First, do no harm (to the economy).

In Roll Call, Reps. Erik Paulsen and Jim Gerlach make the case that the $20 billion medical device tax slated to take effect in 2013 as part of the Affordable Care Act (an offset, btw, that helped the CBO score the ACA as reducing the deficit; see also the Class Act) will kill thousands of Americans jobs. Paulsen and Gerlach write that: 

A new study by two noted economists...has found that, under reasonable assumptions, the medical device excise tax will result in 43,000 lost jobs and $3.5 billion in vanished wages and benefits. ...

This may be the most anti-innovation piece of legislation to come along in some time. The tax hits well-established companies and startup businesses that are suffering losses in their initial years while they invest heavily in the research and development of their first innovation for patients.

Thanks to this tax, companies could be forced to close factories in this country and look overseas where foreign governments are extremely eager to jump-start their high-tech sectors. 

That seems right to me.  Small companies are unlikely to be able to pass the costs of the tax along to their customers, while larger companies will simply have another incentive to shift manufacturing overseas, in an effort to cut costs while maintaining profits.

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