In a blog post earlier this week, I concluded that whether a payment to government service is classified as a tax or a user fee is sometimes arbitrary and that how the payment is labeled is of secondary importance. Mike Udell of Ernst and Young, a former staffer on the Joint Committee on Taxation, reminds me, however, that labeling could have real consequences. Mike raises another example from the health reform legislation – the proposed “fee” on sales of pharmaceutical and medical device products. If the fee were an excise tax, it would be deductible and not included in the gross revenue of manufacturers of these products. But as a fee, it is not deductible, so income tax collections from these firms are higher than if they could exclude the payments from taxable income.