US Supreme Court Upholds Affordable Health Care Act

[kandrathe]

I struggled with this question, mostly because of the vagueness of the term "quality" when it comes to health care. In the end though, it really boils down to what motivates anyone to do quality work.

Favorable performance evaluations leading to higher compensation and possible promotion?

But, demoralized health care workers is not anything on my radar.

I think my bigger concern is the erosion of the "paying for it" side of Obamacare. Just as the SCOTUS decision on Medicare and the States, it leaves all the carrots, but removes the stick. There are many different special interests lined up to get their part tweaked, which I fear will result in more benefits with less ability to pay for it. For example, the special 2.5% additional tax on medical devices -- there is a sound argument that it will cost the manufacturers directly, and be detrimental to manufacturing jobs. As people figure out, and with the help of their pocket legislator avoid the costs, ultimately it will become a tax burden or pile onto the debt (taxes later).

A secondary concern of mine is that many employers will realize the penalties for not insuring their workers are cheaper ($2000 "tax" vs. ~$15,000 average employer contribution for health insurance), and so more companies will increasingly choose to pay the "tax" rather than pay the insurance. According to the CBO's latest estimates (pre-SCOTUS ruling) it will put more people in the uninsured category since they won't qualify for government programs and cannot afford the prices on the health care exchange.