I see 20 to 40 patients per day as a Nurse Practitioner in an Urgent Care. It keeps people from using the hospital ER as their Primary Care. Many of my patients don't have insurance and they just pay the visit fees. Most only need a physician once every 2 years so this saves them a monthly insurance premium. However, if they need surgery or extensive tests they could loose everything in today's economy. They are so afraid. If we had a per person catastrophic subsidy from the government it would cut down on ER costs for the hospitals. The VA's and Tricare clinics could be opened up to the general public for fee for service. Minute Clinics run by Nurse Practitioners in pharmacy's could be given more authority to order labs and xrays. A not for profit government HMO is what we need.