Sorry for the leap.:) I think HSA’s are the answer where there is more competition for your dollar. That said a practice will have to have some type of method whereby their recurring operating expenses such as rent, utilities, office staff and such are covered; this would be offset by a fixed monthly/yearly charge, in theory you per visit payment is solely for medicine.
Concierge medicine as a mainstream choice is in it’s infancy so prices may vary widely. More competition should smooth out pricing a bit. But, hey, what some doctors are charging may be worth it for a person in need of extra care or for a particularly good physician.
If we dump the insurance company regulations as they are now which prevent competition, such as insurance companies cannot sell policy risk pool across State lines, get real tort reform, reform drug manufacturer regulations, and remove 99% of current government regulations we might actually get back to capitalism and a free market whereby doctors can offer their services as they see fit.