I think it is inevitable that Doctors will experience pay reductions under Medicare. At the current debt level, healthcare spending is untenable and even if this administration chooses to forgo the payment reduction, subsequent administrations will be forced to do so.
Also, assuming that the healthcare reform bill is not overturned at the Supreme Court, the added burden of thousands of patients will necessitate that more doctors be trained, which may have the effect of reducing physician incomes in the future.
Even as a premed, I can tell that medicine is not a good financial decision. And, given the pessimism of premeds regarding the future of medicine, I wonder how future generations will view the medical profession and whether it will be viewed with the same level of desirability.