Then get government to shut them down. Qliance is a chain of medical clinics in Washington State trying to bring boutique medical care to people of lower income. Sounds like a good thing, no? Well, not if you are one of the clinics competing with them:

But to Group Health’s [Stephen] Tarnoff, Qliance represents more of a threat than other boutique firms because it has scaled back perks that are typical of higher-end outfits. It is nothing more, he believes, than a “basic primary care” service, but one for which patients have to pay out of pocket. “People who are going to get this are going to have to pay twice,” predicts Tarnoff, once for their monthly primary care fee and once for the insurance they will still need for specialist visits and catastrophic care. If this model catches on, he says, many insurance companies might eventually stop covering primary care altogether.

Tarnoff seems to know what tune to sing to get the ear of the State Insurance Commissioner:

In fact, Qliance’s founders say they would welcome such a change. They compare primary care insurance to car insurance that would cover such routine work as an oil change. State Insurance Commissioner Mike Kreidler, among others, disagrees. “If we see a scenario in which primary care is abandoned by health insurers, then we would start to have second thoughts about what this is doing to the whole system,” says Kreidler. “There are a lot of uncertainties as to what the effect of this is.”

A few years ago, Kreidler cast doubt on the operation of boutique practices by telling them they were acting as insurance companies—by accepting prepaid money in exchange for medical services—without following regulations required of such companies. Yet a bill he supported, which passed this past legislative session, allows “direct patient-provider primary care practices” to run free of regulations on insurance companies. But the new law also imposes some safeguards. One that is crucial: Such practices cannot turn someone away on the basis of their health.

Yes, there are uncertainties! That’s called a free market. It cuts through the uncertainty by figuring out what businesses work and which don’t. If these types of clinics work well and fewer and fewer insurance companies cover primary care, that means that people prefer the clinics to having insurance cover primary care.

But, alas, Kreidler believes that only elites like himself are qualified to make decisions about our health care. About two years ago, he testified against a bill in Congress that would let people buy insurance out of state. According to Kreidler:

Unlike group insurance consumers, individuals shopping for coverage do not have the sophistication of an employer when making coverage decisions. Consumers in the individual market need the protections afforded by State regulation.

Yep, you are too stupid to know how to buy insurance, and you are certainly too stupid to decide if you want insurance that covers primary care.

All I can suggest to the owners of Qliance is to keep an eye on how cozy their competitors get with Kreidler. If the relationship gets too cozy, they might consider moving to a state that is friendlier to market innovations.