A Health Care Revolution

My doctor’s office is typical of many medical offices nowadays. All the pertinent patient information is stored digitally, and the doctor spends as much time in the examination room staring at a computer screen as she does peering down my throat and listening to my heartbeat. The last time I had a checkup, I asked her how she liked her ever-present digital assistant, and she admitted that it’s a mixed blessing. With all the records in one place, “there’s no more running around tracking down blood tests,” she told me. But on the downside, she feels as if she spends more time with the PC every day than she does with patients. Her ambivalence is shared by a lot of people in health care today.

Among the side effects of recent legislation is a slew of new investing opportunities, says senior associate editor Nellie Huang, who wrote our story on top health care mutual funds. For example, the American Recovery and Reinvestment Act of 2009 gave doctors and other providers incentives to digitize health care records, spurring growth among com­panies—such as Allscripts and Cer­ner—that provide the technology. The Affordable Care Act is standardizing coverage in the insurance industry, prompting insurers to take over health care providers in order to diversify their business. At the same time, hospitals under the gun to hold down costs are expanding into the insurance business.

Meanwhile, big drug firms are cutting back on research and development in favor of buying products that have been successfully tested by other companies. “Fund managers are looking for companies with drugs in the pipeline that are potential game changers,” says Nellie. One notable example is Gilead Sciences’ Sovaldi, which can cure most cases of hepatitis C.

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All in all, Nellie writes, “a revolution is under way in health care, and it’s not too late to cash in.” In fact, Dan Wiener, editor of the Independent Adviser for Vanguard Investors newsletter, told Nellie, “I can’t say enough good things about having an overweight exposure to health care in a portfolio” (see Insider Interview).

Impact on patients. So why the ambivalence? All this activity spells oppor­tunity for investors, but it’s not clear how the changes will play out for patients. There’s concern that the emphasis on efficiencies and consolidation may mean less-personalized medical care. And consumers are already seeing higher deductibles, shrinking provider networks and potentially higher out-of-pocket costs.

In my July column, I noted that in order to comply with the law and keep premiums the same, my husband’s employer had switched to a policy with a substantially higher deductible. In response, I heard from Jim Fred­y­ma, a reader from Contoocook, N.H., who took me to task for a “lack of meaningful advice regarding increases in health insurance, co-payments and deductibles.” My column has limited space, but I did refer readers to contributing editor Kim Lankford’s story in the same issue, Solutions For 3 Health-Insurance Challenges, for detailed advice on how to cope with the changes. And now I’m happy to point Mr. Fredyma and others to Kim’s latest story, the second in what we envision as an ongoing series. Kim’s comprehensive analysis offers step-by-step guidance on how to save thousands on medical expenses. “There are a lot of strategies that can help you save money, as well as resources that can help pay the costs,” says Kim. “People just need to know how to find them.” We’ve done the work for you.