t let the doctors’ payments go down, the doc fix still usually achieves the deficit-cutting goals of the formula’s drafters. With only a few exceptions, Congress simply cuts other parts of the budget to compensate for the extra money for the doctors. And that money almost always comes from Medicare or other health care programs.