I don't think you realize what Dr's are up against w/ managed care. The HMO's or whatever are judging them based on increasingly unrealistic parameters, especially time spent w/ patient. They are not being reimbursed at a rate that allows them to cover costs and make a reasonable profit given the level of schooling they have.
The concierge practice fee is an attempt by some Dr's to get around this problem. The increasing cost of medical care (and decreasing net salaries for GP's) is something the average consumer has been insulated from for many years but that doesn't make it any less real. It is only going to get worse and this is what's driving so many physicians out of primary care and into specialties where fees are higher.
I have been searching for a decent Dr for years now and any recommended Dr has long since stopped accepting new patients at all, let alone w/ additional fees. If I had some serious issues to be addressed I would probably seek one of these concierge practices out but absent that would give it a pass. If the fees were paid via FSA's it would be at a 40%+ discount for most tax brackets which would take the sting out of it.