Because the procedure and consumables are the exact same for everyone. Volume is required to make more money, so prices are pushed lower. Plastic surgery is the same for anything not custom. When you can advertise to a specific procedure and it’s standard , prices can go down You see the same thing with ASCs. Hip replacement , knee replacement. Etc. DPC has the same advantage. These aren’t the cost drivers for 6t in healthcare costs. These aren’t the things that keep people up at night. When you see “Need a heart or lung transplant, Dr Strangelove has been your transplant king in Pittsburgh for the last 20 years. We will have you in and out for the low low price of $1,995. Financing available “ ads on a billboard , Or “If a family member has had a catastrophic accident , have the ambulance come to Surgeons R Us. We can fix anything for a flat fee of $2,995 ! “ We take HSA, FSA and Bitcoin “ Then we can talk about it being a free market that competes with the behemoths Right now the huge incumbents are Too Big To Care(Mark Cuban)