The Independent Investor: Trump's War on Drug (Prices)
For the second year in a row, President Donald Trump called on Congress to do something about the escalating drug prices in America. The president is doggedly pursuing this campaign promise in the face of an army of special interest groups and big drug companies. Hurrah for you, Mr. President.
In his State of the Union address he said:
He wants our legislators to "deliver fairness and price transparency for American patients. We should also require drug companies, insurance companies, and hospitals to disclose real prices to foster competition and bring down costs."
Given that drug pricing is a complicated area and there have been various proposals and recommendations proposed, I will focus on just a few at a time. One of the president's proposed actions would reduce drug prices by allowing pharmaceutical companies to offer discounted prices to Medicare and Medicaid directly, bypassing the middlemen, called pharmacy benefit managers (or PBMs). Historically, these PBMs have been useful to insurance companies and large employers. They make their money by negotiating behind-the-scenes deals with Big Pharma acquiring discounts, called "rebates," for their big clients on certain "approved" prescription drugs.
These rebates are targeted to name-brand drugs that are covered by Medicare and Medicaid. Since this is a well-known system of back-scratching, drug companies simply hike prices high enough each year to cover these "rebates." This year, for example, despite the president's call to hold down prices, 60 drug companies increased prices on more than 300 products, and we are only in February of the new year.
Trump wants these discounts, instead, to flow directly to the consumer at the pharmacy counter, rather than the pockets of the PBMs. Since drugs paid through the Medicare system account for 30 percent or more of the country's retail drug spending, this would result in a sea of change to the prescription drug market.
This change would especially benefit those of us with really high prescription drug costs. The rebate system, you see, is usually focused on competitive drugs, such as two opposing blood pressure medicines. The really expensive drugs usually have no competition and therefore fall out of the rebate system.
I have a client, for example, with a fairly rare condition, who pays well over $100,000 a year for one drug. Under the current system, his deductible and co-insurance are sky high, because there are no rebates available to him. He pays the list price for his medication and is required to pay a percentage of the drug's cost himself. He could save as much as 30 percent on his drug costs.
For many of us, however, there would be a downside. Since insurers would no longer be able to apply the rebate money, they receive from PBMs to lower overall insurance premiums, the typical Medicare patient could see premiums go up by as much as $5 or more a month. Some experts think that about one-third of Medicare drug plans will benefit from the change, while two-thirds may not.
Another group to benefit would be those who suffer from the "doughnut hole" In Medicare Part D, which covers drug cost. These expenses can escalate until they reach what is called the "catastrophic phase" where out-of-pocket expenses tops $5,100. At that level, the government steps in and will assist in paying most of the bill. Lowering drug costs will reduce prices and provide some relief to we who suffer from the prescription donut hole on a yearly basis.
Although the Democrats have identified drug pricing as an area they would also like to attack, their solutions differ. In an almost knee-jerk fashion in today's partisan politics, anything one side proposes is immediately shot down by the other side.
"The Trump administration's rebate proposal puts the majority of Medicare beneficiaries at risk of higher premiums and total out-of-pocket costs and puts the American taxpayer on the hook for hundreds of billions of dollars," says Nancy Pelosi, the Democrat's speaker of the House.
It remains to be seen if the Democrats can come up with something better. In the meantime, one proposal I thought made a lot of sense was Trump's proposed change to Medicare B pricing. He wants a much larger set of drugs to be priced no higher than they are in foreign countries like Japan or nations in Europe. He also proposed that the secretary of Housing and Human Services (HHS) be allowed to negotiate prices and permit U.S. residents to purchase medicines directly from other countries.
Despite the partisan rhetoric, there seems to be some willingness to work together. Given the president's lead on drug pricing, I believe it is one area where we could see Congress and the White House come to terms and pass something useful and acceptable for all of us. Wouldn't that be great?
The Independent Investor: Europe, the World's Sick Sibling
The European Community is beset by worries. Brexit, trade threats, a slowing Chinese economy, and internal politics at home have all conspired to slow growth, employment, and positive sentiment.
This year, the EU will be lucky to see 1.5 percent GDP growth. In fact, the International Monetary Fund reduced their overall forecast this week for global growth largely as a result of poor performance out of Europe. Europe's powerhouse, Germany, saw its growth for 2019 cut by 0.6 percent because of anemic consumption and weak industrial production data.
Italy, one of the problem children of the EU, saw its growth forecasts cut by 0.4 percentage points as a result of weak domestic demand and out-of-control government borrowing. France did not escape the knife either. Its GDP was reduced by 0.1 percent, largely because of the continuous, production-stopping street protests.
Trade tensions top the list of obstacles afflicting Europe. While most of the news coverage tends to dwell on the slowing economy of China (because of the ongoing trade war), this issue is impacting businesses throughout the world. Automobile tariffs on EU exports, for example, have impacted growth, especially within Germany.
Brexit has also cast a dark shadow over Europe. Uncertainty has infected every corner of the 18-nation union ever since the UK referendum to leave the EU back in June 2016. The unsuccessful exit negotiations, which recently culminated in the British Parliament's rejection of the terms, brought to naught years of talks between Prime Minister Teresa May and her cabinet and EU negotiators.
Since then, both sides are grappling with the next step forward. Some believe another referendum will need to be called. Others hope new (and better) terms for the UK exit will be required, although the chances of the EU offering better terms is hard to believe. This issue will continue to weigh on investment and growth on both sides of the Channel until it is resolved.
No discussion of Europe would be complete without mention of Italy. This southern nation is already flirting with recession. Fourth quarter growth was already the weakest it has been in four years. Unwilling to adhere to the strict guidelines of EU lenders, the nation's voters insist on upping spending year after year, borrowing more and more, while digging itself deeper and deeper into a financial hole.
The nation has replaced Greece as the "Bad Boy of Europe" with a real risk of witnessing a collapse of their financial sector. The Italians, of course, are watching the exit negotiations of the United Kingdom. There is an implied threat if EU authorities lean on Italy too hard that what the UK can do, so can Italy.
Amid this unsettling backdrop, Mario Draghi and the monetary authorities of the EU's Central Bank (ECB) are walking a tightrope of maintaining some stimulus, while taking some away. Like our own Federal Reserve Bank, the EU has been slowing their purchases of government bonds, which should wind down to zero this year. This may or may not be followed by the ECB's first interest rate hike late in the year — if the data warrant it.
My own bet is that while the ECB is talking a good show, the economic worsening of conditions in Europe will postpone any rate hikes. If, on the other hand, a Brexit agreement can be reached, if a trade agreement with the U.S. can be resolved, and if Italy were to ‘find religion,' conditions may improve. But don't hold your breath.
The Independent Investor: The IRS Has Its Hands Full This Year
The government's partial shutdown has everyone on edge this year. Despite assurances from the powers that be, many taxpayers are concerned that their tax returns won't be processed on time. Should you be worried?
One misconception many have is that the Internal Revenue Service is closed. Not true, the IRS remains open, despite having no budget since Dec. 21, 2018. The agency is running under a contingency plan, which includes operating with only 12 percent of its staff.
Usually, you can e-file your returns in late January, and that remains doable. The IRS announced it will be accepting 2018 tax returns starting January. 28, 2019. They also said they would be issuing refunds. To do so, they will be bringing back a large portion of their laid-off workers. Those workers, like the other 800,000 furloughed federal workers, won't be getting a pay check until the shutdown is over.
The question remains: how many of those workers are willing to return to their jobs without a paycheck? We are already seeing some departments (such as Homeland's TSA workers) balk at working for free any longer. But the government shutdown is not all the IRS needs to worry about.
Thanks to the Tax Cuts and Jobs Act passed in a hurry by Congress last year, the IRS has been working overtime to deal with the mountain of new changes and adaptions necessary to reflect the new tax laws. To add insult to injury, it took months before the new rules were actually delivered to the IRS from the legislative branch. At the time, the Inspector General said that it would take "massive resources" to do what was necessary to fulfill taxpayer expectations, while making sure the IRS is compliant with the new laws.
The new tax reform legislation contained nearly 120 provisions, affecting both domestic and international taxation of American individuals and corporations. As a result, nearly 450 new forms, sets of instructions, and publications would need to be published and disseminated. On the IT side, another 140 information technology systems would need to be modified so that tax returns could be processed, and compliance monitored.
Conservatively, the IRS estimated that 4 million additional phone calls and other contacts would be required to deal with questions taxpayers and their accountants were going to have about how to file individual returns. And here we are beginning tax season and those calls have just begun! Remember, the IRS warned months ago that there might be delays due to the enormity of changes required of them.
"The tax reform is certainly making life difficult for us," says Barry Clairmont, a partner in Lombardi, Clairmont & Keegan, one of the leading accounting firms in the Berkshires. "Tax preparation is taking longer, and, on the corporate side, there is more reporting required due to what we call 'QIB' or qualified business income."
Clairmont's advice is that corporations should begin the filing process now and not wait until the last minute.
On the other side of the country, Terry Milrany, one of the most respected accountants in Fort Worth, Texas, echoes much of what Clairmont says. He, too, sees the general business deductions of the 20 percent "pass-through" change in the tax law as something that is "still evolving" from within the IRS.
"Just in the last two days," he said, "I received another (and hopefully final) update from the IRS on this rule." As for the shut down's impact on tax returns, Milrany, who has been doing tax returns for 50 years, says, "We just don't know how the shutdown or the tax changes are going to impact returns. We are not deep enough into the filing season yet."
@theMarket: Markets Retrace December Losses
It was a week where lackluster earnings battled with the Fed's willingness to hold off on rate hikes for investors' attention. The Fed won. Investors bought on the dips and helped to push the markets out of correction territory.
From a technical point of view, however, all the U.S. indexes are overbought, extended, and in need of some kind of pullback. Traders know this and have been shorting the market as it climbs, betting that we will see at least a 100-point decline in the S&P 500 Index. It hasn't happened — yet.
Normally, markets will do what is most inconvenient for the greatest number of traders.
In this case, the indexes simply keep going up. But before you exhale in relief, be advised that when the last bear throws in the towel, that's when the markets will blind-side you.
For those who followed my advice last quarter and have remained invested, your paper losses are rapidly disappearing. I expect that, despite continued volatility through March, the second half of the year should see all your losses recouped and I expect further gains after that.
Earnings, which were not forecasted to match the gains of the last few quarters, have come roughly in-line with investor's lower expectations. So far, the average results indicate about a 7 percent gain for the quarter. In cases where a company announced less than that, traders were quick to punish their share price.
In some cases, for example, banking stocks, where trading profits were down last quarter as a result of the steep drop in equities, the Algos were whipping prices around on almost an hourly basis. Clearly, this is a market where the only smart thing to do is buy and hold for the longer term.
One positive (but suspicious) development occurred on Thursday afternoon. Someone (I'll call him the Trade Whisperer), let it be known through a Wall Street Journal report that the Trump House was considering pulling the Chinese tariffs in a bid to trigger a breakthrough in the U.S./Sino trade negotiations. It took all of 10 minutes for stocks to spike much higher.
Despite the outpouring of denials from all of Trump's men, U.S. markets still closed higher and continued the move into Friday. I found it interesting that, despite the denials, Asian markets, especially China, gained over one percent Thursday night. Where there's smoke, there may be some fire down the road.
I mention this because, in my opinion, events like this illustrates the extreme fragility of global markets. Anything (real or imagined) can spark a violent move in financial markets. A case in point is the troubling (and expanding) revelations that seem to be surrounding Donald Trump.
At last count, 16 of his closet aides and/or campaign staff have been linked to Russian nationals in an effort to tilt the presidential election in Trump's favor. His former closest confidant, Michael Cohen, is now admitting that his ex-boss actually conspired to obstruct justice (committed a crime) and that the Mueller investigation can prove it.
These are developments that every investor should take on board and treat seriously, regardless of political affiliation. There is potentially a risk that, despite Trump's repeated denials, Mueller does have the goods on the president. If so, look out below.
The bottom line: There is simply too much lurking out there to make an informed investment decision. As such, the best option is to stay invested, but keep looking over your shoulder.
The Independent Investor: Pay Gap for Women Is Growing
If Citigroup, one of the world's largest banks, is any indication, women earn 29 percent less than their male counterparts. It also revealed that only 37 percent of its managerial jobs were held by females.
Wall Street has long been known as "the last bastion" for white males. But to Citigroup's credit, it just made public its internal assessment of the existing pay gap between the genders. One reason it did so was the new disclosure standards that are now required in the United Kingdom since last April.
Last year, when Citigroup first reported these numbers for its U.K. workforce, women were paid 44 percent less, and if bonuses were counted, the gap widened to 67 percent. Kudos to Citigroup for at least narrowing the gap over the last 12 months, but much more needs to be done.
However, let's not pick on Citigroup. Plenty of the nation's top financial institutions are in the same boat. But, as a result of increasing shareholder pressure, many American companies are being required to fess up and supply data of their own inadequacies in this area.
Historically, the wage gap for women in this country has been reported to be 80 cents for every dollar a man receives in compensation. Critics argue that there has been real progress since the Equal Pay Act was passed in 1963. Back then, women only earned 60 percent of what men did.
Over the next 30 years or so that disparity was reduced by half, but it is still 80 cents.
Those who think this gap is justified (mostly white, middle-aged and older males) argue that women get paid less because they do a disproportionate share of child-rearing and household work. As such, women have a higher chance of only working part-time or dropping out of the workforce to care for children or their elderly parents. In addition, critics say that women tend to cluster into low paying sectors like administration, secretarial work, and teaching.
I say this is hogwash! Studies reveal that even in high-paying jobs, as a woman ages, the gap widens between her and her male counterparts. The idea that women should stay home and have babies is a bankrupt myth at best. I contend that "the 80 cents to the dollar" headline is also inaccurate. The real gap is far higher than that.
I have been in this business long enough to know that the way numbers are assembled can be tilted to justify any point of view. If you, for example, track women's earnings over the last 15 years, you would find that women earned 49 cents to every male dollar. At the same time, all this vaunted progress over the last thirty years has been slowing not increasing.
Part of the reason for the wage gap is Corporate America's insistence that only men (and white men at that) belong in the corner office. Despite their abilities, far fewer women have managerial roles in this country. That, in itself, explains why women overall receive less than men. I believe that all these statistically-adjusted numbers hide half the problems facing women in the workplace.
Clearly, we need more women in higher-paid jobs and in leadership positions. Our own company, small as it might be, has long recognized this fact. Our president is a woman, as is 50 percent of our staff. Women here are all in leadership roles and there are no wage discrepancies.
Unfortunately, under this presidency, Donald Trump reversed an Obama-era rule that compelled companies to report wage information to the government. As such, the vitally-important statistics women need to bolster their case will be much more difficult to find. In the meantime, if you are a woman shareholder, or a male who believes in equal pay, like I do, lobby companies you own at every opportunity to follow Citigroup's lead.