Bringing Surgical Precision to Public Policy

Following an election that left the White House, the U.S. Senate and U.S. House in the same hands, even the most ardent opponents of the Patient Protection and Affordable Care Act (PPACA) are calling off wholesale efforts to erase the law from the books.  As Congressman Phil Gingrey (R-GA) told The Hill newspaper, “It would be pointless, in my opinion, to have a vote on repeal of PPACA.”

That doesn’t mean, however, that the legislative surgeons should refrain from picking up their scalpels and performing detailed actions to improve the health reform measure.

A good start was explained in an op-ed in Politico, co-written by health industry leaders including C.R. Bard CEO Tim Ring, a member of the Healthcare Leadership Council.  In the op-ed, the authors explain that it is essential for Congress to repeal the scheduled excise tax on medical devices for both economic and healthcare reasons.  The tax is applied to device company revenues, not profits, and thus will be a heavy financial burden that is already having an impact on jobs.  (Stryker, a major manufacturer of joint replacements and other healthcare products, announced this week it will have laid off five percent of its global workforce by the end of 2012)

As Ring and his colleagues point out, though, the tax will also have an adverse impact on medical innovation.  They wrote, “If the device tax goes into effect, the march of medical innovation will be inhibited and patient access to the next generation of medical technology won’t be realized…small businesses often suffer losses in the early years of operation when they are investing in research and development on new products.  Paying a sizeable new tax while incurring traditional startup-driven losses will be more than many small businesses can bear.”

I would go further and suggest that Congress examine all of the taxes and fees being applied to healthcare sectors by PPACA to determine how they can affect the course of medical innovation, the nation’s role as the global leader in medical breakthroughs, and the state of job growth during these fragile economic times.  That re-examination must extend to scheduled provider cuts, particularly if acquisition of health insurance by currently uninsured Americans does not take place at a pace that lawmakers envision.

The war over PPACA’s existence may be largely over.  The effort to improve it hasn’t even gotten well underway.