No insurance hassles - I did medical billing for a bit. The insurance co's basically just run around doctors because they KNOW folks give up. You could absolutely force the $40 extra payment if dr + patient etc proved it out / appealed it - but often not worth it. Also govt billing into central county system for the poor - ugh - the bureaucracy / overhead was a nightmare (always having to recertify to financial need / paperwork this and that - 50% of time was on stuff I'd consider no value add).

For a while I had individual insurance (prior to obamacare). Because it had pretty high deductibles, I would just do a private pay / cash doctor for primary care etc.

Some big wins:

NO discussion about whether something was covered or not! You want to get service, just call.

No crazy surprise bills - yes - I once tried to go to urgent care for something at the main hospital, but NO ONE would tell me what I would be charged as a cash pay client. Yes, it can be expensive to do cash pay, but with a doctor billing by the time you can basically predict / know your cost.

Service - you are paying by the hour. I never felt pressured out the door (no surprise). The service is good to great.

Convenience - I got someone close who used his downstairs as his office. Have a problem, go in and get checked out. Because you don't need the huge billing infrastructure I think you can get away with smaller office sizes. To pay for a full time biller you need a few doctors, who then need a receptionist etc etc.