Each provider only treats 800 patients a year versus 3,000 to 5,000 so who picks up their slack? clearly this is the same as charter schools and is only a stop gap solution for people who pay out of pocket the monthy fee for a carve out of care. At $55 a month for 800 patients they are grossing over $528,000 a year so that is sweet..

They don’t however cover basic preventive care like mamograms and without a gyn on staff how do they treat the most common reason women go to the doc (family practice can handle it but he is an internest) they also don’t treat depression one of the top four reasons for visits to doctors.

Will it help provide affordable basic primary care and make his investors wealthy? Sure sounds like it but will it solve the problem with health care in this country? Not unless you triple the number of family practice docs so that they can all treat only 800 people.

Washington has 2.5 doctors for every 1000 people but there is a shortage of doctors in Eastern Washington because unlike other business doc’s don’t locate where the need is but where they want to live and can make the most money. Of course they can drop Medicare. Afterall why let the sick poor elderly fill up your practice hours when you get get the healthy wealthy to shop at your practice. This is the whole foods model of health care. Most people won’t be able to afford it and it doesn’t solve the problem of access at all.

With his Utah background I am guessing he is a free market advocate all around? Even though there are strong incentives to cut the overhead in health care we don’t “purchase” health care like a TV. Insurance is there to cover us in case of very expensive accidents and it makes sense to use his model for the small stuff, but only if everyone has access.. Otherwise they are just shifting the high cost low income people onto their colleagues.

Oddly enough the VA provides the highest care at the lowest cost because they essentially own their patients for life and have a vested interest in the outcome. Medicare also only has a 3% overhead not the 30% cited in his video. That is only for the private sector blues that need to pay their exec’s a fortune (Aetnea ceo was paid over 2 million last year)

I was a patient at Seattle Medical Associates since it’s inception and am now with Qliance. On my last visit I asked how well things were going with Qliance and who exactly was signing up. I was told people like taxi drivers and self employed people with small business ventures who could not afford horrendous insurance premiums. These are certainly not “the wealthy”.

I’ve been spoiled with the type of service this model is able to offer…and chose to pay regardless of the full medical coverage I have at work. When I listen to my (hospital) work associates talk about waiting a month and a half for appointments and sitting in the waiting room for almost 2 hours my choice to spend this extra money is validated.

If this keeps even a few people out of the emergency rooms it is worth it. I hope you’re not implying that just because the system is broken we should all be bound to live with the misery of the broken system.

Perhaps eventually there will be more physicians when our best and brightest realize there is a way they can actually practice medicine and not just graduate to be insurance company puppets.

> Each provider only treats 800 patients a year versus 3,000 to 5,000 so who picks up their slack?

Actually, he addresses this shortage problem in another of his talks: http://www.tvw.org/media/mediaplayer.cfm?EvId=2008030136C&bhcp=1

Essentially, doctors have been deserting primary care in favor of pursuing specialities because insurance payouts favor the procedure that specialists do, while squeezing the primary care doctor, forcing them into 30-patient workdays.

So if you make primary care more attractive, you stop the outflow, and draw people back in. Also, if the quality of care reduces the necessity of specialist and hospital care, then again, you reduce the forces which draw doctors out of primary care.

> Even though there are strong incentives to cut the overhead in health care we don’t “purchase” health care like a TV.

There are strong incentives to cut corners in any market. But there are corresponding disincentives, based on the buyer’s judgment (often fortified with the aid of third party reviewers and analysts), to not cut corners. That is, in order to keep patients paying their membership fee, they have to justify that fee, with service. Cutting corners would leave patients dissatissfied and send them looking elsewhere.

Also, cutting corners would leave the patient less healthy, and thus lead to more costs from that patient. With this model, so long as they can’t drop people due to bad publicity or otherwise, there’s a strong incentive to keep people healthy, as that’s what minimizes their need to interact with you.

> it makes sense to use his model for the small stuff, but only if everyone has access.

They do accept everyone, and he’s said that dropping or rejecting folks would be bad for their reputation.

> Aetnea ceo was paid over 2 million last year

That’s a drop in the bucket compared to the total revenues ($27B) of Aetna. The inefficiency comes through paperwork, policing &c.

Thank you Dr. Bliss for setting an example for taking it upon yourself to show our nation on healthcare reform looks and should encourage other doctors and clinics to give care to everyone that needs it, but making it affordable. I think it is a brillant plan and would overall benefit the majority of people that cannot afford insurance in it’s current state. I also agree that people should have a catastrophic insurance as backup for things like cance, diabetes, heart disease and stroke, but the insurance companies have to make it affordable.

Health care has been out of control for many years now and too many people suffer and go with out basic care that could keep them out of hospitals and healthy.

I think you need to take your grass roots plan to the White House and show them your very simple business plan and how it works.

Good Luck and God Bless You!