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Speakers at The Medtech Conference from AdvaMed shared their thoughts about the midterm elections in “DC Download and Midterms Preview,” moderated by Greg Crist, executive vice president, public affairs, AdvaMed. The panel included Charlie Dent, former U.S. representative and now senior policy advisor for DLA Piper; Walt Rosebrough, president and CEO of STERIS Corp.; Elizabeth Pika Sharp, senior vice president and managing director, federal government affairs, at AdvaMed; and Jennifer Nieto, vice president, federal government relations and alliance development, California Life Sciences Association (CLSA).
After the discussion began with an overview with the number of open Republican and Democratic congressional seats, how many seats are “safe,” and how many seats Democrats need to pick up the House, for instance, Rosebrough summed up the upcoming election this way: “Expect the unexpected.”
Regardless of the outcome of the elections, healthcare is expected to be on the new Congress’s agenda. “Access to healthcare is a top priority no matter who is in charge,” said Nieto.
Medtech companies continue to monitor the medical device tax, currently postponed through the end of 2019 but not fully repealed. “I’m not complaining we got an extension . . . but my biggest concern is not for the well-established, financially sound businesses, but rather the ecosystem,” said Rosebrough. “It is important for innovation that small companies as well as thoughts come to life—we have seen that dissipate with uncertainty.” In addition, venture capital hasn’t been as robust, he added.
Other companies have been impacted, too. “To make investments, we need an understanding of the permanence of the law,” Rosebrough said.
“We want permanence and a complete repeal,” added Dent.
Panelists did acknowledge the issue of healthcare access and affordability. “We are very aware that patients need access, and there’s a lot of proposals,” said Nieto, referring to efforts in California and New Jersey. She later told MD+DI that the “CLSA is supportive of a variety of proposals that would help increase affordability and accessibility to medical therapies and technologies. However, the state level proposals I referred to in California (SB 17 and Prop 61) and New Jersey are proposals that, in our view, will not do much to increase accessibility or affordability, and could likely undermine future investment in innovation.” For details on the NJ proposal, please see this article.
As the panel discussed pricing, Crist pointed to an AdvaMed report, “Estimates of Medical Device Spending in the United States.”
“This data clearly shows how medtech is a consistently small percentage of overall U.S. health expenditures, despite the constant flow of new innovations that are having a real impact on patients' lives and combating disease, which is the true driver of health care costs,” Crist later told MD+DI. “That's real value.”
When Crist asked what bills might be introduced in the new Congress, a few healthcare efforts were mentioned. Dent predicted a “healthcare stabilization bill,” while Pika Sharp predicted a bill on “insurance coverage for pre-existing conditions.”
But Dent isn’t predicting “a lot of new bills in the new Congress.” Instead, “oversight will be the order of the day,” he said, agreeing with Pika Sharp, who said she expects “oversight opportunities to abound.” She later told MD+DI: “If Democrats take control of one or both houses of Congress, I think you can practically guarantee a flurry of hearings and subpoenas relating to any number of actions or decisions made by the administration, whether that involves overarching or specific policy decisions or the inside workings of any number of government departments. There is no shortage of issues they'd like to investigate.”
During the panel discussion, Nieto said: “We can work with Democrats or Republicans—either party would likely have a narrow majority in Congress—we want to make sure to stabilize the market and do it without dismantling IP or price controls.”
If Republications maintain do power, Dent expects permanence of tax reform law and repeal of the device tax or a further suspension. And they’ll go “hog wild on the opioid issue.”
There may be “some healthcare fatigue,” said Pika Sharp. But “the Democrats are passionate though and happy to continue talking about it.”
Nieto said that elected officials in California continue to hear about healthcare from constituents. “Elected officials are hearing from constituents that they want better and more affordable access to healthcare,” she told MD+DI. “CLSA (and our member companies and our national trade association partners) is keenly aware that medical therapies and technologies are not always affordable or available to patients who need them—we are committed to working with legislators at the federal, state, and local levels to ensure patients have critical access to important life-saving therapies and technologies.”
Dent said during the panel that “everyone likes to talk about healthcare, but no one wants to do anything big.” He said that “at the end of the day, [expect] stabilization and incremental changes.”
When Crist asked the panel about the topic of “Medicare for All,” Dent said that “we are talking about trillions of dollars—it is an enormous number. We can’t afford it now . . . . How do we pay for it—a payroll tax? . . . a sober conversation hasn’t happened.”