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The Weekly Economic & Market Recap    

April 19, 2019  

The healthcare sector had been outperforming the broad market for many years until recently. A key factor influencing the relative performance of stocks over the less few years has been relative earnings growth which has helped lift healthcare stocks. Additionally, investors sought safe havens such as healthcare stocks during last year’s market volatility. By the end of last year, the healthcare sector made up 15.6% of the S&P 500 due to its relative out-performance. The political winds shifted as the next presidential cycle kicked off at the start of 2019. The changing political climate caused the sector to badly lag the overall equity market. Healthcare stocks are now down slightly for the year compared to the broad equity market which has advanced 16%. Several issues are negatively impacting investors’ perception of health care stocks, but clearly the uncertainty regarding the direction of U.S. health-care policy is the most significant factor. The demands for change have come from both sides of the political spectrum. The Trump administration is pushing for better price transparency and for the elimination of rebates paid by pharmaceutical companies to the pharmacy benefit managers. Rebates distort the behavior of consumers and health insurance companies with the result that patients get steered to costlier branded drugs. Congressional Democrats, some who have launched presidential campaigns, have announced plans to expand Medicare coverage to everyone. There are several competing versions of the “Medicare for All” approach, but in its extreme form it would effectively eliminate the role for private insurance and represent a massive reformulation of roughly 18% of the U.S. economy. The volatility exhibited by the healthcare stocks is reminiscent of the of the draw-down we saw from the companies with significant international exposure when the trade war began to heat up last spring. The significant selloff is an indication of the potentially damaging impact that a change in policy (even when its implementation is many years in the future and highly uncertain) can have on specific industries and on equity performance.

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