So, I'm forced to ask, what's the downside?

This does kind of read like the bought this article in the Strangercrombie auction.

Sounds sort of like a "micro" version of the old Group Health cooperative of the 50's and 60's to me.

Doctors who actually LISTEN to their patients? That's hard to find at any cost... and the fact that it's actually affordable for most people is just too ironic for words.

I have bipolar disorder (currently on Lithium but having severe suicidal ideation) and HIV (high T-cells (~950) and low VL (~115), so not on ARVs). Is Qliance an option for me?

Oh crap, it is a strangercrombie auction winner. My browser had blocked the banner image.

To the person with bipolar disorder, and HIV,..YES! Qliance is for you, there are doctors who meet regularly with people living with HIV. Go NOW

The downside is not to the doctors in the system who limit their practice to 800 and charge on average $50 a month (over $480,000 a year). And the patients benefit. The loss is to the insurance companies.

They only have a few providers and in the lower tier some of them are nurse practioners (which give great care) but if every doctor did this what you would do is push low income people onto other providers. The interesting experiment would be if the State paid for some of the people with chronic conditions like diabetes (10% of all patients account for 70% of care) to use the service and compare the outcome in quality and cost. In Medicine we test everything else before we prescribe it as a solution so it is a simple test. 3 sets of patients diabetes, heart disease and depression at 3 locations. 1 at Group Health, 1 at Swedish and 1 at Qliance.

Most doc's have about 2,000 on their panel and there is a huge shortage of primary care docs so perhaps this would encourage more docs to go into primary care again? The transition will be ugly though. Think private school vs public school.

To the "qliance advocate". Thank you for responding to my post, but your response has pretty much indicated that Qliance would NOT be helpful. Assuming that the providers there listen as poorly as you comprehend the written word, it seems that my most pressing problems (i.e. SEVERE suicidal ideation) would be ignored to focus on something else that is not as pressing. But thanks again for responding, you've prevented me from getting my hopes up and wasting my time trying to get help from somebody who just doesn't get it.

sounds great, except that it misses the main point of insurance which is to provide coverage in emergencies or for seroius illnesses. what happens when your primary care doctor finds that you have cancer or a brain tumor? while insurance is certainly screwed, it does come in handy when you need surgery, chemo, or other treatments. without access to specialists and hospitals, patients could be in real danger.

I believe the idea (which for some reason is not fully articulated in this article) is to use this for regular things but keep a 'catastrophic' health insurance policy to cover true emergencies, cancer, etc. That way you're not going to the ER for a splinter.

MC- they certainly aren't advocating not having insurance. On the contrary - they are saying that insurance provides a disservice in primary care situations. The doctors at Qliance always have advocated (to me) that people should have a high deductible plan (for catastrophic illnesses or injuries that require specialists, hospital stays, surgeries, etc) but to go to them for primary care because you get better service, which translates into them catching more things that would otherwise be ignored, which leads to less reliance on insurance because issues are dealt with BEFORE they become catastrophic.

Endofmyrope - yes, the doctors at Qliance can (most likely) help you. They would address both problems and would take both situations seriously and treat you with complete respect. If you are discounting Qliance because of one persons response - that's a shame.

EndOfMyRope: Remember this is primary care. I am not a medical professional, but you may have something more complex. You may need a specialst beyond what they may be able to do for you.

Sorry to state the obvious, but have you told the Doctor who prescribed the Lithium about your side effects?

If you doctor is no longer helpful, I would suggest you consult with them, at least for a second opinion, and if they can't help with everything, you are not out of a lot of money, and only an hour or two of time.

Please don't give up trying to get that addressed, whatever you do.

@EndOfMyRope, you can visit the website and get a pretty good idea of the services they provide. I'm bipolar, too, so paid special attention to their statements about mental health. They do not provide more than "primary care level" services for mental health. For me, that's okay as my illness is well managed and mostly what I need is someone to check in with now and then. Judging only by your two comments here, I'd say that you need something far more comprehensive in that department.

dj,
while having both catastrophic and qliance is ideal, who can afford that? for our family of four, we pay over $400 for a super high deductible, cover nothing plan. to add this service would be another $200 per month. how many consumers can do this?

MC has it right. While I appreciate the change in paradigm that QLiance represents, and it does seem that they offer a fine and mostly affordable approach to maintenance and non-catastrophic health care. But the main point of real insurance is to deal with the astronomical costs of the relatively extreme measures required when catastrophe stikes, exactly the situation where QLiance shows you the door (as I understand it. QLiance offers nothing for that, so you still need to insure yourself for the unthinkable. Suddenly that $129/month, or even less, doesn't seem so cheap when you still need to pony up for a regular policy, with a high deductible presumably.
The problem is that in hindsight it's obvious that traditional insurance should never have been allowed to apply to the routine care and screening or minor accident care. If we could uncouple that from the catastrophic coverage we could possibly begin to return to a rational system where we know our providers and vice versa. But I'm not ready to go without catastrophic coverage or pay two health insurance bills anytime soon.

EndOfMyRope, call the Crisis Clinic at (206) 461-3222. They can help!

I like the idea of an unlimited monthly use Primary Care Provider (PCP) but I'm also not convinced it's a perfect solution for low income individuals (Disclaimer: Nothing really is...)

As has been pointed out, what it sounds like you are essentially buying is a PCP rider to whatever insurance policy you also carry. While many issues can be handled in the primary care setting, those at QLiance are right to suggest a catastrophic coverage plan as well. So as I've already mentioned you end up with a catastrophic plan with a PCP rider. That's actually probably very good coverage but it's not bargain basement cheap.

It's probably a very good option for a middle-class worker who doesn't get good insurance from work but has chronic health issues that need addressed many times per year.

mc: Like the real-estate agent in this article, couple Qliance membership with a (relatively) cheap major medical plan to pay for the cancer treatment, surgery and road-traffic-accidents and you have yourself a workable, somewhat comprehensive model.

And EndOfMyRope: Are you really assessing the value of care at Qliance based on a posting in the comments section of The Stranger? Really?! I don't think this is a good idea. Go there yourself to see if these people can help you. You plainly need some assistance. What do you have to lose?

Qliance hmmm. this was on my mind for a while. good article.