6 min reading time

I suspect the end of Obamacare (how will that unravel?) and the medical device tax going away.

What do you foresee?

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Peg Graham
Improving the Caregiving Experience, Chair of the YANA Health Forum
Also becoming clear that there will be a major challenge for Price to come up with an approach that will work in the rural counties that comprise the bulk of Trump’s support. Much of the unhappiness with “Obamacare” had to do with the level of premium increases, not the insurance coverage itself. A tax credit approach only helps those who can afford the too-expensive premiums that our “market” currently supports. The issue is about UNAFFORDABLE premiums regardless of how the insurance market is structured.

Julie Omohundro
Principal Consultant at Class Three, LLC
I’ve been looking for non-partisan articles on the choice of Tom Price to head HHS. It’s like looking for a virtual needle in a virtual haystack, but here is one that doesn’t seem to have much of a tilt:
http://www.politico.com/agenda/story/2016/11/big-areas-tom-price-change-policy-hhs-000247

Jordan Katz
Territory Manager at Philips IGT
I heard that tax was suspended is that true?

Bret Neuville
Account Executive – Manufacturing | Wisconsin Sports Fan | Not-so-pro Golfer and Snowboarder
Paul, it was very interesting reading your take on how the medical device field will change alongside Trump. I was intrigued by your mention of population demographics. Do you think the reduction of taxes on medical devices will drive companies to start new research and ultimately lead to newer and improved devices?

John Jones
CEO of LabLynx, Inc and the Laboratory Informatics Institute
The healthcare system is busted for most people. ACA tried to fix that and things have gotten worse. The insured under ACA are getting less and paying more and eventually it will degrade to the point where they pay and get nothing. This is the worst case scenario. Fast forward and ACA is gone. Now they have no insurance and they are not paying for it either. Which is worse? Pay and get nothing (obama plan) or get nothing and pay nothing (trump plan).

The real problem is that healthcare is only affordable for those with employer paid insurance. This will form two healthcare classes and those without coverage will simply have a worse life of it. I know this sounds cruel… under Obama or Trump the results will be the same… Natural law will prevail and the poor will die at a higher rate. Basically, money talks.

Julie Omohundro
Principal Consultant at Class Three, LLC
Paul, from where you sit, I can see no dramatic impact, but from a regulatory premarket perspective…OMG, we just finally worked through FDASIA, if we have to work through a new ODE Center Director any time soon…!!! Me, I’ll probably just retire.

Plus, as far as I can tell, most stakeholders are as happy with Shuren as most stakeholders are ever likely to be with the head of ODE, so that almost any change is likely to leave some happier than others. I personally don’t think that’s likely to be a real improvement for anyone in the long term, including some who might think that it worked out better for them. When everyone is reasonably happy, things move along much better for everyone, I think?

Julie Omohundro
Principal Consultant at Class Three, LLC
Linda, this is consistent with my impression that Trump has focused on pharma, but that devices don’t seem to have caught his attention so far.

Paul Teitelbaum
Experienced Strategic Advisor in Medical Technology
Obamacare gone (changed) but we haven’t heard anything yet about trying to bend the cost curve to get people healthier and reduce utilization (would have a negative impact). Med device tax gone (would help emerging companies and innovators in particular). Lower corp taxes would presumably help and curb the reverse mergers into Irish companies, easier repatriation of cash in foreign countries to bring a lot of money back for investment and growth. FDA – no idea (and that’s a big one). All in all though, I don’t think dramatic impact – population demographics, 120 million obese people, 40 million diabetics and maybe 60? million with heart disease and tens of millions with orthopedic issues will drive demand and innovation for a very long time.

Todd Andres
Successful Medical Device Entrepreneur and Executive Seeking Consulting and Board Member Opportunities
1. Excise tax is history.
2. The public option and Medicare for all are dead. Both are too expensive for the taxpayer and providers because they generally pay below provider costs.
3. Income based subsidies will be curtailed, possibly in favor of higher deductibles unfortunately.
4. Thru basic standards, Payers will be able to sell across state lines. This may introduce competition and efficiencies.
5. The premium and deduction hikes are a death spiral caused by the heathy dropping out, causing more of the same. They will either increase the fine for the mandate to the same as the cost of insurance or they will have reintroduce pre-existing conditions or a high premium for letting in those who’s insurance has lapsed. There is no other way.

Clarisa Tate
Medical Device Professional, RA/QA/Engineering
Medical device tax, open payments, double digit percentage higher premiums, etc. These are the bad aspects of ACA from the point of view of start-ups and small medical device companies. Portions of the ACA is great like coverage for all, even those with pre-existing conditions. But from a small business standpoint, it became very hard for some to compete with big companies and in some cases had closed their doors after ACA came.

Jim Smith
Sales Engineer at Holmes Energy & Lighting Products
Hurt a lot of device manufacturers. Wasn’t fair to a lot of good people.

Roger Greenwald
Owner at NJK & Associates, Inc.
I suspect that Ivanka will lead FDA, or maybe Baron. Two great choices.

Julie Omohundro
Principal Consultant at Class Three, LLC
Is it safe to say that Califf’s tenure as FDA Commissioner will be a short one? What about Shuren?

More generally, earlier this year someone from Australia commented casually to me that Shuren was a lame duck, destined to be replaced after the upcoming election. I realized I didn’t know if Center Directors are traditionally replaced with changes in Administration. Does anyone here know if that is usually the case?

C. A.
Operations at QuVa Pharma, Inc
There are always winners and losers upon implementation of new regulations, such as the ACA. The real question that should be posed is who are the winners and losers from the ACA. The winners appeared to be the hospitals, look at their stock prices prior to Trump election win, and companies in general as they are legally allowed to push the increased cost of insurance onto the employee in the form of higher premiums and higher insurance deductible for less coverage. What will happen if ACA is repealed or revised? Determine the answer to that and invest accordingly; if you are correct, and make money, then you are on your way to financial independence for yourself and your family. Best of luck.

Peg Graham
Improving the Caregiving Experience, Chair of the YANA Health Forum
Listening to Fox News and looks as if there is a growing appreciation for certain aspects of healthcare reform. Hoping that companies keep value-based payment approach in their strategic planning. Otherwise, the weight of the demographic bulge will overwhelm the delivery system. We need to scale the system we have so that insurance costs don’t crowd out every other bit of spending at both government level and household wallets.

Martin Cheng
Motex medical supplies manufacturer | surgical mask | medical gloves | wound care | ppe industrial safety
Ouch.

Jason Cotham
Radiologic Technologist with 9 years of experience in Neuroendovascular and Interventional Radiology.
I read quite a bit about this particular issue. I also read about Healthcare in other countries. I believe in private business growth and progress through competition. I think that changes in legislation to remove frivolous lawsuits that guide physician practice. Doctors are scared to use their education and diagnose without being sued for malpractice if they miss something. So they order test after test. These laws cause unnecessary costs and should be changed in my opinion. I think that we can’t have world full of sunshine and rainbows unless we can pay for it. There is a reason it hasn’t been solved. It’s tremendously complex. How can you ask an insurance company to not use someone’s health when assessing risk? I think those who cannot get insurance should have that option of government assistance. I understand that. I also believe children and veterans should be covered. I will pay for that. These are my feelings. I hope I didn’t offend anyone. I respect everyone’s opinion and I love to hear new perspectives.

Julie Omohundro
Principal Consultant at Class Three, LLC
Jason, hopefully someone with a deep knowledge of ACA/reimbursement/insurance will eventually weigh in on Joe’s question. In the meantime, everything I’ve read says that the healthcare insurance industry has remained profitable throughout, although not as profitable as prior to. I’m sure there are sectors within the industry who fared less well than others; that may be who was contacting you. Regardless, I think there are reasons why the rare buyer of private insurance is likely to be eagerly sought after.

Here is one assessment by Motley Fool. I’m sure there are more available now, and many more to come, as unanticipated change is always a boon to prognosticators and pundits:
http://www.fool.com/investing/2016/11/09/why-health-insurance-stocks-are-tanking-today.aspx

Diptesh Kumar Dey
Regional Sales Manager at Sunknowledge Services Inc. – Premier Next-Gen Medical Billing and Collections Company
Changes are inevitable but progress are not. Let’s see what Trump’s victory will change as if though Obamacare ends up.

Christopher Duna, MBA
Salesforce Administrator Volunteer at The Game Academy
what is wrong with paying taxes?