On July 29, the Federal Trade Commission, joined by Utah and California, sued the telehealth company, hims & hers . The complaint alleges the company did the following:
- Charged consumers almost immediately after they submitted an online intake form, often without the medical consultation it advertised,
- Made canceling a subscription deliberately difficult, and
- Shared consumers’ sensitive health information, including specific medical conditions, with Meta, Snap, and other advertising platforms.
Hims and Hers disputes the claims and says it will fight them vigorously. Whatever the case’s outcome, the complaint describes something familiar to anyone who studies subscription business models: fast sign-up, hard exit, data monetized on the way out. It’s the standard “bad actors” playbook. It’s just never before been run on people’s health information at this scale.
Hims & Hers isn’t an outlier. Amazon bought One Medical in 2023 for roughly $3.9 billion — not a hospital system or an insurer, but a membership, an app, and same-day access. CVS Health has spent more than $18 billion on Oak Street Health, part of CVS Health and Signify Health to build its own primary-care and in-home-care networks. Concierge and direct-primary-care practices, charging patients $100 to $200 a month for a doctor who isn’t rationing 15-minute slots, are among the fastest-growing models in American medicine.
I’ve spent my career helping companies build what I call the Forever Transaction: A relationship where the customer keeps renewing because the company keeps delivering on a Forever Promise, not because fine print or friction locks them in. Netflix and Amazon Prime won that way.
Subscription healthcare has enormous potential but only when it’s built on trust, transparency, and a promise that puts patients first. (Photo by Tima Miroshnichenko)
Healthcare is now running the same playbook. Done well, it works: a member who can text her doctor and get a same-day video visit is more likely to catch a problem early and stay engaged. Direct primary care in particular has real promise as a lower-cost alternative, and continuity of care is a genuine clinical good. The problem the FTC noted is when healthcare adopts the habits of the Membership Economy’s worst actors, rather than the best. And the stakes here are way higher than a forgotten gym membership or streaming service.
To be sure, one lawsuit against one company doesn’t indict a category. Teladoc, the largest player in the category, trimmed its 2026 revenue forecast the same week, citing pressure on its BetterHelp mental-health subscription business — a sign the strain isn’t confined to one company’s legal troubles. But this summer, HCA Healthcare disclosed that the expiration of enhanced Affordable Care Act subsidies cost it roughly $400 million in the second quarter alone, as patients who lost their exchange coverage went uninsured instead of finding new plans. Roughly 2.6 million people have dropped off ACA plans since last year, and hospital executives say almost none of them landed anywhere else. Subscription medicine isn’t an alternative for those patients; it requires disposable income most of them no longer have. But as public coverage keeps fraying, subscription and concierge care will increasingly be the only reliable access to a doctor that anyone has, insured or not, just at the moment its own leading players are being accused of the industry’s worst subscription habits.
That combination is why healthcare subscriptions can’t be regulated like a lifestyle app anymore.
Four changes are overdue:
- Apply the billing, cancellation, and data-privacy standards the FTC just used against Hims & Hers across the whole subscription-health category as a baseline, not case by case after each lawsuit.
- Require plain-language disclosure, so patients know exactly what a membership fee buys versus what insurance already covers before they sign up.
- Enforce consistent licensure and scope-of-practice as telehealth crosses state lines at scale.
- Tie the growth of concierge and membership networks to investment in the safety-net capacity they draw from — residency funding, Medicaid-facing primary care, loan forgiveness — given that the Association of American Medical Colleges projects a shortage of up to 124,000 physicians by 2034, including as many as 48,000 in primary care, the exact specialty concierge medicine pulls hardest from, and the exact specialty a growing uninsured population will need most.
A subscription only earns the right to renew if it keeps its promise to the member every single day. Healthcare is now testing whether that promise can survive contact with a system where the member’s well-being and the public’s access to care are diverging fast.
The Membership Economy Is Coming to Healthcare (Photo by Thirdman from Pexels)
The membership economy is coming for your doctor’s office. Whether it becomes the best thing to happen to American primary care in a generation, or a nicer waiting room for the people who can still afford one, depends on the guardrails we build now. Let’s not wait for the next lawsuit or the next earnings call.