SAN FRANCISCO — A panel convened at this year’s JPMorgan Healthcare Conference attempted to divine what lies ahead in terms of governmental policy in this election year and beyond, no small feat considering the dynamics of the multiple parties and interests involved.

Steve Ubl, president/CEO of the Advanced Medical Technology Association (AdvaMed; Washington), said that there has been “a pent up demand for oversight” of medical devices in the areas of post-market surveillance, off-label uses and sales and marketing practices.

Ubl said that Democrats as a group tend to have “more suspicion of business generally and more suspicion of healthcare businesses specifically.” This suspicion has led, he said, to a proliferation of recent legislative issues “whether it’s FDA post-market revisions or rolling back federal preemption for PMA devices.”

He also noted recent legislation on physician gift disclosure and device pricing disclosure as other hot button issues over the past year. In addition, he cited an increasingly critical media environment for medical devices and healthcare as a whole.

“The good news is that the device industry has held up very well,” said Ubl.

He said he hoped that investors can see that “device industry remains, despite a turbulent environment, a relatively safe place to be and relatively popular industry ... with Congress as a whole.”

AdvaMed, Ubl said, will work with FDA and Congress in the new year to downgrade device classifications for some products, including in vitro diagnostics. He said that AdvaMed will lobby to establish physician payment for remote monitoring technologies in 2008.

With remote monitoring, he said “there’s a tremendous opportunity to reduce hospital readmissions and ER visits.”

Technologies such as cardiac resynchronization therapy and ICDs, he said, “are increasingly performing double duty. They can both deliver the therapy and also upload information to physicians so that they can better manage their patients’ care and better modulate their prescription drug regimen and avoid expensive re-hospitalization.”

Ubl said AdvaMed is also working on legislation that would “substantially modernize” reimbursement codes, particularly for molecular testing.

The issue of pay-for-performance is one that Ubl said his organization welcomes an opportunity to help put into practice.

“If you develop the right quality standards and you pay providers on the basis of whether they’re meeting those quality standards, you can drive diffusion of beneficial technologies.”

On the challenging side for 2008, Ubl said that pending legislation requiring median price listing for medical device makers is one contentious issue. He called the issue “a solution in search of a problem.” Ubl termed it “blatant interference on the private market place and it’s really not information that the typical patient is going to view as valuable.

“In the first place, most patients [primarily] care what the procedure cost is or, moreover, what there out-of-pocket exposure is,” not the cost of the device.

Another challenging issue he predicted for the industry in 2008 is that of comparative effectiveness. He said this concept has potential to be a useful tool for patients and physicians to inform clinical practice, but added: “in our view, it should not be used to deny individuals coverage.”

He termed comparative effectiveness research no better than a “snapshot in time,” and that the “unique innovation model of the device industry” does not lend itself well to this type of research.

Panelist Nancy-Ann DeParle, a partner at private equity firm CCMP Capital and the former director of the Centers for Medicare & Medicaid under President Bill Clinton, described the current state of politics in Washington as – borrowing from Al Gore’s bag of phraseology — “an inconvenient truce.”

“The White House and Republicans, at least in the House, she said, have stayed pretty much in lock-step over the past year. I think that’s one of the biggest surprises over the past year.”

In fact, she said they appear to have hardened their stance against such issues as the expansion of for the State Children’s Health Insurance Program (SCHIP) and increased taxes on tobacco.

The Democrats, on the other hand, DeParle said, “can’t agree among themselves.”

She said that the current Congress does not appear to have the necessary dynamics to get a filibuster-proof bill passed on any dynamic legislative issues. “As long as this is the case, I would argue there’s not going to be any significant movement on healthcare or any other issues in this Congress.”

The real winner here appears to be the White House, DeParle said, contending that the administration been successful at thwarting the agenda that the Democrats had wanted to accomplish after gaining control of the Senate and House. She noted that the Democrats had moved into year 2007 with a laundry list of things it wanted to accomplish and, instead, has gotten virtually nothing done.

“Congress ended this year really not with a bang, but with a whimper.”

If one were to look at a scorecard of the big issues from last year, DeParle said the White House prevailed in every battle. Besides winning skirmishes concerning funding of the war in Iraq, President George Bush was able, she said, to thwart the Democrat’s push to make some changes to Medicare, which included various program cuts.

DeParle said that in the case of Medicare, the real winners were the providers, who got “a free pass,” by avoiding the cuts to their various programs.

“I think the Democrats took their best shot last year on children’s health and Medicare and just agreed to live to fight another day.”

The upshot of all this, DeParle said, is that all of the parties involved have “agreed to disagree and that they are just going to put off a showdown until the first Tuesday in November and decide then what is going to happen.”

DeParle said the real action probably won’t happen until 2009, with the potential to be a transformational year, especially if the Democrats win the White House and are able to increase their holdings in the Senate and House. She said that year could be the one where we see some form of universal healthcare for Americans passed.