Hmmm, I like the idea of laying the design down on the front of the quilt but don't know how well that would work for me. I have proportionally short arms and legs on a long torso. Standing at a long arm, I really can only work in about a foot area maybe six inches in front of me, despite the machine and set-up having a deeper throat. So, for a narrow repeat like 6", this could be a great solution but for a larger design I just don't have the reach.
With my vision issues and the long arm I've been using doesn't have back controls although the frame is set up to use pantos, what I've been doing is copying the design onto parchment paper I buy at the dollar store, $1 for a 25' x 1' roll. I just sew through it and I can see the quilting pattern on all colors of fabric. Yes, the downside is that I have to first copy and then have to take off all that paper. Fortunately for me I do like rather larger designs and thicker batts than are currently popular and it gives me results I am happier with than I could otherwise do.