A) Cut subsidies to Medicare Advantage
B) Pay hospitals less for high-margin services such as radiology
C) Lower Medicare reimbursements for care and procedures by specialists
D) The money shouldn’t come out of existing health-care spending
E) Primary care doesn’t need more money
Guess which option is winning? Well of course it's choice "C". Because you know those unscrupulous specialists who do procedures, i.e. non-cognitive medical interventions that a properly trained chimpanzee or even a bonobo could do, ought to be coughing up chunks of change for the poorly paid underclass of primary care docs. Bringing up the rear in the poll is "money ought not to come out of existing health care spending". In other words, don't even think about supplementing physician payment with any more federal money than they already get, dammit!
Why do we keep accepting the conventional wisdom that this is a zero sum game? We just forked out $700 bill to greedy bankers on Wall Street. It took us 50 nanoseconds to decide it would be a good idea to send $80 bill to AIG. If Obama wants to truly reform health care, he's going to need primary care docs; much more than our economy needs a privately owned company like AIG to survive. That puts physicians in the proverbial driver's seat, right? This emphasis on the pay discrepancy between specialists and primary care is just what the policy wonks in DC want. It's the angle they can use to avoid a federal bail out of the American health care train wreck. Just siphon money from the surgeons and proceduralists!