Home About Archives RSS Feed

The Independent Investor: Is There a Doctor in the House?

By Tammy DanielsiBerkshires Staff

A doctor shortage in America has been predicted ever since the first Baby Boomers started to retire.  Now, that shortage is coming into question as technology and non-doctor, medical professionals are stepping forward to fill the gap.

The Association of American Medical Colleges predicts the nation will need 90,000 doctors by 2020 and 130,000 physicians by 2025. It is understandable how that organization arrived at that number. Just compute the proportion of Americans who will reach the age of 65 between now and 2030. Add to it the number of Americans newly insured, thanks to the Affordable Care Act, and you come pretty close to those numbers.

However, those figures simply represent the demand side of the equation assuming everything else remains the same.  To be sure, there will still be a shortage of general practitioners, those front line physicians who are our first stop in accessing medical treatment and services.  But a whole host of breakthroughs in medical knowledge, technology and treatment protocols are reducing not only the hours required to treat an aging population, but also the location of such treatment.

As a result, fewer patients visit hospitals today and when they do, their stay is reduced by a variety of outpatient choices. This pares down on the number of doctor visits each patient requires. In addition, many surgical procedures, thanks to advances in knowledge and technology, can be accomplished today through minimally invasive procedures that require less recovery time and therefore less doctor time.

Take my upcoming knee replacement, as an example. I have only seen my orthopedic surgeon once and will probably not see him again until the surgery. My hospital stay will be 2-3 days at the most, barring complications, and I'll most likely see him a week or so after the operation. That's it. Of course, in the meantime, I am seeing an army of technicians, physical therapists and so on.

This brings me to another sea change in medical treatment, the rise of the non-doctor primary care providers that include physician assistants, nurse practitioners, pharmacists and social workers. More often than not, you will find them working in teams. Think of the doctor’s assistant as the operations manager who, in my case, is sending me hither and yon to see various practitioners both before, during and after my operation.

In today's world you may never even see the doctor for some ailments. This year my GP suggested I see a dermatologist, (something I have avoided in the past). I have been back five times since that first visit and have never once seen the doctor. My skin ailments have been handled by a physician's assistant and a nurse practitioner. I'm sure the same thing is happening to you.

Training 130,000 doctors over the next decade requires an enormous amount of resources. In contrast, expanding medical practice law to allow nurses and pharmacists to provide more comprehensive primary care is a cheaper and a more time-efficient method to fill much of this potential doctor shortage. More emphasis on "team care" in our medical schools would also help leverage an underutilized medical work force that could do much, much more. Combined with the continued breakthroughs in medical technology and devices, we may just be able to keep up with the demand from people like me.

Bill Schmick is registered as an investment adviser representative with Berkshire Money Management. Bill’s forecasts and opinions are purely his own. None of the information presented here should be construed as an endorsement of BMM or a solicitation to become a client of BMM. Direct inquires to Bill at 1-888-232-6072 (toll free) or email him at Bill@afewdollarsmore.com.

     

The Independent Investor: The Pipeline Made Simple

By Bill SchmickiBerkshires Columnist

The U.S. Senate rejected passage of the Keystone Pipeline by one vote this week. The controversial energy plan will be back on the agenda, however, in January. For most of us, separating fact from fiction as both sides alter the facts is difficult at best, but here are some things we do know.

First, we can describe the project. The proposed Keystone XL project consists of an 875-mile stretch of pipeline and related facilities that will transport 830,000 barrels per day (bpd) of crude oil from Alberta, Canada, through Montana, South Dakota and Nebraska. It will then connect to existing pipeline facilities that flow through Nebraska, Oklahoma and ultimately down to the Texas Gulf Coast region.

About 40 percent of the total project has been completed. A 298-mile line that runs from Steele City, Neb., to Cushing, Okla., already exists as does another 485-mile piece between Cushing and Nederland, Texas. Oil is already flowing within these segments of the pipeline from various oil wells within the U.S.. The remaining segment has been held up for years thanks to the political wrangling among various American politicians and lobbyists.

There has been a cost to this controversy. Thanks to the delays, the price tag to complete the project has already doubled to something like $8 billion to $9 billion. Once approved, it will take two years to build out the pipeline and get things connected.

Depending on who you listen to, the project would mean as few as 20,000 high-paying construction jobs to as many as 42,000 (if you count indirect jobs). Energy spokesmen will tout as many as 200,000, but don't believe that. What no one disputes is that those jobs are only temporary. The actual head count of permanent jobs, once the project is complete, comes in at 50 or less.

Alberta has the third largest proven oil reserves in the world after Saudi Arabia and Venezuela, but much of it is buried within what is called "tar sands." Tar sands are a mixture of sand, water, clay and bitumen. The oil-rich bitumen can be processed into heavy, viscous oil. Producing the stuff will emit an estimated 17 percent more greenhouse gases than traditional oil drilling in the U.S. That is why the likes of Al Gore and Robert Redford are against it.

So if it is environmentally evil and good for just a few long-term jobs why in the world would this country want to approve it?

Over the long-term it makes sense strategically for us and our trading partner to the north.

Let's take Canada first. Our neighbor to the north is our largest source of oil imports, providing almost 2 million of a total of 9 million barrels of imports per day. Strategically, we know that two other major suppliers are problematic. Mexico's oil output is declining and Venezuela is unreliable at best.

Transporting oil via the pipeline from Canada would replace that shortfall for America. In addition, what we don't use, we can export. By law, America is only allowed to export third-party oil. Right now that only amounts to 30,000 bpd. Next year, that number is estimated to rise to 230,000 bpd. The Keystone pipeline would dramatically increase that number while reducing the amount we import from unreliable sources.

The fact is that with or without us, Canada will extract oil from their tar sands. So the argument becomes will we make it easier and safer for them to do so? Our environmentalists want Canada to just abandon the extraction program entirely.

Personally, I would rather our environmentalists focus more on our own issues and let Canada handle the environmental fallout from their tar sands extraction. In typical "America knows best" fashion we see nothing wrong with dictating what another country should do with its natural resources. But does Canada demand that we reduce our coal-fired generation industry, which has a carbon footprint 60 times larger than Alberta oil sands? Does anyone recognize that Canada produces less than 2 percent of the world's greenhouse gas emissions and tar sands make up just 5 percent of that total?

For once, let's do something that is good for Canada, a country that has stood by us through thick and thin for decades. Sure they can find other means of transportation — namely truck and rail — but why should they have to? The pipeline makes sense for us and for Canada.

Bill Schmick is registered as an investment adviser representative with Berkshire Money Management. Bill’s forecasts and opinions are purely his own. None of the information presented here should be construed as an endorsement of BMM or a solicitation to become a client of BMM. Direct inquires to Bill at 1-888-232-6072 (toll free) or email him at Bill@afewdollarsmore.com.

     

@theMarket: Markets Are in Half Time

By Bill SchmickiBerkshires Columnist

Stocks have had a wonderful run since mid-October's swoon. The S&P 500 Index is now up over 10 percent from its bottom. As we approach another record high, expect some backing and filling before moving higher. I wish I could say the same about the price of oil.

The price of oil is the main topic of conversation among traders and investors. Typically, as the price declines further, Wall Street energy bears vie for headlines by predicting even worse times ahead for energy. Technicians are now considering $40 a barrel as a real possibility and others are jumping on the band wagon as oil broke $75 a barrel on the downside this week.

Methinks the selling is overdone at least over the short-term. We are only a week away from the OPEC meeting and I expect some traders will cover their shorts until after the meeting. What we do know is that Saudi Arabia needs $85 barrel oil to balance their budget. But that Middle East nation is both wealthy and autocratic. It can afford to watch oil drop lower if they choose to. Besides, there may be other reasons in the wind for allowing oil to slide lower.

Excuse my penchant for Machiavellian plots, but it has occurred to me that the nation that is hurting the most from this price decline is Mother Russia. Globally, Russia is the No. 1 producer, followed by Saudi Arabia, while the U.S., at 9 million barrels a day in production, ranks third.  

Readers may have noticed that now that the weather has grown colder, surprise, surprise, events are heating up once again in Ukraine. Vladimir Putin, in my opinion, plans to annex even more territory in the east of that nation. If Europe protests or threatens to increase economic sanctions as a result, Putin could threaten both Ukraine and/or Europe with a cutback or even a cessation of energy exports. He has done it before and there is no reason to believe he won't do it again.

If I know that then surely others do as well. If I were the U.S. (and its ally, Saudi Arabia), lower oil prices would be a far more effective tool to slow or even stymie Putin's land-grabbing schemes than sanctions. At the same time it would give a real shot in the arm to American consumers, airlines, farmers, shippers and the transportation sector.

At some point, declining oil prices, coupled with the existing economic sanctions, could truly devastate the Russian economy and bring Russia to its knees. Right now, the Russian people love Putin and his misguided efforts to restore the Soviet empire. Will that adoration persist in the face of a deep recession or even a depression?

We blame Saudi Arabia for not acting to support energy prices. Pundits (including me) have claimed that it is their intent to slow U.S. shale and gas production, thereby hurting America's efforts in becoming energy-independent. Maybe so, but at the same time, it is hurting Russia far more than the U.S. and that's my point.

As for the markets, this last week has been largely a period of consolidation or sideways movement. Markets are overbought and need to work off the excesses, which is exactly what is happening. Remember, markets can adjust by either declining or sideways movement. All year long, we have seen a pattern of sideways rather than down so expect more of the same. Stay invested and enjoy the coming rally into the New Year.

Bill Schmick is registered as an investment adviser representative with Berkshire Money Management. Bill’s forecasts and opinions are purely his own. None of the information presented here should be construed as an endorsement of BMM or a solicitation to become a client of BMM. Direct inquires to Bill at 1-888-232-6072 (toll free) or email him at Bill@afewdollarsmore.com.

     

The Independent Investor: U.S. and China Square Off

By Bill SchmickiBerkshires Columnist

In Beijing this week, the annual Asia-Pacific Economic Cooperation summit is winding down. As representatives from its 21 member nations return home, one thing is certain.  China has become America's main rival for influence in that region.

Depending on who you talk to, China's Gross Domestic Product (GDP) is expected to overtake that of the United States sometime in the next five years. Some argue that it may be sooner than that. But while we Americans might fret over falling to second place economically, China's communist leaders could care less. They are eyeing a far larger prize — control of much of the world's natural resources and the means to transport them back to China.

There is nothing underhanded or dishonest about their ambitions. For the last decade, China has been investing, purchasing and partnering with countries and companies worldwide. Whether developing a Peruvian mountain loaded with copper or inking an energy deal with Russia's Vladimir Putin, China is methodically expanding its control over the means of production worldwide. This week's tariff and free-trade deals among Asian nations and the United States is simply another step in their long-term plan.

Much has been made of President Obama's agreements on Tuesday to reduce tariffs on a range of technology products worldwide including videogame consoles, semi-conductor chips and even prepaid cards. The media also applauded an agreement by the two nations to further reduce greenhouse gases and expand the duration of visas for education and business. There was even some progress on developing some military and defense initiatives.

However, in my opinion, China's real objective was to convince Asian members that their plan to extend their economic influence to energy-rich Central Asia was good for everyone concerned. The Chinese are dangling a host of goodies from a free-trade deal in competition with one of our own, and $90 billion in infrastructure investment funds as well as additional investment from an army of Chinese private and state corporations. It is tempting.

You see, China wants to create a "Silk Road Economic Belt." Their objective would be to establish a far-reaching network of transportation, distribution and logistics that would bind China, Central Asia and Europe into one vast economic network. No one is laughing. Asian members only have to look at China's track record in South America and Africa, among other places, to understand just how serious the Chinese are. Strapped for investment, struggling with anemic economies and high unemployment rates, many of these nations would just love to invite the Chinese into their parlors.

If there is a fly in this Chinese ointment, it is of China's own making. Territorial disputes instigated by China with the Philippines, Vietnam and Japan over the last few years have made many nations wary of China's true intentions. Fortunately, all sides have backed off from a shooting war but China's increasingly aggressive military stance has many neighbors troubled.

It is one thing to invite an investment partner into one's country, but quite another to risk occupation by such an acquisitive Big Brother such as China. In light of these fears, China's willingness to talk turkey with the U.S. on military issues may simply be a ploy to alleviate these concerns among some nations.

The bottom line here is that while we at home continue to debate a pipeline that should have been built long ago, China is focusing on sewing up most of the world's natural resources. It is that kind of long-range planning that we need here in America. Unfortunately, we neither have the will nor the leaders to implement such a strategy. And we will regret it.

Bill Schmick is registered as an investment adviser representative with Berkshire Money Management. Bill’s forecasts and opinions are purely his own. None of the information presented here should be construed as an endorsement of BMM or a solicitation to become a client of BMM. Direct inquires to Bill at 1-888-232-6072 (toll free) or email him at Bill@afewdollarsmore.com.

     
Page 1 of 1 1  

Support Local News

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.

News Headlines
Williams Seeking Town Approval for New Indoor Practice Facility
Central Berkshire School Officials OK $35M Budget
Scoil Rince Bréifne Ó Ruairc Participated in North American Open Championships
Pittsfield Police Participating in US 20 Speed Enforcement Project
MassDOT Project Will Affect Traffic Near BMC
Dalton ADA Committee Explores Expanding
Milne Public Library Trustees Announce New Library Director
Clark Art Presents Free Thematic Tour on Music in Art
BCC, Mill Town Partner to Support Philanthropy Through 40 Under Forty
SVMC' Wellness Connection: March 15
 
 


Categories:
@theMarket (480)
Independent Investor (451)
Retired Investor (183)
Archives:
March 2024 (5)
March 2023 (4)
February 2024 (8)
January 2024 (8)
December 2023 (9)
November 2023 (5)
October 2023 (7)
September 2023 (8)
August 2023 (7)
July 2023 (7)
June 2023 (8)
May 2023 (8)
April 2023 (8)
Tags:
Federal Reserve Markets Energy Europe Taxes Oil Rally Congress Currency Euro Metals Interest Rates Banks Debt Economy Deficit Retirement Fiscal Cliff Commodities Selloff Pullback Stock Market Recession Debt Ceiling Crisis Election Jobs Greece Banking Bailout Japan Europe Stimulus Stocks Employment
Popular Entries:
The Independent Investor: Don't Fight the Fed
Independent Investor: Europe's Banking Crisis
@theMarket: Let the Good Times Roll
The Independent Investor: Japan — The Sun Is Beginning to Rise
Independent Investor: Enough Already!
@theMarket: Let Silver Be A Lesson
Independent Investor: What To Expect After a Waterfall Decline
@theMarket: One Down, One to Go
@theMarket: 707 Days
The Independent Investor: And Now For That Deficit
Recent Entries:
@theMarket: Sticky Inflation Slows Market Advance
The Retired Investor: Eating Out Not What It Used to Be
@theMarket: Markets March to New Highs (Again)
The Retired Investor: Companies Dropping Degree Requirements
@theMarket: Tech Takes Break as Other Sectors Play Catch-up
The Retired Investor: The Economics of Taylor Swift
@theMarket: Nvidia Leads Markets to Record Highs
The Retired Investor: The Chocolate Crisis, or Where Is Willie Wonka When You Need Him
The Retired Investor: Auto Insurance Premiums Keep Rising
@theMarket: Melt-up in Markets Fueled by Momentum