To be clearer: There’s a spectrum between 100% cash market, to indemnify plans where you e.g. you have a flat 10% co-pay, to “in-network” plans like PPOs, and pre-paid plans with corporate employee docs (e.g. Kaiser). Not all HMOs have employee physicians as you noted.

My point is that third-party free medical services are out of reach of most Americans. Even if the doc is separate from the insurer, they have to follow their claims process. You generally have to take your employers plan. The less fortunate take Obamacare and its limited doc networks, or are totally out of luck!