TPGs Coulter Says Global Health Care Is Best for Deals

Disruptions in the international health-care industry offer the best opportunity for investment, according to TPG Capital co-founder Jim Coulter.

You cant just bet on the economy, Coulter said today at the Bloomberg Year Ahead Summit in Washington. A disruption with cyclical downside protection is interesting.

TPG, which manages $66 billion in assets, is buying hospitals in China and India because of innovations in health-care services there, Coulter said. The Fort Worth, Texas-based firm is also investing in U.S. surgery centers, he said. TPGs recent investments in the industry, according to the firms website, include Evolent Health Inc., Genomic Health Inc., hospital operator Iasis Healthcare Corp. and Australian health-care provider Healthscope Ltd. (HSO), which held an initial public offering in July.

TPG is also seeking investments in young companies in whats known as the sharing economy, in which customers use mobile applications and Web tools for shared services, Coulter said. The firm last year bought a stake in passenger transport company Uber Technologies Inc. and this year invested in home-rental service Airbnb Inc. TPG co-founder David Bonderman is on the board of both companies.

Its a much better business model when you dont have the cost of physical assets, said Bonderman, who was on stage with Coulter. They achieve scale over the Internet very rapidly.

Bonderman, 71, and Coulter, 54, founded TPG in 1992. The firm is seeking $10 billion for its seventh buyout fund, according to an offering document obtained by Bloomberg News, after raising $19.8 billion in 2008 for its previous pool. TPG has told investors it plans to avoid mega-sized deals after experiencing losses in Texas utility Energy Future Holdings Corp., casino operator Caesars Entertainment Corp. (CZR) and savings bank Washington Mutual.

In smaller, technology-focused companies, valuations may at times run ahead of reality, but we should not underestimate the force of disruption thats going to occur, Coulter said today. For us as investors, we have to find the right entry point. Clearly the edge is pretty interesting right now in the sharing economy.

To contact the reporter on this story: Devin Banerjee in New York at dbanerjee2@bloomberg.net

To contact the editors responsible for this story: Christian Baumgaertel at cbaumgaertel@bloomberg.net Josh Friedman, Pierre Paulden

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TPGs Coulter Says Global Health Care Is Best for Deals

Health care and the Obama presidency: a giant squander?

Theres no doubt that, as midterms go, President Obama has not fared well. In 2010, his Democratic Party lost 63 House seats the biggest midterm loss in that chamber since 1938 and with it, control of the House to the Republicans. Although they also lost six Senate seats, Democrats were at least able to retain their majority there. Four years later, however, Democrats lost the Senate, too, when Republicans picked up eight Senate seats in the 2014 midterms with one more still at stake to regain a Senate majority. Republicans also padded their House majority by gaining a dozen more seats (a handful of House races have yet to be decided). The net result is that Obama is facing an opposition-controlled Congress for the last two years of his presidency.

The successive Republican waves are particularly devastating because they swept away what many pundits believed to be a coming period of Democratic electoral dominance. When Obama was elected president in 2008, he appeared to display substantial coattails; Democrats picked up 25 House and eight Senate seats and enjoyed comfortable majorities in both chambers. More importantly, demographic trends suggested the size of the Democratic voting coalition was likely to expand in the coming years. In short, Obamas election was, asone pundit put it at the time, likely to create a new governing majority coalition that could dominate American politics for a generation or more. Instead, the purported realignment lasted a bit less than two years. To borrow one of the catch phrases ofRed Sox radio announcer Joe Castiglione, the Obama presidency has been, politically at least, a giant squander."

But just how big a squander is it, historically speaking? One chart that made the rounds of the twitterversethis week indicates it was a very big squander indeed. It shows that Obamas Democrats have suffered a net loss of 13 Senate and 77 House seats during the two midterms held in his presidency, which ranks as the third worst cumulative midterm-seat loss among modern presidents, behind only FDR and Truman.

But is this really a useful metric? Roosevelt, who suffered the greatest cumulative seat loss, is nonetheless typically ranked as one of the nations three best presidents someone who was the consummate political leader. The problem with using total seat loss as a measuring rod is that presidents like FDR, who enter office with substantial coattails, as indicated by large partisan majorities, and who serve the longest both arguably measures of political skill stand a greater probability of losing more seats. Moreover, looking only at midterms may not be a fair measure of a presidents party leadership, since midterms operate under such unfavorable dynamics to the president. Perhaps a better metric is to assess the proportion of seats a president loses over the course of his presidency inallelections. This is not perfect, of course, because it still penalizes presidents who enter with a substantial governing majority they have greater room to fall but it is probably a better gauge of a presidents political pull than a raw seat count of midterms alone. Middlebury College student Tina Berger calculated that figure for all the modern presidents and summarized the totals in this chart.

Alas, Obama does even worse by this standard among modern presidents only Dwight Eisenhower lost a greater proportion of party seats across his presidency. The Republican Ike, however, presided in the midst of the post-Depression Democratic-dominated era (he was the only Republican president to serve between 1933 and 1969) and he managed to retain his personal popularity even as control of Congress reverted to what might be called its natural partisan state during this New Deal period. Obama, in contrast, has watched his popularity stagnate in the low 40% approval level for the better part of a year and, with Democrats winning four of the last six presidential elections, it can hardly be called a Republican era (Karl Roves McKinley-esque visions notwithstanding.)

To be sure, not all of the blame for Democrats losses can be pinned on Obama. Surely the Partys congressional wing is partly culpable for its dismal showing. Nor should we forget, when judging his political leadership, that Obama won reelection in 2012 and did so while helping Democrats net eight House and two Senate seats. The bottom line, however, is that, in this era of nationalized politics, elections even midyear ones are invariably in large part referendums on the presidents performance. And, at least by this one metric, Obama appears to have come up short.

Where did it all go wrong? Pundits are quick to blame the Presidentsdetached leadership style,but as Ive noted in previous posts, its not clear how muchtemperamentorcharacterreally matters. The fact is that Obama inherited an economic mess and a war on terror two issues that defy easy solutions under the best of political circumstances. Moreover, as David Mayhewpersuasively argues, the American system of separated institutions, each operating according to its own electoral clock and responding to different constituencies, seems to possess a systemic equilibrating tendency that prevents either party from holding onto strong majorities for very long, regardless of the presidents skills. In this respect, Obamas presidency demonstrated a not unexpected reversion to the political mean.

Still, I doubt very many pundits in 2008 predicted the speed and degree to which Obamas governing majorities would dissipate if they predicted dissipation at all. If one were to isolate one primary reason for this speedy partisan erosion, it is probably Obamas decision to pursuehealth care reform,despite strong Republican opposition and lukewarm public support. Along with the economic stimulus bill, health care proved to be the focal point of Republican resistance early in his presidency, and his failure to bring even a single Republican aboard when passing Obamacare cemented the partisan divisions that have come to characterize our national politics, and provided a rallying point for Republicans as they fought to regain partisan control of Congress. This is not to say pursuing health-care reform was a mistake. It is to say that Obama and his Democratic Party paid a steep political price for doing so.

And so I wonder: As he contemplates finishing out his presidency facing two years of an opposition-controlled Congress, and with the fate of his signature piece of legislation now partlyin the hands of the Supreme Court, does the president ever ask himself whether passing health-care reform was really worth it?

Matthew Dickinson publishes his Presidential Power blog at http://sites.middlebury.edu/presidentialpower/.

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Health care and the Obama presidency: a giant squander?

Open enrollment for 2015 health care coverage starts Saturday

Several Quad City Organizations held a press conference Friday, November 14, 2014 to explain how they will be helping residents in the Quad Cities sign up or renew health insurance under the Affordable Care Act.

Saturday, November 15 is the first day of the open enrollment period for 2015 health coverage under the Affordable Care Act. The enrollment period runs through Sunday, February 15.

What we want to get across is that, not only is it important to enroll for insurance if you dont have it, but its also a time when you can compare what you do have to maybe some of the new plans that are coming out to see if somethings more affordable, said Linaka Kain, manager of marketplace exchange for UnityPoint Trinty.

Genesis Health System, UnityPoint Trinity, Community Health Care, The Project, Casa Guanajuato, Progressive Action for the Common Good and Eagle View Health all had representatives at the press conference. All the organizations will also offer in person navigators or certified application counselors to help people sign up for coverage and better understand the Affordable Care Act.

It is important to have health insurance because you, you know, we, were not able to think ahead and know when something is going to happen. So, its best that you take care of yourself and be proactive instead of reactive after somethings happened, said Kain.

In both Iowa and Illinois, people wanting to enroll for health care coverage can use the federal website, healthcare.gov. Illinois residents can also visit getcoveredillinois.gov.

Although the enrollment period runs through February 15, 2015, those who want coverage by January 1, 2015 need to enroll by December 15, 2014. If a person does not enroll for coverage by the February 15, 2015 deadline, they will likely not be able to buy the marketplace health insurance coverage for 2015 until the next enrollment period, according to healthcare.gov.

Those that do not have health insurance during the year 2015, may have to pay a fee. According to healthcare.gov, that fee would be 2% of a persons income or $365 per adult or $162.50 per kid, whichever is more.

If a person was enrolled in a 2014 marketplace plan, that benefit year ends December 31, 2014. To continue the plan in 2015, a person can renew their current health plan or choose a new one through the open enrollment period.

Below are a list of contacts in the Quad Cities who can help with the enrolling process:

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Open enrollment for 2015 health care coverage starts Saturday

Salt Lake City to host health care enrollment fairs

Salt Lake City invites the public to learn more about individual, family and small business health insurance options at community health care enrollment fairs beginning next week.

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SALT LAKE CITY The public is invited to learn more about individual, family and small business health insurance options at community health care enrollment fairs beginning next week.

The fairs will provide opportunities for enrollment throughout this years Affordable Care Act open enrollment period, Nov. 15-Feb. 15.

Under the Affordable Care Act, most people in the United States must have health coverage in 2015 or pay a fee either 2 percent of income, or $325 per adult and $162.50 per child whichever is higher.

Health navigators will be present at the fairs to provide information about the open enrollment application process and offer enrollment assistance. Bilingual assistants will also be available to help answer any questions.

Federal health insurance marketplace carriers including Arches Health Plan, Altius, BridgeSpan, Humana, Molina and SelectHealth will take part in the free community fairs on Dec. 7 and 14, Jan. 6 and Feb. 4. Utah's Avenue H will also be on hand to answer questions about small business insurance.

Anyone interested in applying for health insurance at the fairs should plan to bring proof of income, Social Security numbers for each individual applying and the date of birth for each person to be covered. If not a U.S. citizen, documentation of legal residency status will be required (such as a green card).

Fairs will be held: Friday, Nov. 21, 3-8 p.m., Sorenson Unity Center, 1383 S. 900 West; Sunday, Dec. 7 and Sunday, Dec. 14, 1-5 p.m. Salt Lake Main Library, Urban Room, 210 E. 400 South; Tuesday, Jan. 6, 5-8 p.m., Horizonte Instruction and Training Center, 1234 S. Main Street; and Wednesday, Feb. 4, 5:30-7 p.m., Rose Park Elementary and Community Learning Center, 1105 W. 1000 North.

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Salt Lake City to host health care enrollment fairs

Standard & Poor’s U.S. Consumer, Retail, And Health Care Weekly Review (Nov. 10) – Video


Standard Poor #39;s U.S. Consumer, Retail, And Health Care Weekly Review (Nov. 10)
In this segment of Standard Poor #39;s U.S. Consumer, Retail, and Health Care Weekly Review, Director Rick Joy highlights sector trends and the actions we recently took on Walgreen Co., Perrigo...

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Standard & Poor's U.S. Consumer, Retail, And Health Care Weekly Review (Nov. 10) - Video

Trey Gowdy on ObamaCare Architect Jonathan Gruber’s Admission of Deception to Get Bill – Video


Trey Gowdy on ObamaCare Architect Jonathan Gruber #39;s Admission of Deception to Get Bill
Rep. Trey Gowdy and Fox News #39; Megan Kelly discuss the admission of M.I.T. Professor Jonathan Gruber that deception was used to get the Affordable Health Care Act through Congress. Megan Kelly...

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Employees pay more out of pocket for health care

NEW YORK (CNNMoney)

In 2015, employees will pay 55% more for health insurance premiums and out-of-pocket medical bills than they did in 2010, according to a report Thursday from human resources company Aon Hewitt.

The average worker with employer-sponsored health insurance will pay about $2,664, or nearly 24% of the total cost of their plan next year. Five years ago, employees paid $1,835, which worked out to 22.3% of the total premium payment.

What's more, employees will pay an average of $2,487 in out-of-pocket costs, such as copayments, coinsurance and deductibles next year. That's nearly double what employees paid in 2009, when those costs amounted to $1,276.

Related: Paying thousands before health insurance even kicks in

The increase comes after a period in which the weak economy kept insurance costs from rising too much. But with the job market now improving, employees are spending more on health care and other "discretionary items," said Tim Nimmer, chief health care actuary at Aon Hewit.

Related: Obamacare enrollment unlikely to meet 2015 goal

Overall, average health care costs are expected to rise to $11,304 per employee in 2015, up 5.5% from $10,717 in 2014.

The figures are based on data from 561 large U.S. companies with 13 million insured employees.

First Published: November 13, 2014: 12:03 PM ET

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Employees pay more out of pocket for health care

Health care law's opponents riled by 'stupidity' video

WASHINGTON The Republican Party's ardent campaign against President Barack Obama's health care law gained new momentum Wednesday as lawmakers reacted angrily to assertions by an architect of the policy that it was crafted in a deliberately deceptive way to pass Congress.

On both sides of the Capitol, leading conservatives said they may call economist Jonathan Gruber to testify about his remarks, which were made last year and surfaced this week in a video on social media. In the video, Gruber suggests that the administration's signature health care legislation passed in part because of the "stupidity of the American voter" and a "lack of transparency" over its funding mechanisms.

"The strategy was to hide the truth from the American people," said Sen. Jeff Sessions, R-Ala., who is to chair the Senate Budget Committee next year. "That is a threat to the American republic."

Gruber has been a complicated figure in the history of the health care law. He helped the Obama administration craft the measure and has been a leading advocate of it, but he has also made sporadic comments sparking political brushfires that have been problematic for the law's supporters. In the recently surfaced video, Gruber expresses frustration with the political process surrounding the law, rather than with the law itself.

The White House sought Wednesday to distance itself from Gruber and his comments.

"The Affordable Care Act was publicly debated over the course of 14 months, with dozens of congressional hearings, and countless town halls, speeches and debates," White House spokeswoman Jessica Santillo said in a statement. "The tax credits in the law that help millions of middle-class Americans afford coverage were no secret, and in fact were central to the legislation. Not only do we disagree with (Gruber's) comments, they're simply not true."

Nevertheless, the widely circulated video has again made the health care law a primary focus for congressional Republicans, even after an election in which the party played down its zeal to repeal it. Now, rank-and-file conservatives and their grass roots supporters are using the Gruber video to pressure congressional leaders to be more aggressive in their efforts to dismantle the law.

Rep. Jim Jordan, R-Ohio, a member of the House Oversight and Government Reform Committee and an influential tea party voice, said House Republicans may hold hearings on the matter, given the intensity of the reaction.

Michael Steel, a spokesman for Speaker John Boehner, R-Ohio, said House leadership is also closely monitoring reaction to the video. "(Gruber's) comments are a sad reminder that this awful law was passed in the worst possible way, with lies, secrecy and more lies from Washington Democrats," he said in an email.

According to his allies, Boehner plans to gauge the reaction among his members this morning at a closed-door conference meeting at the U.S. Capitol.

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Health care law's opponents riled by 'stupidity' video

Health care's army of workers learns to cope with latest setbacks

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WASHINGTON The questions kept coming up across Michigan as soon as the Supreme Court said it would take up a case that could reshape the Affordable Care Act by ending insurance subsidies in many states.

Dizzy Warren, director of Michigan's biggest health-care enrollment group, dealt with it in her presentation to health- care advocates last week in Detroit, then again on Wednesday's conference call with 57 workers: What do we do now?

Her answer? "Keep calm and keep enrolling," she said.

Organizers are bracing for more skepticism and confusion as the second year of enrollment begins this weekend under the Patient Protection and Affordable Care Act, which has promised health insurance to tens of millions of Americans without it. In the past two weeks, Republicans won control of Congress and pledged to chip away at the law, the Supreme Court agreed to review the case that challenges who's eligible for insurance subsidies, and the Obama administration lowered the bar for its enrollment goals.

Now comes the toughest challenge: signing up uninsured Americans who are confused, clueless or downright hostile to the programs available for them.

"It seems like the program itself is trending in the wrong direction, not in the right direction," said Les Funtleyder, a health-care portfolio manager at ESquared Asset Management in New York. "Momentum seems to be going against them, not for them."

The administration said this week it expects coverage to expand to about 10 million at most 2 million more than this year and 3 million fewer than congressional budget analysts had estimated.

Open enrollment runs from Nov. 15 to Feb. 15, and until recently, the administration's allies said they hadn't heard much from the government about its plans for the year. That began to change with a brief conference call Nov. 7 with President Barack Obama and his health secretary, Sylvia Mathews Burwell.

"We are confident that we are going to have a successful open enrollment," Burwell said this week at an event hosted by the Democratic-aligned Center for American Progress. Success, she said, means that the Affordable Care Act continues to dent the "fundamental number," the U.S. uninsured rate, which is down about four percentage points this year to 13.4 percent, according to Gallup.

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Health care's army of workers learns to cope with latest setbacks

Less Angst Over Health Care at Small Businesses

Small business owners are less angst-ridden about health care than you might think.

Health care costs are second among owners' major concerns in a survey released Thursday by Bank of America. Seventy-two percent cited health care costs as a big concern, down from 74 percent in a similar survey in the spring. The No. 1 concern was the effectiveness of government leaders, cited by 74 percent versus 75 percent in the spring.

Owners are less worried about health care now that they've seen what insurance under the health care law looks like and costs. Uncertainty about the law had intensified owners' concerns. And surveys taken before the new insurance began selling last year showed owners were extremely anxious about whether the law would continue to drive premiums higher.

"There used to be regular double-digit, sometimes triple-digit premium increases and now we're seeing increases of often under 5 percent," says John Arensmeyer, CEO of the advocacy group Small Business Majority.

The law has increased competition among health insurers, and that has helped lower premiums and in turn, owners' anxiety, Arensmeyer says.

The Bank of America survey, taken last month, also found oil, gas and other commodities, are much less of a concern, cited by 63 percent of owners, down from 70 percent in the spring. Energy prices have receded as a major worry as the national average price of gasoline has fallen below $3 a gallon from nearly $3.70 in April.

The survey, which questioned 1,000 owners, found they're modestly upbeat about national and local economies. Forty-five percent expect the national economy to grow in the next 12 months, up from 40 percent in the spring. Half predict growth in their local economies, down slightly from 51 percent.

They're slightly less upbeat about their companies. Sixty-two percent expect their revenue to grow over the next year, down from 68 percent in the spring. Owners of the largest small businesses, those with $750,000 to $5 million in revenue, were the most optimistic; 70 percent predicted revenue growth.

Surveys of small business owners have had differing conclusions in recent months, making it hard to draw conclusions about small companies in general. An American Express survey of 1,130 owners in September showed 63 percent were upbeat about their companies and the economy, up from 54 percent in the spring.

The expected drop in revenue in the Bank of America survey coincided with a modest dip in hiring and expansion plans. Forty-one percent said they plan to take on new employees in the next 12 months, down from 43 percent in the spring. Twenty-four percent said they don't plan to expand in the next year, up from 21 percent.

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Less Angst Over Health Care at Small Businesses

Realizing the Opportunities of Genomics in Health Care – Geoffrey Ginsburg, M.D., Ph.D. – Video


Realizing the Opportunities of Genomics in Health Care - Geoffrey Ginsburg, M.D., Ph.D.
Dr. Ginsburg is the founding director of the Center for Applied Genomics in the Duke University Medical Center and the founding executive director of the Cen...

By: Mayo Clinic

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Realizing the Opportunities of Genomics in Health Care - Geoffrey Ginsburg, M.D., Ph.D. - Video