Specialist Salaries Come Under Scrutiny, But There is No Easy Answer to Reduce Costs

A New York Times article published this weekend takes aim at the increase in specialist salaries in the United States, suggesting the increasing pay specialists receive contributes to the high healthcare costs facing our nation.
According to the article, written by Elisabeth Rosenthal:
“The incomes of dermatologists, gastroenterologists and oncologists rose 50 percent or more between 1995 and 2012, even when adjusted for inflation, while those for primary care physicians rose only 10 percent and lag far behind, since insurers pay far less for traditional doctoring tasks like listening for a heart murmur or prescribing the right antibiotic.”
The report also takes on the income gap among primary care physicians and specialists:
“Specialists earn an average of two and often four times as much as primary care physicians in the United States, a differential that far surpasses that in all other developed countries, according to Miriam Laugesen, a professor at Columbia University’s Mailman School of Public Health. That earnings gap has deleterious effects: Only an estimated 25 percent of new physicians end up in primary care, at the very time that health policy experts say front-line doctors are badly needed, according to Dr. Christine Sinsky, an Iowa internist who studies physician satisfaction.”
The article takes aim at the high cost of what it argues are relatively simple procedures, and it certainly brings attention to some of the forces that influence how medical services are priced. For example, something as simple as a lesion removal becomes costly, when you must factor in the services of a dermatologist, who has undergone years of advanced training to identify and treat complex skin conditions; the anesthesiologist, who likewise has undergone years of advanced training; and the facility fee, which if the facility is a hospital is priced to help absorb the costs of operating an emergency room and other advanced services.
I don’t think anyone would argue specialists shouldn’t be paid more than PCPs — they go through longer training in order to treat more complex conditions, and should be compensated for that. However, is a three- or four-fold income gap, over a 30 to 40 year career, commensurate with an extra three to five years of training?
If not — which is the camp I lean toward — how can healthcare services be priced more appropriately?