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David Stanley Ford

Proposed health care overhaul gets personal
Tax would crimp medical device makers

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Published: November 4, 2009

Until now, my reasons for opposing the health care overhaul were entirely dispassionate and flowed from 1) common sense (how are they going to provide more care for less money, and can we afford another huge entitlement when existing ones are going bankrupt?); 2) experience (government entitlements always cost far more than projections and government is far less efficient at providing services than the private sector); and 3) philosophy (the way to reduce prices is to increase competition — not reduce it).

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This is just one more example of the ways health care costs would be driven up, not down, by the Democrats’ reforms.

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But now the proposals being considered will hit my family particularly hard. This time, it’s personal.

In order to pay for its new entitlement, the Senate Finance Committee bill (Baucus) proposes to tax medical device manufacturers $40 billion over the next 10 years. To the average person, medical device manufacturers may not mean much. They produce heart monitors, stents and pacemakers.

They also produce insulin pumps. My 16-year-old son, who has had Type I diabetes since age 9, depends on a pump to live a reasonably normal life. If he didn’t have an insulin pump — a device the size of a cell phone that delivers insulin through a tube directly under his skin — he would be required to give himself as many as four injections a day, as he did before he got the pump. And his life expectancy would be shorter.

In just the six years since David began using the pump, the technology has improved markedly. The programming has become more sophisticated as well. The pump can now deliver carefully calibrated doses for high-carb foods like pizza and ice cream — foods that are otherwise parlous for diabetics to enjoy — and the pump is preset with carb counts for many common foods.

Insulin pumps provide better blood sugar control than other diabetes treatments. But they are far from perfect. Even careful users will frequently experience highs (which increase the likelihood of long-term complications like heart disease and blindness) and lows (which can be immediately life-threatening).

Yes, we families with Type I pray for a cure. But the recent progress in technology has offered really tantalizing possibilities. Medical device manufacturers have recently debuted a technology that is key to the health of Type I diabetics: continuous glucose monitors. These provide 24/7 data on the patient’s blood sugar to supplement the six daily finger sticks. Eventually, the combination of these two technologies — the insulin pump and the continuous glucose monitor — could provide the Holy Grail for Type I diabetics: an artificial pancreas. The AP would keep blood glucose at normal or near normal levels and thus prevent the worst effects of diabetes. We’ve heard estimates that the technology may become available within five years.

Unless the medical device industry is hit with a major tax.

While the United States leads the world in medical technology, most device makers are not huge conglomerates, but smaller companies already hurting in this recession. The chief executive of B. Braun Medical, which makes pain control devices, told the Washington Post that paying his share of the new tax would "exceed my research and development budget.” The $4 billion annual tax would represent about 40 percent of the industry’s outlay for research and development ($9.6 billion).

If this tax is enacted, medical device manufacturers will cut back drastically on R and D, and may have to lay off employees. In addition, they will charge higher prices for their products to compensate for the money confiscated by Washington. Since health insurance plans frequently cover half or more of the cost of these already expensive products, health insurance rates would have to rise as well. This is just one more example of the ways health care costs would be driven up, not down, by the Democrats’ reforms.

As for David, he will see the prospect of an artificial pancreas — his greatest hope for a healthier and longer life — recede over the horizon.

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David Stanley Ford





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Jean, As usual, a good post. Thanks.
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Milkman, Oklahoma City - Nov 5, 2009 at 12:51 pm
Tax payers pay for basic research,when the answer is found big pharma,etc take over and get rich..SOME "FREE " MARKET!!
In July, the federal government promised to have 160 million doses of H1N1 vaccine ready for distribution by the end of October. Instead, only 28 million doses are now ready to go. Who really screwed up here -- the government or private pharmaceutical companies, including GlaxoSmithKline, Novartis, and three others that had agreed to manufacture and deliver the vaccine by late fall? Last spring and summer, those companies gleefully gobbled up $2 billion worth of government contracts for vaccine production, promising to have every American, or at least every American child and pregnant woman, supplied with vaccine before trick-or-treating season began.



As for Big Pharma, the truth is that they're just not all that into vaccines, traditionally preferring to manufacture drugs for such plagues as erectile dysfunction, social anxiety, and restless leg syndrome. Vaccines can be tricky and less than maximally profitable to manufacture.



So it should have been no surprise that Big Pharma approached the H1N1 problem ploddingly, using a 50-year old technology involving the production of the virus in chicken eggs, a method long since abandoned by China and the European Union.



Those of us who are involved in the care of small children have little to rely on but hope -- hope that the epidemic will fade out on its own, hope that our loved ones have the luck to survive it.



On the public health front, we need to socialize vaccine manufacture as well as its distribution. Then, if the supply falls short, we can always impeach the president. On the individual front, there's always soap and water
Jean, Fort Gibson - Nov 5, 2009 at 12:26 pm
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