A Medical Devices Group subscriber wrote me,

I've been receiving your e-mails for several years now and I generally find them to be interesting, useful, and often humorous.

I've never responded before, but I was really put off by this e-mail about the device tax repeal.

I'm not sure if it was intentional, but I found your message to be incredibly cynical.

First, I find it sad that so many people in the medical device industry fight and rage against the tax while never mounting any serious reason for the fight except not wanting to pay money out of their pocket.

Yes, I'm familiar with many arguments that have been made against the tax, but none address the root issue that our current health care system is unsustainable and needs to be overhauled.

Bringing more people into the healthcare system will result in greater device usage, and that expenditure needs to be paid by someone.

Why can't the industry be part of the solution instead of just an entrenched enemy of change? If we don't become better stewards of the healthcare system, greater and more disruptive changes will likely be forced upon us.

I don't know of any jobs that have been lost because of this tax (even the ones that were publicly declared to be due to the tax) that weren't truly because of some other underlying problem in a particular company or industry segment.

So back to the original point of your message - the tax bill is being repealed - but what are we celebrating, exactly? Because the corporations are 2.3% richer?

The second thing that I found so discouraging about your message was the characterization of the omnibus bill that the tax repeal was a part of.

Actually, its not the characterization itself (which I agree with), but I just don't see anything to celebrate in this kind of legislative act.

This is the worst example of bad governance in which no one really cares for the greater good or prudent use of tax dollars as long as they get their piece of pork.

So, in summary, I come away from your message feeling like legislators just slapped a bunch of crap together to fund their pet projects and, oh by the way, we just got out of our tax so yay and screw the taxpayers.

That is not exactly a happy holiday message to me.

Stepping off my soapbox...

I replied,

Thank you for writing me. Oftentimes I wonder who’s reading this and did it have any impact at all.

I’m certainly glad my previous ones were well received.

1. Agree. Our healthcare model is unsustainable.

2. Disagree. I’m fine with industry paying taxes. But an excise tax on total sales of medical devices? No, not appropriate.
   • Relative to other goods and services in our national economy. Most excise taxes are sin taxes (alcohol, tobacco, oil, highway, air).
   • Relative to international competition.
3. Agree. ow many jobs are actually lost? ¯_(ツ)_/¯ But I am aware of real-life cases of job losses among Medical Devices Group members from it.

4. Agree. Greed abounds. Will some corporations enjoy the windfall? Absolutely.

5. Disagree. …but innovation gets stifled. You pay taxes before you even have a profit. It’s hard enough bringing a medical device to market! This tilts the balance even more in favor of the Medtronics of the world.

6. Agree. Very cynical. The state of our politics disgusts me. It seems reasonable debate has given way to Us versus Them.

In sum, yes, I’m glad the tax is gone. It’s better for the industry, better for innovation, and – would I have preferred reasonable legislators coming to the same conclusion – yes. But yes, I got the outcome I sought, and yes, I celebrate it.

Does that sound fair?

He simply replied, "Thanks for the thoughtful reply. I do think this is a good debate and happy to let you post/share it on your site but I prefer to remain anonymous."

Marc Silver, MD
Heart Failure Expert/Author, Consultant and Screenwriter
Thanks Joe for the updates. Great work this year.

Lev Melinyshyn
CEO at Uresil, LLC
Cleared the Senate - Whoot! One more signature to go

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
Incredible! People are claiming 2% of of profit was the cause of thousands of people being laid off. Ridiculous! One of the reasons there was a tax was to help pay for pre existing conditions. 1 out of 7 will women wii have breast cancer. 1 out of 3 people will have cancer in their lifetimes. Having spent 34 years out of my initial 55 years in the industry, I retired. I could have moved up in the corporate world... BDX. My wife was diagnosed with breast cancer at stage 3. I instead put my ambitions on the back burner to tend to my wife and then 6 year old son. If a corporation can’t survive with losing 2% profit then they deserve to be bought out or go out of business. The industry is littered with medical device industries.....Marquest, Sorensen, Seamless, Sherwood medical, Deknatel, phaemaseal, AS Aloe, Argyle, Deseret, Martell, Devon, Airlife, IBM Medical,

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Arthur : The medical device tax was a 2.3% tax on the value of products sold, NOT the profit thereof. That's a huge bite out of a device manufacturer's revenue. With razor thin margins compared to the pharmaceutical industry this punitive tax did indeed alter the business trajectory of many companies and the careers of their employees. If you're going to argue at least know what you're arguing about.

Glenn Jacobs
Mechanical Design Engineer at ?
Another thing President Trump has done for America

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
If you were or are NOT involved in Medical Devices, I would be be quiet....one of the pillars of Obamacare was taking care of folks with pre existing conditions......thus the 2% tax on medical devices to help offset this cost. People here clutching their pearls about a 2% tax and people losing their jobs are clueless. The Medical Device Industry has a 100% turnover every 2 years. The reason I know, is that my former employer, hired the Alexander Group to conduct a year long study. My company had an average of 12 years tenure, and they announced at a NSM they wanted to be “like everyone else.” 2 years and outta here.

Glenn Jacobs
Mechanical Design Engineer at ?
Arthur A. I am involved. Having worked in Medical device design for over 35 years. (How's that ?) For Obama Care, How would you like to pay taxes for something you did not buy or want to buy? I did. It was actually cheaper for me to pay the penalty than buy the insurance. $3K a year vs $2K /month

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
Glenn Jacobs do you pay taxes for roads and highways? You don’t want to buy or own those- right? Used for the greater good..

Glenn Jacobs
Mechanical Design Engineer at ?
Michael Kren you are confusing being taxed so things may be used for all vs being taxed for not buying something that someone else says you need. So with that, I guess you have no problem with sending me a "tax" on my requirement that you buy a 56 foot boat?

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
Glenn Jacobs not confusing anything..

Anthony Leo
Global Account Manager at Covestro
Great news in a thriving market with excellent innovation.

Lev Melinyshyn
CEO at Uresil, LLC
It just cleared the House. Senate up next. Then beer. A lot of it.

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Great news and it's about time. I personally saw the devastating effects of this ridiculous and punitive tax in the form of layoffs and ruined careers. May it never come back!

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
An excuse.. Companies have done well for most part..Record profits ..

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Michael Kren Yeah, an excuse Michael. I'll tell that to myself and the hundreds of people laid off from high-paying jobs and decades-long careers that the medical device tax was just an excuse. I'll also tell the people who had their high-quality American made products substituted with cheap, unreliable Chinese-made crap about your "excuse."

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
Charles Bue are you in the med device segment? Ive been in it for quite awhile.. products have been outsourced before the tax was even thought of.. (edited)

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
Charles Bue You are not even in the medical device industry....just as an FYI, medical devices have been made outside the USA since the 1980’s......Medline Industries was one of the first to manufacture in China. I had a Medline iv Cather inserted a month ago.....Made in India. Stick to Telecom and shipping small packages.

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Arthur A. I was. For 15 successful years. Our products were entirely made in the US until the medical device tax forced us to shutter domestic production lines and lose bids in favor of low cost products made in China Most were defective and our customers paid the price. Stick to what you know Arthur. You're embarrassing yourself.

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Michael Kren Not the ones I sold.

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
Charles Beu You are not even in the medical device industry....just as an FYI, medical devices have been made outside the USA since the 1980’s......Medline Industries was one of the first to outsource...

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
Arthur A. Yep!! Those in the med biz know this

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
Charles Bue 15 years ? I sold medical devices for 34 years, starting when I was 22, and was able to retire at 55. The medical device tax was only around from 2013 to 2015. You sound very bitter for being fired from Abbott. I DO know what I’m talking about. Just look at my resume.

Michael Kren
Award winning Sales professional I Helping companies drive revenue growth and account acquisition.
Arthur A. Yep.. most of it went to Mexico.

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
Arthur A. Quit lying Arthur. I wasn't "fired" nor am I "bitter." Trolls like you are better suited for Twitter and Instagram.

David Schneider
Assistant Portfolio Manager/Analyst at Hoover Investment Management
A rare case of rationality from Washington.

Joe Hage
Chairman at Medical Devices Group
I'm as happy with the result as anyone, but "rationality?" No. This was a "kitchen sink" approach to governing. They threw 52 weeks worth of misspent time into a list of 'something for everyone' so no one would vote against the bundle.

David Schneider
Assistant Portfolio Manager/Analyst at Hoover Investment Management
It could have been a lot worse

Arthur A.
Retired from Becton Dickinson & Co. 1982-2012
Marissa Marsala.....the problem with CareFusion was that they had ZERO sales overseas.....you can’t expand market share nor increase sales by just relying on the USA. The future, as well as the present, relies on Overseas growth. That is why CareFusion was acquired by my previous employer.....BDX. I spent 30 years & 6 months with them. Quit blaming the 2%tax when poor management was the problem.

Marissa Marsala
Recruiter & HRBP Building World-Class Teams | Marketing Strategist | Career & LinkedIn Coach | Motivational Speaker
See above, Arthur. I listed 3 reasons. In April 2009, 800 positions were eliminated. This was due to expense ratios being way out of alignment as compared with our peers (to the tune of 3-4% higher than all others in our category). This certainly ties to management and spending. Agreed. This was openly publicized by industry analysts as it impacted shareholder value and caused that round of layoffs. The excise tax came years later.) After Cardinal Health split off, CareFusion was named as the "spin-co." I was in a marketing leadership position at that time and asked at a Town Hall meeting how the med device tax would impact our innovation calendar. (I was directly involved with one such project. 8 of 15 were killed. The numbers did not bear out against the tax and new FDA guidance on clinical trials which also came at about the same time as the tax. Double whammy.

Marissa Marsala
Recruiter & HRBP Building World-Class Teams | Marketing Strategist | Career & LinkedIn Coach | Motivational Speaker<
This is great news! I recall when I was working at CareFusion, this tax -- coupled with FDA Guidance on Clinical vs. Market trials caused the demise of a large number of innovation projects. These two factors coupled with our expense ratios also triggered a large sequence of layoffs. I suspect that other companies were similarly impacted... and in turn, advances in patient care and safety.

Joe Hage
Chairman at Medical Devices Group
Carefusion's team was the single greatest contributor to the no2point3.com effort we initiated for the Medical Devices Group. I still remember!

Marissa Marsala
Recruiter & HRBP Building World-Class Teams | Marketing Strategist | Career & LinkedIn Coach | Motivational Speaker
Joe Hage I'm thrilled that the clouds are parting and that this tax is being sun-setted!!!

Kristin B. Charlton
Development Professional - Sales - Fundraising - Major Gifts - Marketing - Alumni Solicitation, Business Development
Well,this just means we have to come up with the money to plug the giant hole in the ACA. Either way somebody has to pay for it unfortunately.

Charles Bue
Delivering Telecom, Merchant Services and Small Package Shipping Savings of 23%-34% With No Up-Front Cost or Risk
The ACA doesn't need tax money to "plug the giant hole..." The ACA needs to be relegated to the ash heap of history.

Kristin B. Charlton
Development Professional - Sales - Fundraising - Major Gifts - Marketing - Alumni Solicitation, Business Development
That will not happen.

Gary Austin
CEO at OneCare, LLC
Good for everyone!