LAS VEGAS CBS KXNT -Las Vegas businessman Scott Graham hasn’t calculated every effect of the federal health care reform on his business, but he did ask his accountant to help him understand the financial impact.  The bottom line, as accountants say, is that Graham will have to eliminate three positions on his 11-person staff if the U.S. Supreme Court upholds the law.

Graham is president of MBI X-Ray and Medical Supply, and a members of the National Federation of Independent Business, which is a party to the legal challenge before the Court this week.

The Patient Protection and Affordable Care Act will affect MBI in three ways, if it stands, says Graham.  As the cost of employee benefits rises, Graham predicts his client base will shrink.

“We’re seeing a number of doctors saying ‘if this really goes through, we will just retire and leave,’ “Graham told KXNT.

Physicians are grousing about the requirement for electronic medical records. The systems are expensive to implement and maintain, and aren’t profit generators, some have told Graham.

Graham’s remaining clients are likely to spend less, buying only basics, rather than upgrading to more sophisticated diagnostic equipment. Some may look to out-of-state vendors if Graham is forced to add a federal excise tax to the 8.1 percent sales tax he already charges Nevada clients.

“We will have to add a tax on everything we sell to the doctor,” Graham says. “So now doctors costs go up with less reimbursement.”

The federal excise tax will be imposed on all medical device manufacturers and distributors as part of the reform act.

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