Healthcare

Healthcare is fascinating and is a big pie in America's GDP at $4.5 trillion or close to 20%. It was not always this way. In 1960, it was 5%. In 1980, it was 8.9%. In 1990, it was 12.1%. In 2000, it was 13.3%. In 2010, the first year that the ACA was enacted, it was 17.2%. The costs don't seem to be sustainable, but here we are. Since the beginning of 2010, the SPX has returned 12.8% a year assumming all dividends were reinvested. Healthcare in general has outperformed despite the big techs emerging in the 2010s. The breakdown below does not do service to how complicated and complex the industry is as the PBMs are inside UNH, CVS and CI.

Insurance Companies: UNH (up 17x since 2010 at 22.4% a year), CVS, ELV, CI

Hospitals: HCA (9.87x since 2011 at 19.3%)

Drug-Makers: PFE, MRK, AZN, ABBV (15.27x since its spinoff in 2012 14.9%), AMGN (5.2x since 2010 at 12.6%), GILD, BMY, LLY (20.5x since 2010 at 24%), NOVO (17x since 2010 at 22.4%)

Drug Distributors: MCK (7.8x since 2010 at 15.8%), CAH, COR (formerly Amerisource Bergen)

Device Manufacturers/Equipments: SYK (6x since 2010 at 13.7%), BSX, 

Service Providers: ABT, DVA (3.5x since 2010 at 9.4%)

Everyone is getting a cut and the pie that divides is interesting beyond the science of health.