COVID-19 effectively put a halt to most elective surgeries. As the nation gets vaccinated, however, medical authorities have given the all-clear to resume those surgeries. But will patients come back?
The answer to that question is important to the nation's hospitals, whose bottom line has suffered as much as, or even more than, most of their patients. Last year, hospitals were forced to shut down surgery in order to create capacity for skyrocketing cases of the coronavirus. But even after beds opened up again (as a result of the reduction in new, serious Covid-19 cases), most patients are still putting off surgery, concerned that they might catch the coronavirus during a hospital stay.
In 2020, the nation's hospitals' revenues declined by $320 billion. At the same time, drug expenses increased by 17 percent, labor by 14percent and hospital supplies by 13 percent. This year, hospitals are expected to lose another $53 billion to $122 billion, which amounts to 4 to 10 percent of their total sales. In the meantime, costs continue to rise.
A recent health-care market research survey by Becker's Hospital Review, found that fully 68 percent of respondents, who are considered health-care leaders, believed patient fear will delay or limit demand for surgery for at least the next six months. In response, hospitals are working overtime to turn the way they do business on its head.
Since making patients feel safe must be their top concern, hospitals have implemented a number of changes in the way in which they operate. For instance, 68 percent of hospitals surveyed have reserved operating rooms and/or intensive care units just for Covid-19 patients. About 23 percent of these organizations have allotted an entire building, including parking lots, to ensure coronavirus patients are isolated from other patients. That increases the feeling of safety but cuts down on the number of non-COVID patients that can be served at any one time. As a result, more than 70 percent of hospitals are running at less than 75 percent capacity.
That level of separation also incurs costs that would otherwise be saved. Additional cleaning, maintaining PPE, and conducting testing, as well as the need for higher numbers of employees to accomplish all of the above, hurt the bottom line. As readers might imagine, the demand for additional cost savings is of paramount importance. That is where virtual care solutions come in.
Virtual health care reduces cancellations, streamlines surgical operations, provides less time in the physical hospital setting, and reduces costs dramatically. Many hospitals had already been employing some level of virtual care, but it was mostly confined to information gathering and storage. The bad news is that few hospitals have the appropriate tools necessary to effectively deliver virtual care at the scale required.
There are no easy answers to the dilemma hospitals face, outside of more aid from the federal government. The Provider Relief Fund, which was included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act is currently helping hospitals to stay afloat. But the $100 billion fund is not nearly enough, according to the American Hospital Association. Given the present trend, I have to agree that it won' t be enough to keep the doors open in many emergency rooms, let alone surgical centers.
What's worse, most medical experts believe that we should expect additional coronavirus-type threats in our future. Prior to the pandemic, we already knew that our healthcare system was broken. It is clear to me that we can no longer deny the obvious. The hospital system may be the wakeup call that we all needed to finally overhaul the healthcare system in the U.S.; at least I hope so.
Bill Schmick is the founding partner of Onota Partners, Inc., in the Berkshires. His forecasts and opinions are purely his own and do not necessarily represent the views of Onota Partners Inc. (OPI). None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-413-347-2401 or email him at bill@schmicksretiredinvestor.com.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of OPI, Inc. or a solicitation to become a client of OPI. The reader should not assume that any strategies or specific investments discussed are employed, bought, sold, or held by OPI. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct.
Most Americans seem excited and hopeful about the prospects for the Biden Administration's infrastructure plan. Local politicians as well as their construction buddies are salivating at the possible promise of getting their share of this multi-trillion-dollar prize. But looking beyond the pork barrel, we might want to consider how innovation and technology could help America regain its first-class status in infrastructure.
As of 2019, the United States is ranked 13th in the quality of its infrastructure after countries like Singapore, Japan, Germany, and the United Kingdom among others. Of course, it may not be a fair comparison since the U.S. has to rebuild and maintain 4 million miles of roads, streets, tunnels, bridges and other structures, while a nation like Singapore is smaller than New York City.
The sheer size of our infrastructure is made even more difficult by how many fingers are in the nation's pie. All of this infrastructure is essentially owned, operated, and maintained by state and local highway agencies. At the local level, about 40,000 individual governmental units of varying sizes and populations are responsible for 75 percent of the nation's highway mileage.
In turn, these agencies contract with thousands of private companies that furnish products, services, and equipment to build, maintain, and operate the system. This private sector portion is comprised of highway contractors and consultants, material and equipment manufacturers and suppliers, plus all the professional, trade, and industry assortations that proliferate at the national, state, and local levels. We are talking about many thousands of individual businesses from the largest multinational corporations to single-person operations.
Over and above this vast public and private sector army sits the federal government, which provides funding in the form of financial assistance to the states, as well as certain regulations, policies and guidelines.
As one can imagine, like in every army, there are traditional ways of thinking and doing and when it comes to infrastructure, even more so. When thinking about infrastructure, more often than not, familiar terms like "shovel ready," "pothole repair," and "black topping," accompanied by long traffic delays and detours comes to mind.
But while we have largely delayed or ignored our infrastructure, other countries have been achieving technological breakthroughs and new innovations for years. My hope is that the U.S. will be able to take advantage of some of these advances in our own infrastructure plan in the coming decade.
Software programs, for example, are changing the way infrastructure projects are being designed. New building information modeling programs enable three-dimensional, computer-generated designs that allow professionals at all stages, from architects to engineers to building managers, to collaborate on a project. Among other things, using these state-of-the-art programs decreases errors, gives much greater predictability when it comes to costs, and would help to deliver projects that are on time and on budget.
Another innovation is the application of 3D printing to construction and design. 3D printing is poised to totally disrupt the construction site, according to many construction experts. A Dutch company, for example, designed and built the world's first 3D-printed steel bridge recently. The use of 3D technology not only can reduce costs, but aid in constructing safer, more durable projects.
Plastic roads is another concept that promises to replace traditional asphalt as a primary material in road construction. Advantages over asphalt include quicker installation time, triple the service life, and an effective way to recycle the plastic that is filling up our oceans and landfills.
Blockchain technology can also be applied to infrastructure long before the first 3D blueprint is drawn up. Remember that army of private and public sector entities? Imagine how long it usually takes the government to actually contract out and procure all the processes involved in even one project. That's where blockchain comes in. The technology would be ideal in its ability to eliminate the layers and layers of contracts and middlemen that sit between the conception and delivery of just about any infrastructure project.
These are just some of the advances that are available to the U.S. The challenge will be to overcome the skepticism and resistance to change that confronts all of us. I'm hoping that with the correct approach, our effort to rebuild America could be the envy of the world.
Bill Schmick is the founding partner of Onota Partners, Inc., in the Berkshires. His forecasts and opinions are purely his own and do not necessarily represent the views of Onota Partners Inc. (OPI). None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-413-347-2401 or email him at bill@schmicksretiredinvestor.com.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of OPI, Inc. or a solicitation to become a client of OPI. The reader should not assume that any strategies or specific investments discussed are employed, bought, sold, or held by OPI. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct.
America is running out of water. During the next 50 years, the nation could see its fresh water supply reduced by one third. But if you think that's a problem for the next generation, you are wrong. This year alone, as many as 83 out of 204 U.S. water basins could begin to feel the brunt of these shortages.
And don't think these shortages will only affect those regions that we would expect to be dry. The central and southern Great Plains, the Southwest and central Rocky Mountain states, as well as the South, Midwest, and parts of California are all in danger. The twin culprits are rising temperatures and changing rainfall patterns brought on by climate change.
The wettest regions of the country are getting wetter, while the driest areas are getting dryer. At the same time, we are seeing more intense concentrations of rainfall that make capturing and using that water more difficult. If you combine that with temperature changes that are expected to heat up the nation by 5.7 degrees in the years ahead, you have a perfect storm for water shortages.
But that's only the tip of the iceberg. The demand for clean, fresh water is also increasing. Population growth alone is setting us on a path where we are going to need to make hard choices between water use for drinking, irrigation (37% of water usage is for agriculture) and manufacturing. We already are fighting over water in many states. The Colorado River is just one example of the ongoing controversary of water use and state's rights.
However, most Americans simply assume that if push comes to shove, there will always be enough clean tap water in most of the major cities and towns, at least in places like the Northeast, where I live. Think again. Our drinking water has been contaminated by industry, weakening government oversight, and aging infrastructure for years and years. Did you know, for example, that a water main breaks in the U.S. approximately every two minutes?
Leaking lead from aging pipes in New Jersey, radioactive waste in the ground water in Arizona and New Mexico from uranium mines, hookworm disease in Alabama from sewage pipes, mining spills in Kentucky, chemicals in the South Carolina water supply—these are just some of a long list of calamities that are popping up more and more frequently throughout the country.
In the middle of this crisis, the demographics of the U.S. population are changing. Some cities and communities are getting bigger and richer, while others in areas such as the upper Midwest, the Great Plains, and the Mississippi Delta are dealing with fewer resources and declining populations. Unfortunately, these trends will mean increasingly unaffordable water for certain segments of the population going forward. Today, for example, in some areas of North Carolina, a low-income family of six people needs to work 4 to 5 days each month just to cover their water bill.
Utility disasters, such as the massive lead-tainted water crisis in Flint, Michigan in 2015, are expected to grow in frequency and with increasing economic impact. This week's latest calamity involves a Florida reservoir in the Tampa Bay area on the brink of collapse. It was leaking toxic wastewater and could have devastated much of the region's environment and economy. It was narrowly averted, although environmentalists had been warning of the danger for years.
The truth is that many cities and states face huge upgrades in their water infrastructure and have for many years. The only way to obtain the money is to raise taxes or borrow the funds through municipal bond offerings. If you live in a big city or state with a prosperous population, that may be costly but still possible. But what do you do if your utilities are serving a shrinking or stagnant population with lower income prospects?
Given the dilemma we face as a nation in this area, the Biden Administration's infrastructure proposal seems to be on the right track in proposing $45 billion in grants to help water utilities replace lead water lines and another $56 billion for water and sewer projects. It seems clear to me that preserving our water supply, both now and in the future, is every bit as important as fixing our roads and bridges. As for our growing water shortage, let's hope we all finally take climate change seriously.
Bill Schmick is the founding partner of Onota Partners, Inc., in the Berkshires. His forecasts and opinions are purely his own and do not necessarily represent the views of Onota Partners Inc. (OPI). None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-413-347-2401 or email him at bill@schmicksretiredinvestor.com.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of OPI, Inc. or a solicitation to become a client of OPI. The reader should not assume that any strategies or specific investments discussed are employed, bought, sold, or held by OPI. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct.
Renewable energy stocks were all the rage last year. This year, however, not so much with clean energy funds taking hits of between 25-50 percent. Will President Biden's proposed $2.25 trillion infrastructure bill breathe new life into this sector?
President Biden ran on a platform that included the build out of an infrastructure plan that would "achieve net-zero emissions, economy-wide, by no later than 2050." By the time of his November election last year, investors had bid up the clean energy sector, which includes everything from electric cars, and clean water to solar and wind power, by over 200 percent in some cases.
New renewable energy exchange traded funds (ETFs) and mutual funds were offered with names like "Tan" and "Fan" that were snapped up in anticipation that they could only go higher. Of course, like all mini-manias, prices failed to keep up with investor's expectations. Markets moved on to buying "reopening trades" like dirty old oil stocks, airlines, and cruise ships.
However, on Wednesday, March 31, President Biden unveiled some of the details of his multitrillion-dollar infrastructure plan. In addition to programs to upgrade the nation's schools and spend $580 billion in job training and R&D, the plan should benefit many companies in the clean energy sectors.
About $621 billion will go toward physical improvements to roads, bridges, public transit, ports, airports and electric vehicles. Another $300 billion is earmarked for improving drinking-water infrastructure, expanding broadband access, and upgrading electric grids. Included in that spending will be energy-efficient affordable housing, electric vehicle charging stations, as well as potential extensions in government tax credits that would benefit both the solar and hydropower industries.
Congress has already extended the investment tax credit used for residential and commercial solar projects at the current rate of 26 percent for two years in 2020 as part of the $2.3 trillion spending and coronavirus relief bill. If the clean energy lobbyists get what they want, it could mean billions of dollars for solar, wind, clean energy storage, and other industries from electric vehicles to pollution controls that would decarbonize our environment.
Allied Market Research, an expert in this area, forecasts that the global clean energy market will be worth $1.5 trillion by 2025. There is an array of companies to choose from, in fact, so many that the average investor may have a hard time making investment decisions. However, fear not, because there are many exchange traded funds that do the work for you.
Some funds that are available include the IShares Global Clean Energy ETF (ICLN), the Invesco WilderHill Clean Energy ETF (PBW), and the ALPS Clean Energy ETF (ACES). There are also some more focused funds such as the Invesco Solar ETF (Tan) and the First Trust Global Wind Energy ETF (Fan).
Although President Biden's infrastructure plan should be good news for Americans and the economy it is far from a done deal. His plan to raise corporate taxes to 28 percent from 21 percent and to establish a global minimum tax for multinationals corporations to ensure they pay at least 21 percent (up from 13 percent) in taxes in any country won't sit well with Republicans and many others on Wall Street. I expect there will be a lot of horse trading in the weeks and months ahead before a final agreement is reached and passed. But if it is, some of the prime beneficiaries should be the clean energy companies.
Bill Schmick is the founding partner of Onota Partners, Inc., in the Berkshires. His forecasts and opinions are purely his own and do not necessarily represent the views of Onota Partners Inc. (OPI). None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-413-347-2401 or email him at bill@schmicksretiredinvestor.com.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of OPI, Inc. or a solicitation to become a client of OPI. The reader should not assume that any strategies or specific investments discussed are employed, bought, sold, or held by OPI. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct.
Last week, a bipartisan slate of U.S. Senate co-sponsors introduced the Secure and Fair Enforcement Banking Act (the SAFE Act) that would allow the cannabis industry to tap the federal banking system. If passed, this could be a game changer for marijuana companies.
The SAFE Act has already been passed by the House back in September 2019 but was never brought up for a hearing, much less a vote in the Senate.
The bill's author, Congressman Ed Perlmutter, a Colorado Democrat, has introduced several versions of this bill many times over the last eight years. During that time, the legalization of marijuana has moved from a pie-in-the-sky hope of a few legislators to something that may actually have the votes to pass.
Forty-seven states have already legalized either recreational or medical marijuana (as well as the District of Columbia and four U.S. territories). That should have been pressure enough to overcome lawmakers' resistance and yet, the legal status remains the same. Cannabis is still a Schedule 1 drug that makes it illegal on the federal level; as such, most cannabis companies are excluded from utilizing banking accounts. They have to operate on a cash-only basis.
At the same time, the banking sector, as well as numerous public companies that might want to enter the cannabis space, are precluded from doing so in fear that they will run into problems with federal insurers and the federal government.
The cash-only model hamstrings marijuana companies that would like to borrow in order to expand but can't because bank loans are unavailable. It is both frustrating and somewhat ludicrous to many that this U.S. sector, which is valued at $17 billion, remains a cash business. It has also developed into a public safety issue since cash-laden tills of cannabis companies are prime targets for robberies and burglaries.
During the pandemic, a large number of states deemed the cannabis industry an essential business due to medical marijuana prescriptions. That also presents a public health concern, since more and more of these medical marijuana companies are dealing with increased demand. Many of them need access to the banking system to insure the continued flow of product to their patients.
In any case, in order for the SAFE Act to pass in the Senate, a minimum of 60 votes would be needed. At last count, advocates believe they have 59 votes, which would be more than enough momentum to at least field a Senate committee hearing. After that, the bill could be moved to the full Senate for a vote within the next month.
In the meantime, the New York State Legislature is expected to vote on its own Marijuana Regulation and Taxation Act, any day now. Passage would legalize recreational marijuana, as well as provide $350 million in tax revenue per year. This could be another large boost in revenue for several marijuana companies. The market for recreational pot could become a multibillion-dollar industry in the state. Some forecasters expect sales to grow as high as $7 billion throughout the next four years.
And while investors focus on the U.S., don't forget that Mexico has already passed legislation in their lower house, the Chamber of Deputies, this month. The bill will now go to the Senate before being sent to President Andres Lopez Obrador, who already supports passage. The legislation is expected to be approved by their Senate any day now. Mexico, with 130 million people, would represent the largest marijuana market in the world by population.
With all this good news on the legislative font, it appears to me that we are on the cusp of a major series of catalysts that should benefit the cannabis industry and propel the stock prices of several well-positioned and profitable marijuana companies here in North America.
Bill Schmick is the founding partner of Onota Partners, Inc., in the Berkshires. His forecasts and opinions are purely his own and do not necessarily represent the views of Onota Partners Inc. (OPI). None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-413-347-2401 or email him at bill@schmicksretiredinvestor.com.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of OPI, Inc. or a solicitation to become a client of OPI. The reader should not assume that any strategies or specific investments discussed are employed, bought, sold, or held by OPI. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct. Investments in securities are not insured, protected, or guaranteed and may result in loss of income and/or principal. This communication may include opinions and forward-looking statements, and we can give no assurance that such beliefs and expectations will prove to be correct.
We show up at hurricanes, budget meetings, high school games, accidents, fires and community events. We show up at celebrations and tragedies and everything in between. We show up so our readers can learn about pivotal events that affect their communities and their lives.
How important is local news to you? You can support independent, unbiased journalism and help iBerkshires grow for as a little as the cost of a cup of coffee a week.