1. The majority of patients are otherwise uninsured and cannot afford health insurance, so if they need primary care they pay out of pocket. Google walk-in clinics and get a feel for the typical "co-pay" for a walk-in clinic in your area and compare the same to our cost.

2. Some of our patients are insured, but they prefer not to use their insurance for primary care visits, because: a. they can not see the primary doctor they want; b. it takes a few days before their primary can schedule an appointment; and c. using insurance their co-pay is significantly more expensive than joining our network.

Our model is serving a need to uninsured not because they are "poor or ignorant" as you suggest, but because uninsured need primary care. Many other practices offer memberships, so this our model is not unique but I have not come across any that offer memberships at our prices - feel free to find one, it might exist.

>"now obamacare makes it clear to them they can get it easier than paying cash every visit."

Almost all insured and medicare patients pay out of pocket per primary care visit, it is called co-pay. However, in addition to the patient out of pocket co-pay either medicare or their insurance is getting billed...which drives up the cost of the patient healthcare, and guess what the patients are paying these costs in the form of FICA and/or insurance premiums.