It's a question posed and answers explored on page 18 of this week's GP as the outcomes of the coalition government's NHS plans become clearer.
It remains a White Paper begging more questions than answers, which is why it is just as well that there is a consultation period until 11 October.
The White Paper presents private firms with many more opportunities for NHS expansion and what will be fascinating over the coming months will be whether GPs act on the BMA's Look After Our NHS campaign and its anti-privatisation agenda - or not.
This week's GP also analyses the news that the White Paper proposes a proportion of GP practice income would be linked to the outcomes that commissioning consortia achieve. GP reaction is split: would the 'quality premium' come from historic funding (what practices already receive = bad news) or funds freed up by the abolition of PCTs (new money = good news)?
If the news is bad, as expected, why should practices take on new work if there is no incentive for them to do so?
New contract talks have begun and it seems impossible to think there will be no carrot, only stick on the negotiating table.
Surely the whole point of negotiation is that the government is prepared to give some ground to achieve the outcomes it wants? Playing hardball at this stage by imposing commissioning responsibilities without incentives may be a negotiation position open to influence.
When writing about the White Paper it is imperative to read all the documentation. It can be easy to become buried in detail and lose sight of the main thrust of the proposals.
What is important to remember is that this is a White Paper which gives the profession the opportunity to take more control over its work and increases its power over patient outcomes. The rest, as they say, is up to you.