The whole point is that there is no insurance involvement. You pay as you go as a patient and because you pay as you go, the doctor charges the patient less. This would mean the patient and doctor would not only have a relation concerning the care given but also each would have a say in what procedures are allowed and which ones the patient could afford. The insurance company would not be involved in selecting the procedures for the patient. The doctor would not need a back office to collect insurance money because the money would have been paid at the time of service.
Some doctors have as many as six people hired just to collect money from insurance companies.
The business of being a physician should be taught somewhere. Many doctors do not understand how they are to be paid until it is too late.