What Free Market Health Care Would Actually Look Like

Dr. Lee Gross’ direct primary care practice takes the complexity and unaffordability out of health care.

- By John Osterhoudt

If you have health insurance but no primary care physician, the process for getting physical can be a bit complicated. Whether or not you get your health insurance through an employer, you’ll probably have to find a practice in your area that is in your network. Then you’ll have to find out if it’s accepting new patients. You may have to wait months until the office will let you come in for a physical. You’ll have to figure out if you’re responsible for a co-pay. Even after the visit, you may need to cover the additional cost of any blood work or other tests, and you probably can’t figure out how much you’ll be billed for that ahead of time. At some point, you’ll also have to decide whether it’s worth the trouble to set up a tax-advantaged account to cover the unpredictable costs of this visit or any future ones.

Or you could just find a direct primary care doctor who’s accepting new patients and pay a flat monthly fee that covers all your in-office services and tests. If you need an out-of-office test or a prescription, the practice may also give you access to steep discounts compared to what it would cost with insurance.

There are currently more than 1,400 direct primary care practices operating in 49 states. Among them are doctors Lee Gross and William Crouch at Epiphany Health Direct Primary Care in North Port, Florida. They charge just $75 a month for an adult, $30 per month for one child, and $15 a month for each additional child. After that, nothing more is owed for services provided in the office—no health insurance necessary. In January, Reason’s John Osterhoudt visited Epiphany and spoke with Gross about what free-market health care should, and can, look like.