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This book explores Medicare spending for physician services that has climbed more than 9 percent per year, since 2000. Slowing the increase in Medicare outlays is important; in fact, it is becoming urgent. Medicare's rising costs, particularly when coupled with the projected growth in the number of beneficiaries, threaten the sustainability of the program. As discussed in this book, the Medicare Trustees' warn that even their unrealistically constrained estimate of Part B spending growth will still significantly out pace growth in the U.S. economy. Thus, Part B and total Medicare spending growth will continue to put pressure on the federal budget. However, that pressure puts other national priorities, such as homeland security and education, at risk. This book examines the Medicare law that specifies a formula for calculating the annual update in payments for physicians' services. The concern of many members regarding the impact of potential payment reductions on patients' access to services is looked at as well.