Tom Tobin

Underrated risk for those expecting elective surgery/routine dx volumes to rebound anytime soon. Even higher-acuity stuff is likely affected at the margin. The TL;DR here is that people are losing insurance. ACA exchange is due to a combo of policy and price, and the drop is happening the fastest here, but some % of Medicaid covered lives are likely to burn off over the next 2-3 years as well due to policy. Both are the more profitable channels for hospitals vs Medicare, bad for willingness to accept pricing power from device makers etc. going forward. Next few years are going to be very different for HC investing than the 2010s. If you have to be involved, try to be long exposed to aging and nothing else if you can. Lots of ways to do this but it rules out a ton of large cap.