obamacare and layoffs

So I am reading about layoffs at Medtronic and Boston Scientific and now just read about another company dealing with Pavemakers - stents etc etc......so is anyone else concerned? It seems this is becux of Obamacare......any comments? Frighteneds me a bit.....

17 Comments

Obama has a lot to answer for !

by IAN MC - 2012-11-17 02:11:12

As a distant observer , it seems to me that Obamacare is the cause of everything bad in the world :-

-- the lousy weather
-- the fact that most of us don't win the lottery
-- the cold which my mother-in-law had last week

and why do you think those missiles are raining down on Israel.? ... Yes, you've got it , Obamacare is to blame !

Keep on smiling , even though your country is broke !

Ian

Obamacare & Medical Device MFGR

by donr - 2012-11-17 07:11:23

I think the other company the poster is thinking about is Stryker. Stryker makes a lot of medical devices, like the electric drills & screwdrivers used in the OR, Joint implants & perhaps stents.

The entire med device industry faces a new tax on every device they produce under Obamacare. I recall that it is about 3%. Doesn't sound like a back breaker, but couple that w/ the mandatory health insurance requirements that firms that employ over 50 people face & the costs of their product will have to go up. It is Economics 101 that when prices go up, demand for a product goes down. What the mfgrs are doing is trying to predict what the impact will be on their profit/loss statements. Bringing 30 million more people into the system will not necessarily increase demand for the products they make. They do not know; no one really knows.

There are exceptions - like the smallest businesses affected by the new law. They operate on often razor thin margins & can predict what the effects of increased company health care costs will do to their costs. Mainly they can do that because they have fewer variables in their costs/profits - like a Pizza business or a restaurant w/ the magic 50 or more employees.

Don

med prescriptions higher & higher

by breeze - 2012-11-18 01:11:05

my hubby went into get his BP medicine and it has doubled in price.....
we could not believe it - I don't have to take BP meds
but if this continues to go up which it will makes me wonder what we will all do.....
PM and stents and anything else will go sky high along with the hospital bill

Could be good thing

by ElectricFrank - 2012-11-18 01:11:21

I'm getting the impression from many of the newer postings that pacemakers are moving into the realm of the TV drugs. I expect any day to to see scare ads to get people to "ask your doctor" for a pacer.

So if the Affordable Care Act is cutting down on waste and fraud we may see some layoffs in the medical devices industry.

frank

Here are the facts

by Grateful Heart - 2012-11-18 01:11:34

We supposedly have good medical coverage. For the past 4 or 5 months, everytime I fill a prescription now, my out of pocket cost is going higher and higher. I can't take statins due to many side effects so the doctor wrote a presciption for Welchol. My "co-pay" for the Welchol was way too much money so I told them to keep it.

I went in to the pharmacy 2 days ago to pick up other meds and they wanted $375 for 1 prescription. This med was previously $23 so...you guessed it...I told them to keep it. I am so furious I haven't been able to post on here the past few days because I didn't want to rant...until I saw this thread.

I have to renew my heart meds in a few days and I am expecting them to go through the roof and guess what...if it does...I am going to tell them to keep it. I don't know about anybody else...but I see a pattern here. So explain to me again please how Obamacare is helping the average person...I don't see it and they can keep that too.

ok but and.......

by breeze - 2012-11-18 01:11:37

I am more concerned about the layoffs and what will happen to us that need the PM to keep us going...I am not against folks getting on the healthcare band wagon
These companies are laying off becuz they can't afford the healthcare tax...... PM are expensive so is the hospital care that you get if you stay over nite - I fainted and ended up in the ER three years ago - I ended up staying for three days becuz it happened on a Saturday and the EP guy at the time was not around for me.
So my main concern is if they keep laying the ppl off that
send our reports to our EP's - well then are they going to have qualified Tech's to read our reports or have the time to read our reports and send them to our Dr's? especially if there is a serious problem going on - we live about 200 miles from my EP so I depend on my Medtronic transmitter to get the info to them and then send to my EP Dr - if they keep laying off qualified ppl......what happens then? and NO I don't blame Obama for everything.... I am just wondering about my PM and trying to keep positive about all that is going on.....I didn't come in here to blame anyone .... I just wanted some info on others and how they feel about our PM ppl being layed off............

An observation from Europe

by IAN MC - 2012-11-18 02:11:47

You don't know you're born in the US compared to Europe , you pay FAR lower total taxes than most so-called rich nations !!!!!!!

As a country you choose to spend your money in different ways to us . For example we pay DOUBLE the price that you pay at the pumps for petrol ( or "gas " as you call it ! ) because the taxes we pay on gas are much higher than yours

I have a small " compact" car and it costs me £75 to fill the tank , that is about $ 120 ...BUT everyone here gets free health care !!

The USA chooses to spend over 40% of the world's spend on the military although you have less than 5% of the world's population . As a contrast,China has 4 times your population but accounts for less than 6% of the world's spend on defence
We spend far less than you on defence BUT we have free healthcare !

I'm not saying that one country is right and another one is wrong BUT if you spent your money differently you would be able to have free healthcare for everybody.

If you're not moaning about your crap healthcare, you're moaning about increases in taxation .... you can't have it both ways ! You have enjoyed low levels of taxation for a long time, welcome to the real world !

Ian

well....

by breeze - 2012-11-18 07:11:32

Ian - I appreciate your comments - but I am not "moaning" about anything - we are retired folks a limited income - my hubby is a retired Army man - I am concerned about our choices that are being limited for us
I have a PM since 2009 - I am blessed with not having any other problems that sometimes go along with the PM and BP - so you can say or think or write what you want but you are not in our lives and you do not know what is going on with us - this is not for you to go "political" on - this is about PM changes that might happen and any other heart issues that might come up with the changes in the American Healthcare system.

Paycheck

by ReWired - 2012-11-18 11:11:40

Today in the USA my paycheck is taxed above 50 percent, Federal Taxes, State Taxes, City, County, Gas, Food, Merchandise and so on.
I am wondering how much taxes comes out of your paycheck because with Obamacare I suspect that we will only have 25 percent after all the new taxes and addons. Like a franchise adding a 5 percent Tax Charge to pay for his employee Obamacare.
Everyone taxes here in the states, I wished we would be a 45 percent one time take all take out of the check.

Health care debate

by MSPACER - 2012-11-18 12:11:09

I don't want to get too political with this discussion, but let's face facts. In this country, the cost of health insurance is way beyond most people's means. Most large employer's cover the cost of insurance, with employee's paying in about 10-20% of the yearly cost. To those working in small companies who can't afford to give their employees' insurance, they will be exempt, but those people will have an opportunity to get health insurance for possibly the first time. There are countless individuals on this board who have written posts over and over stating they needed a pacemaker, and could not afford it because they have no insurance. I do not know if Obamacare is going to lower costs or not. I certainly hope it does, and I hope that more people get insurance. Because let's look at facts-where do these people end up when they get sick? The ER and that is way more expensive, then if they had a primary care doctor to visit. And, the uninsured are more likely to be much sicker than if they had been visiting a regular doctor.

I feel everyone should have insurance because when you get sick, you should be covered. Your tax dollars are paying way more out for the uninsured when they visit an emergency room, than if the person was insured.
Why is the mirror image of Obamacare working in Massachusetts? Why do our members of Congress have choices in selecting health insurance from "exchanges", but the ones against Obamacare don't feel that anyone else without insurance should be allowed to shop for insurance from the exchanges.

I don't understand why there is so much backlash from people in this country about trying to improve people's lives? The idea of health care for all was the original idea of the Republican Party. Richard Nixon tried to pass a plan that was even more liberal than Obamacare. Look up your facts!

To answer your question breeze

by Grateful Heart - 2012-11-18 12:11:24

I understand your concern and yes, I am concerned too. What will happen...only time will tell. Everyone should have health care but how to do that is the big question. So far, it appears the Affordable Health Care Act is not affordable for us. Hopefully, it will improve and will work out for all.

Take care,
Grateful Heart

?

by Matabar - 2012-11-19 01:11:48

Ian said it all. Besides the majority of the provisions for Obama care don't even go into effect until 2014 so why is everyone moaning about layoffs and price increases now. This country has been robbed blind by greedy, under-regulated insurance companies for decades. Give something new a chance. The voters have spoken.

Breeze

by IAN MC - 2012-11-19 05:11:07

I'm sorry if you felt my comments were aimed at you. They weren't !

I genuinely hope that you and your husband are not hit too hard by any changes that come in your health system.

You are rightly concerned about your choices in life ; I was simply attempting to make the point that every country has to make choices too and some countries choose to rank "health for all" as being less important than the military for example. It's a judgement call at the end of the day and there will never be enough money to go round !

Best wishes

Ian







Well Said

by Moner - 2012-11-19 12:11:11

Breeze,

Thank you for expressing your opinion, I couldn't have stated it better.

Moner
>^..^<

asfasfasf

by boxxed - 2012-11-20 07:11:42

The CRM Industry has been in a rut and steady decline for a while. Here are the big reasons why.

1) GPO's. It's not uncommon anymore for private practices to be bought by hospital systems. Just the way the numbers, business, and regulations work out I've heard that it can be better to be owned by a hospital. These GPO's and hospital systems can be run by business administrators, and not necessarily physicians. This has led to some massive price erosion in the industry. When one hospital hears about a deal from another one in another state, they want the same price. The big 4 (Medtronic, St. Jude, Boston Sci, Biotronik) have been in a price war and undercutting themselves to maintain market share in their territories. This is simply because they can't afford to get locked out of a contract by a single practice because it can mean you're locked out of an entire healthcare system. These contracts are now being negotiated on a multi-year basis and can be based around a 2-vendor % system. Like for example, a hospital network may negotiate a contract where 80% of devices implanted will be Medtronic, 20% will be St. Jude. Boston Scientific and Biotronik? They'll be out of luck for a year or three (barring some scrap implants physicians throw their way) until they can renegotiate during contract renewal with a much more attractive price.

Before this wasn't a big deal because margins were very, very high on the products. But, and this part I'm not 100% sure about, insurance companies have been slashing reimburstment for the labor/device sale as the prices kept on dropping. Margins are getting increasingly thin.

2) Massive service burden. Not all people who check your device are smiling and jovial sales reps. Most of them are clinical support. A territory typically has only a few reps (maybe even 1) to a territory, and then a team of clinical support technicians to run around and do these checks @ hospitals, ER's, clinics and implants. These device checks are FREE and earn no revenue for these companies. It's status quo in the industry for the companies to offer this service for free that is built into the sale of a device. And the installation base of PM's/ICD's keep on going up, and the companies are forced to hire more and more people to provide a FREE service that generates NO revenue. This unfortunately has caused a circumstance where companies are bloated with alot of fat that is absolutely neccesary, but eat up revenues by paying out all these salaries, commission, and benefits. They cannot lay off some of the reps because, let's face it, it can still be a 'good ol' boy' system I'm sure in some territories. Reps that command X amount of revenue cannot be touched. But the clinical support? They don't bring any money in. And they're integral to the broken system. What this means for you, the patient, is there will be less Clinical Supports per territory to manage an increasingly larger population of devices.

So these two factors, plus a JAMA article a few years back, have already made things pretty tough for the CRM companies. They're not seeing the 20% yearly growth they used to. They're barely breaking even, if @ all. So all this medical device tax will do is put that much more strain on an already precarious financial situation. Especially if the cost of healthcare goes up as well so these companies are not just losing more of their revenue with the tax, they're forced to pay more to insure clinical supports who do not generate any revenue @ all.

Me personally, I'm all for health care for all. But I don't think the medical device tax is a silver bullet, maybe moreso the last straw that may or may not break the camel's back.

Free...?

by breeze - 2012-11-20 09:11:41

Did I read you right when you say PM check ups are FREE? my PM checks have never been free.? My EP and his nurse do my checks one time from a rep from Medtronic and in my EP's office - but never free...even my remote phone testing is not free......

So I thank all of you for your posts-I find them all very interesting... still concerned and will be no matter what

Thanks again

asfasfasf

by boxxed - 2012-11-21 11:11:14

I meant to say that in industry, it isn't uncommon that the physician (but arguably now the hospital administrator) is the customer. I know that sounds wrong and callous and can fly in the face of intent of healthcare, but it can the truth.

In that regard they provide a free service to the physician that's built into the cost of the device. At the end of the day the physician still takes time to review the report of the device check to make everything is up to snuff, but they don't have to hire a full time tech to do it. To some practices, that is a cost saving advantage where the cost of such a service burden is passed right back to the device companies.

None of the companies will (if they can, would, or should) make a move to monetenize device checks because that'll just give the other companies an advantage in their business pitch. And while that would have been a marginal advantage a few years back, it makes a huge difference now that devices have become virtually commoditized where all of the companies offer a range of devices that all do the same things reasonably well without a stark disparity.

So with all the devices being able to do the same thing other devices can, with relatively smart and safe logic backing it, it really comes down to price and service at this point (and to a potentially unsettling extent, relationships with physicians and a return to the good ol' boy system.). A Boston Scientific can do everything a St. Jude device can, and vice versa. There is a relative parity among the companies in features and how well they perform it.

Maybe there will be a big market shift when Boston's leadless ICD's hit the market or similar things of that nature. But as of now, I'd be comfortable with my own mother having any of the devices @ this point as far as features, functionality, and effectiveness goes (leads obviously are a slightly different story).

You know you're wired when...

Your device makes you win at the slot machines.

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