In general, I am a very, very happy cardholder. Just recently, when my EVDO modem died, American Express paid for me to replace it with nearly no questions asked. That saved me about $250, since the modem had just gone out of warranty. That pays for over half my annual membership. They also paid for some MacBook repairs earlier this year, which was a real plus.
Then again, I just got a letter that the "domestic companion airfare program" has been discontinued. This was the program that said that when flying within the country, I could get a free ticket when purchasing one at their normal prices. When going to YAPC in Chicago, this saved us about $400. It's really the reason I decided to upgrade to a platinum card.
Now, instead of being able to travel for less, I have to hope for my electronics to fail to recoup the cost of membership.
It's annoying to lose such a great program, but... I still really like my American Express.