Stuart M. Essig
Management
Glenn, just to follow up on some thoughts about the overall policy impacts on Integra. A couple of things; first, you know well that we’re a pretty broad-based company. Our whole strategy over the last 3 to 5 years has been one of diversification into multiple hospital supply areas, and indeed with only 10% of our revenues in capital, we’re relatively less affected than certainly capital equipment companies. Now, if you think about what has been going on on the policy side, what’s happened is there is some lack of confidence by hospital purchasing people, financial administrators, etc., in what’s going on in the economy. There is not a lack of capital. There is a lack of confidence, and the lack of confidence then has caused conservative behavior, and that conservative behavior for example on the fourth quarter caused the slowdown in our capital product lines simply because they can be postponed for a quarter or two as they’re mostly replacement. Now, if you then look specifically at some of the topics that have been floated, the biggest target appears to be Medicare and we have very little exposure to Medicare. Indeed, one of the opportunities under the Obama plan is the addition of some 40 million people under Medicaid program or under some form of program. Now, those people are not being served. They’re being served at great expense to hospitals, and so indeed much of what we provide, hospitals have to provide to patients; brain tumors, burns, head trauma, there is no choice to turn those patients away from the hospitals; so they then become indigent care, and so there’s actually an upside to the addition of these uncovered patients to the hospitals. Sure, they would like it to be insured or Medicare, but even under Medicaid, given that a lot of our products are not reimbursed are indeed covered under either DRGs or covered under general hospital operating funds. There’s actually an opportunity for them to be positively impacted. Again, keep in mind that while we have a very broad base of business, our overall perspective is we don’t have high-ticket products for the most part, we don’t have products that are priced in the $10,000 to $15,000 range of implants or disposables. Indeed our typical implant a $1000 DuraGen-type implant, and so in a way, and I guess it’s in my nature to be optimistic; I’m enthusiastic about the fact that people be cared for, and I believe our mix of business indeed could be positively impacted over time. The hospitals are certainly being conservative and that’s certainly impacting behavior, particularly on the capital side, but I think as things start to be clarified, maybe some of that uncertainty goes away as we get to the back half of the year.