Guns and MAD are exactly the kind of violence society is founded upon. Ultimately you can't just stop paying tax or start driving illegal vehicles, because the state (usually) has a bigger gun than you. (In the case where it doesn't, you end up with something like Somalia or the mafia). MAD is the ultimate gun, not the absence of gun.
A doctor might be willing to die, but every man has a price he is not willing to pay - whether that's his child or a random child you pick off the street and make violent threats towards.
Payment is just a disguise and a convenience - the underlying order is still based on violence.