Turning Health Care Upside-Down

At Qliance, patient care comes first, cost calculations later.

By Mike Lewis | September 2009 | FROM THE PRINT EDITION

Credit: Photo by Richard Darbonne

The June trip to Washington, D.C., Dr. Garrison Bliss explains in a hurried phone call from the nation’s capital, involved more defense than offense.

“We just want to make sure [lawmakers] don’t do something to damage what we want to do,” Bliss says. “We want them to know that insurance has been central in the destruction of primary care.”

Which explains the trip, a culmination of years of efforts at the state and federal levels to ensure that the traditional health insurance industry didn’t squelch the company’s operations before they had properly got off the ground. But this is more than just a turf battle, because Seattle’s Qliance Medical Group, a subscriber-based primary care startup founded in 2007, threatens to shake the foundation of health insurance as American consumers know it.

Bliss, along with CFO Norm Wu, began Qliance on the notion that primary care never should have been the bailiwick of the insurance industry. What’s more, they maintain that the industry is directly responsible for both reducing the quality of care and radically inflating its price.

“The insurance model is broken for primary care. It never should have been used for that,” Bliss says. The historic problem, Bliss argues, is that the health care and insurance industries decided that primary care was worth very little and catastrophic care, or major injuries and disease, was worth a bunch.

It turned out to be a disastrous decision both for the economy and for individuals, he argues.

On how the health care system got into this miss, Bliss explains: “What we did was to pervert the concept of insurance, to try to make it pay for everything in health care. And what that created was a monster that doesn’t provide very good health care and provides it at enormously inflated prices.”

Enter Qliance.

First opening its doors to patients in a downtown Seattle location in 2007, Qliance operates under a business model that asserts people should pay for their own primary care and use health insurance for catastrophic care—much in the same way people manage insurance on their homes.

Bliss’ and Wu’s model? No insurance. No limit on visits. Each initial appointment lasts a minimum of 30 minutes and annual exams can last from 60-90 minutes. Patients can drop in anytime for urgent medical matters and