I think it's a question of behavior economics. People look at the $75 a year for AMA and ask themselves, "What do I get for my money?" For those that perceive they get "enough," they either join or stay members. For those that do not perceive "enough" value, then they either don't join or leave. The biggest tangible benefit is the local AMA club, as AMA membership is required for access. And yet AMA spends far more on the superb facility in the center of the country, when the overwhelming majority of it's members are located more than a day's drive away. I think that's foolish, but hey, what do I know.