Three spine surgeons weigh on how the midterms may impact the spine arena.
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Question: What effect will the midterms have on the spine industry?
Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): I do not anticipate there being much change. One of two things will happen. The legislature will remain controlled by the Republican party, in which [case] we will continue to see more of the same from Washington. Conversely, the Democratic party may gain control in the House, Senate or both, at which point we will see gridlock, and even less will happen.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: This is something no one will know for sure. Whether the blue wave cometh or not, expect more of the same from CMS and the payers. Unfortunately, we have to assume getting paid will get more and more difficult. Expect patients to shoulder more and more of the cost and doctors to get paid less and less. Until the medical societies and hospital associations convince D.C. where the problem truly lies with healthcare, we will suffer the misgivings.
Christian Zimmerman, MD. Spinal Neurosurgeon at Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): My opinion is, using past history as a guide, the midterms are usually unkind to the governing majority — once again a proclamation of our constitution's enduring potentiality for balance and fortitude. That being said, after so much repugnant discourse and execrable public displays, my prescience longs for more civility and honor returned to the governance we hold in reverence and need.
My observation is that spine companies have already priced policy risk/change into the drug/device distributor's shares, which seemingly follows Medicare's perennial plan for reimbursement cuts to both facilities and providers. Since the medical device excise tax (prosthetics and orthotics are non-taxable) suspension from the ACA took its effect a number of years prior, repealing this action with a newly imposed form of taxation is highly unlikely under current circumstances. Business friendly seems to be the lean, and implant companies will continue to reap the benefits of the current policies. Pharmaceutical companies, on the other hand, may receive more unwanted attention.