Health care reform has become an extremely complex and polarizing subject.

The topic is so vast that much of the debate around the entire health care law has devolved into speculative opinion. And truthfully, much of the success of health care reform will hinge on how the reforms are implemented.

In that regard, the new health care reforms are off to a rocky start.

But there is one single element of health care reform that is small enough and tangible enough to debate. That is the disagreement over the medical device tax set to take effect in January. That debate has already had far-reaching effects, factoring into the government shutdown and leading to some rare bipartisanship in the Capitol.

The medical device tax is a 2.3 percent tax on the revenue of medical device makers that will help fund the implementation of health care reform.

It does not sound like much, especially to those who know how much some of the publicly traded device makers like DePuy or Zimmer make each fiscal quarter. But the numbers are deceiving.

A 2.3 percent tax onrevenueequates to an estimated 15 percent tax on profits. There are certainly companies that can pay that increased tax. But that is not the point. The concern is more about the long-term impacts that the tax will have on the industry and on the U.S. economy. And the signs are already concerning.

According to a recent column by former U.S. Sen. Evan Bayh, D-Ind., published in the Wall Street Journal, the tax will hurt American workers.

“Cook Medical has canceled plans to build one new U.S. facility annually in each of the next several years, and Zimmer plans to lay off 450 workers, while Hill-Rom expects to lay off 200. Stryker, based in Michigan, anticipates having to lay off 1,000 workers,” Bayh wrote.

Perhaps even more concerning is the tax’s impact on the number of startups and entrepreneurs who enter the medical device industry.

While a company the size of DePuy or Stryker will most likely find a way to continue making money under these new tax laws — even if it means laying off a portion of their U.S. workforce — the tax could have even harsher consequences on smaller firms.

Given the way the tax is formulated — taxing revenue and not profit — a company could lose money and still be hit with a very large tax bill. This will almost certainly be a disincentive for young companies that contemplate entering the medical device industry, resulting in fewer companies that could bring much-needed price competition and new energy into the industry.

There is no question that reforms in the medical device industry are needed. U.S. health care consumers should not pay 10 times the price for an orthopedic implant as compared with what is charged in European markets.

But a tax that penalizes small, innovative companies the most, eliminates American jobs and dissuades companies from investing in the U.S. does not seem like a solution at all. It seems like less competition, less innovation and less job growth in a sector that exports product worldwide.

Legislators and the American public should demand answers on health care that bring down costs without hurting our economy and stifling job growth in the process.