I don't understand this meme.
If you have an hmo you're supposed to have a primary care doctor/physician.
If you have ppo then sure, it would make no sense to have a primary care since its not required to see a specialist.
But if you have insurance and your not well off then it a pcp isnt an issue or you have an hmo.
When the aca was passed, insurance was mandatory.
Sorry i forgot that the gop tax bill in 2017 repealed the individual mandate penalty.
Some states still do have a penalty for being uninsured.
The penalty wasn’t close to making it mandatory. It was still cheaper for people to pay $900 out of their tax refund than to buy “affordable” $300-600/month insurance with a $2-8K deductible. Lots of people opted for the penalty.
I can't speak for others but for me I don't have a general practitioner because I will never go to any doctor if I don't have to. I just simply can't afford it or am absolutely terrified to find out how much the time bomb of a mystery the medical bill will be. I've never even looked because I already know I can't afford to see a doctor for pretty much anything. It sucks