We just became Europe.

“We believe that the tax will cost us somewhere between $5 million and $10 million a year,” says Richard Packer, Zoll’s chairman and chief executive officer. “Our profit in 2009 was $9.5 million.”

That would be a devastating blow. Zoll employs about 1,800 people. Roughly 1,600 of them are in the United States, and about 650 of those are in Massachusetts. Once the new tax kicks in, that could all change. “We can’t run this company at a break-even or a negative rate,” says Packer, “so we will be forced to look at alternatives.”

The company’s first option is to pass the increase on to customers like hospitals and ambulance companies. That might or might not work, given that they are coming under increasing pressure to cut their own costs.

The next option is to cut research and development — a short-term, money-saving move that will surely cost Zoll down the road. And a third option, says Packer, is to “look at trying to shift jobs to lower-cost places around the world.” That would be bad news for Massachusetts and the USA.