As the November 6 US presidential election approaches, probably one of the biggest issues that I, as a Canadian, should care about is the proposed pipeline to deliver Alberta's oil to the US. But as a Canadian who writes about the US medical device market on a regular basis, I?m actually pretty concerned with the future of the Affordable Care Act (ACA).

I admit it?I don?t love or find regulatory or health care systems across the world particularly interesting or easy to understand. Having just pinned down the details of what the Affordable Care Act will entail, I was relieved (from a purely selfish perspective) when it was upheld by the Supreme Court in June?all that work wasn?t for nothing! But now as the presidential race barrels down to the finish line with both candidates neck and neck, the future of the ACA is once again looking pretty uncertain.

If the presidency switches hands, Romney has made it pretty clear that his plan is to undo the Act?taking away the insurance that was going to be provided to about 30 million more Americans, but also potentially getting rid of that tricky medical device excise tax (which most manufacturers address with open hatred). There's debate on if this is good or bad or makes no difference to the medical device markets. Will increased insurance coverage boost procedure volumes for certain elective procedures? Will the medical device excise tax kill the profitability of companies operating in the US? Will these two factors totally cancel each other out? While the Americans are going to have to sort out these questions for themselves, I?m kind of hoping the excise tax doesn?t get repealed if only because I?ve already written so much about it.

Another interesting perspective on the election that this Clinica article provided was insight from Nobel Prize winners suggesting that innovation in science (and therefore health care) would be stifled under a Republican president. Thank goodness we?re not hearing about any problems in that area already?just kidding, we totally are, all the time. Whether this will actually happen under Romney though, well, who knows.

But no matter what your opinion on either candidates? platform, personality, or impressive ability to dodge questions?we only have to wait a bit longer to see what direction health care reform takes.

Our friends at our sister company HLI know a lot about health care reform?check out their blog here.

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