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Shree Viswanathan: Opportunities In Heico Corporation

ValueWalk’s Raul Panganiban interviews Shree Viswanathan, founder and sole employee of SVN Capital. In this part, Shree discusses if there room for growth, his thoughts on working from home during the coronavirus pandemic, and opportunities in Copart…

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ValueWalk’s Raul Panganiban interviews Shree Viswanathan, founder and sole employee of SVN Capital. In this part, Shree discusses if there room for growth, his thoughts on working from home during the coronavirus pandemic, and opportunities in Copart and Heico Corporation. Transcript continues.

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Q3 2020 hedge fund letters, conferences and more

So just in regards to ideas, anything that you can discuss publicly or specifically, that you find attractive, and you'd like to share?

Sure. Um, you know, the Copart is, is a name that I've, that I've owned. It's a it's one of the largest salvage yard companies in the country. You know, when a particular vehicle meets with an accident, generally the insurance company will send an appraiser and evaluate make a quick evaluation as to whether they want to give you the policyholder, the money to go get the car fixed, or should it be totaled. So they make a quick computation, they know what the value of a car is, prior to the accident, they have through this appraisal, they have some view of what the cost of repairs, they make a mathematical computation and see how much they can get if they sold it to a salvage yard. And that salvage yard is essentially controlled by this company called port.

Now, you know, this is currently as we speak, this has somewhere between 40 to 60% market share, depending upon a couple of different metrics. So or being fair if we said, you know, they have a 50% market share another 37% is or controlled by another company called IA, which is here in Chicago. Essentially, it's a duopoly. The rest is all mom and pop salvage yards around the country. So this company Copart, they sort of have this relationship with the insurance companies, and they direct all these damaged vehicles to to Copart. Why do they send it to Copart? Well, as you can probably appreciate, you know, the type of technology that has been going into these vehicles.

Take a simple Kia car, for example. And I'd now has a rearview mirror with a 3d kit with three cameras in its bumper. And as it gets bumped into, or as it sort of backs into something, those cameras get down, not dinged and damaged. 10 years ago, even Mercedes Benz didn't have the kind of technology that a Kia has today. So the amount of technology that has gone into these cars, they make it difficult or more expensive for them to be repaired when they get damaged. So more and more vehicles are getting sent to these salvage yards. And cobalt is a is a big player in that area. What they do is collect the car. Think of Copart as a sort of an eBay for dinged and damaged vehicles. years ago, they used to conduct a sort of an auction on their salvage yard is to provide free coffee and dump and donuts. People come bid on a vehicle and take it away.

Now since 2003, they've been doing 100% of their auctioning through their own proprietary application through their own proprietary software. So there is no physical auctioning, it's global, it's online. And that online has made it global. In fact, Mexico and Dubai are two of the largest markets have grown nicely in UK and as we speak, they're growing in Germany. So this is a business that was founded by the current chairman Bill Johnson. His son in law, J Adair, is the CEO. Between the two of them, they have about little more than 12% ownership stake in this 25 $26 billion market cap company. There is no debt on the balance sheet or at least net debt. No net debt on the balance sheet. Generates an applause to little more than 20% return on capital. It's a little bit more capital intensive. Then, you know, typically what I'd be describing. But that capital intensity is essentially in terms of buying land. And I'll think of, you know, Seattle, or Chicago, these are the hubs where there are more vehicles and where there are, there is a higher likelihood of accidents happening.

Or, you know, think of Louisiana or Florida or Texas, where there is a higher likelihood of Hurricane coming through and damaging different towns and villages, or towns and cities. So those vehicles need to get moved into the no salvage yards. And Copart has done a very nice job of acquiring these land properties around various different parts of the country, little more than hundred and 80 yards around the country today and growing. So this is a business. But you know, back in February, March, for example, when the country went into a lockdown, or a global lockdown, for that matter, immediate fear was, there are, you know, that are not going to be any vehicles on the road, there weren't many. And as a result, not going to be many accidents, which in turn was viewed as a negative for Copart, because they were not going to be getting any new vehicles.

Obviously, that lasted for a little while, in fact, it did not slow down that dramatically, it did slow down, but it did not slow down that dramatically. But the stock price in the meantime, men down proximately, 50%, less, you know, a little less than 50. But this is a business that I had followed for a number of years. At Keeley, for example, that I weren't, we owned it. So I knew the business to a certain extent and had followed it for a long time. And it essentially, you know, fell on my lap. It's a fantastic business, good quality business that I can understand. Quality in terms of return generation quality in terms of the balance sheet, pre cash flow generation, and quality in terms of the management team, CEO, Jay Adair, gets $1. In salary, he gets stock options. But he gets $1 in salary. And this is the other point that's very unique about Copart is when I when you go through the proxy, typically, in a publicly traded company, the board the management team is looking to get some kind of compensation consultant to bless the compensation programme for the C suite members.

Our cohort is one where I noticed that they don't have they don't use any compensation consultant. The Board and the management team decide, you know what each one gets, which I think is fantastic. You know, one other name that jumps out that does that has been doing it for a long time is Berkshire Hathaway. But in any case, so it has, you know, good quality operation, good quality management team, and valuation fell on my lap has bounced back. But you know, I, it's become a reasonable weight in the portfolio. And it's a it's a it's a very, it's a very interesting, it's a typical sort of SPM capital kind of an interesting opportunity.

And do you see it doubling within the next 3 to 5 years or is there room for growth?

Yeah. So, you know, there is absolutely room for growth, both from the US and particularly from the International standpoint. As I said, they've grown, they've continued to grow in, in UK, they're growing the book in Germany as we speak. Mexico is another market that they have a bigger presence. And so, yes, the number of the type of, you know, service that they provide, at the cost that they incur, and the margins that they generate, you know, absolutely. It's a business that I do think and easily double within the next 3 to 5 years or 5 to 7.

What are the kind of risks that you see? And does like with COVID, with more people working from home, if that kind of trend will have any effect on usage, and then and then Uber as well. And if or delivery as well, like, I guess that whole dynamic of how we're switching more towards I guess being more at home?

Yeah, good question. So, um, yeah, any business for that matter will have certain risks associated with their business model? Um, you know, yeah, COVID related, lockdown scenario is definitely a is definitely a risk in that, you know, overall, what is on the road has decreased, it has improved quite a bit relative to what it was in, you know, March, February and March timeframe. But overall, working from home sort of brings that volume down. However, the other aspect of damaged vehicle damaged vehicles, you know, it comes from natural disasters, you know, fires in California, or in canes in southern part of the country. Tornadoes in the Midwest, when these things generally damaged vehicles to a large extent, and that's another source of vehicles for them. That hasn't been negatively impacted by COVID.

The other technology standard from a technology standpoint, you know, newer vehicles seem to have, you know, for example, auto braking facilities in braided into these newer vehicles. In fact, the company went to the extent of studying it, you know, what sort of what sort of detrimental impact do some of these newer technologies have, they came out with a, not just the company, but there is an outfit called CCC Information Services, which sort of tracks the entire equals ecosystem of vehicles, Damage Repair and insurance, they came out with a study saying, even if those types of technologies are adopted, 100% adopted, the volume declined from that improvement is going to be somewhere between 10 to 15%.

So, yes, it is, you know, the generally speaking, the frequency of accidents, it has been on a sort of a downward trend. I'm continuing to keep an eye on the frequency part of it. However, the severity of those damages, has continued to go up because of the new technology that I talked about. So, there's an offsetting trend to this downdraft from lower frequency. But those are the, those are the risks that I'm keeping an eye on. Competition is always a factor that I'm keeping an eye on, ay ay ay, which actually was recently spun out of a company called KARS is the, you know, advertisement that you might have seen on TV.

So competition is always a factor that I'm keeping an eye on. However, I until the scoreboard was forced upon them, was actually doing its auctions both in person as well as an online that was a little bit less effective in terms of operating margins, more capital, or less capital intensive from IAS standpoint, in that they were leasing the land as opposed to copart buying the land. However, because of the nature of how they go about auctioning vehicles, cobalt has been able to kind of put up much better returns. So those are the risk factors that I'm keeping an eye on.

And then you mentioned the M&A idea, or for the inorganic versus organic growth. Can you tell me more about the company that you're looking at with in regards to into that and is that an exception to what you're what you're truly looking for?

Sure. Yeah. So this is a company called Heico Corporation. It's based outside of Miami, Florida. What they do is essentially parts for aircraft. You know, years ago, I used to follow the entire aircraft space very closely. There is a demand for newer and older aeroplanes. Graphed because of the increase in consumer or commercial passenger traffic. But, you know, this company focuses on manufacturing aircraft parts for you know, they have two different segments in one segment, they essentially cater to the commercial passenger operators, and in the other segment, they cater to defence space and with lesser extent medical technology, still manufacturing similar type of, you know parts I think of in the commercial side of it, and I think of an unknown, you know, the food tray in in in front of your seat and it gets banged up pretty regularly, it needs to get replaced, the airline company has a couple of different options.

One, it can go to the actual OEM and get the replaced, or they can go to somebody like a high call to get the part replaced. Now, OEM for a variety of different reasons, their pricing is going to be definitely a lot higher. Heico Corporation, on the other hand, produces the same part at somewhere around 50 to 60% of OEMs cost. Now, the unique aspect of this kind of an operation is any single any art that goes into an aircraft, even if it's a small screw or a bolt, and I need to get approved by FAA before it can be put into the pie. And so whether it's a nose cone or a food tray, you know, it has to be approved by FAA. So there is a specific term for these types of manufacturers, these types of pouch manufacturers or PMA manufacturers approved. And there are only a limited number of guys who are approved for that.

So that's the barrier to entry as far as high core is concerned. Now, you know, the commercial passenger traffic obviously came to a screeching halt. And it is still only trying to improve from a very low level at this point, at least in the Western world, China has improved quite a bit, but the rest of the world is still trying to catch up with volume. passenger volume has been pretty low, expected to be low until at least a vaccine This is discovered. So this is another name that was part as a result of this lockdown in the endemic business that is run by a father by a father and two sons.

Father was Mendelssohn is a he was a CPA from New York moved down to Florida stumbled on this entity which existed before they took control in 1990. I'm the father and two sons, they own close to 18% of the company, it's about 14 and a half billion in market cap. It started off as providing engine parts for Pratt and Whitney back in the early 90s, when Pratt and Whitney had problems with their engine manufacturing, and they did a phenomenal job. And as a result, we're able to kind of grow that, you know, the PMA part of providing these parts, it became so attractive, that Lufthansa from Germany actually stepped in to take an equity stake in that segment, they still own a stake in that in that segment of their operation. So it's a it's a no fantastic business in that.

Particularly at a time like this, you know, countries, countries, typically, any country for that matter, you know, there are three things that they want. One, they want their own flag. Number two, they want their own airline. And number three, they want their own beer. And you know, countries and operators at a time like this are going to focus a little bit more on their cost. Even though their planes are not running quite as extensively as they used to. It's a matter of time before travel sort of comes back. And even as it comes back and sort of ramps up these operators are going to look for keeping their costs low. So I think this PMA kind of a product from Heico Corporation would be very attractive.

And again, it's a business that has is it on the on the Commercial, you know, airline focused segment, they generate approximately, in our high teens kind of a return on capital on the defence and space part of it, it's closer to 30%. So combined, the commercial passenger side used to be a bigger chunk of the overall business, it's now become almost 5050. Combined, it's still a very healthy, mid to high teens, kind of a total return no debt on the balance sheet. Now, this is a business where they've grown and continue to grow through acquisitions. The family's very comfortable doing it, in fact, they have done a little more than 85 acquisitions since they took control back in 1990. However, while my my sort of risk or constraint still exists, the type of acquisitions these people are very different.

What do I mean by that? You know, they don't acquire all the they don't acquire 100% of the target all the time. They leave 30 to 40% of the company from the selling management team, you know, that allows them to remain invested in the business and fact many of the selling management teams today, they make, you know, between the between their equity stake and overall compensation, they make a lot more than the three that are actually running the company, the three Mendelssohn's. So, you know, so they constantly look for these smaller businesses that are involved in a variety of different aspects of airline operations. Why do they look to go sell to Heico Corporation, I'll think of an engineer coming out of, you know, Northrop Grumman, or Lockheed Martin. And no one picks up three, four engineers along with him, sets up shop in his garage or, you know, sets up shop in a small place and grows over a period of time. And then it's a sort of a ceiling ceiling in terms of distribution or capital or whatever that may be.

At that point, he's looking to kind of expand his base. And that's where I go kind of steps in, the management team sort of maintains a relationship with a number of different businesses that are that they are interested in. And when they when they selling when the management teams are ready to sell, they pick up the phone and call a Piko. And typically, that's how that's how these deals get done. And, as I said, the most interesting aspect is they leave a piece for the selling management team, which makes it very, very unique. And you know, I've spent a number of fears in the financial services area. There's a company called affiliated managers group in Boston, which has done something very similar within the asset management space. So it's a very attractive feature of Heico Corporation. Again, it goes back to the point about understanding the business good returns, good quality management team with skin in the game, and reasonable valuation, you know, the stock got hit during the February March timeframe. And while one part of it is still somewhat suffering through this pandemic, the other part is actually making up for it very nicely.

Yeah, that is amazing. And I just want to double check the checker on that one is Heico Corporation?

Heico Corporation. There is a there is a similar there is another, there are two classes of stock. Heico Corporation is the common mode or common. The other one is HEI.A. And that's another interesting or interesting aspect of this company. I generally do not necessarily like dual class listings. You know, most most print organisations, newsprint organisations, and as a result as an extension of that many technology companies have taken on that dual class ad claiming that it protects them from editorial power. I generally view that as you know, there was an insurance newsletter writer, cheers me, but I never read chef. Um, back in the 70s and 80s. He actually said, when you invest in a dual class stock, you're actually asking the management team to take advantage of you fully subscribe to that viewpoint.

However, in this case, The reason why they have two classes is not because they want to have some sort of a control over the outcome or equivalent of an editorial control. It's because in the late 90s, they were trying to make an acquisition. And the seller wanted the potential seller wanted specific stock and specific tax protections and things like that. So they created this other class, that deal did not go through, but post that, it became a little bit more cumbersome convoluted, who can convert that, you know, HEI.A back into the common, they've just let it go. And interestingly enough, there is still a sort of a spread between the two HEI and HE.A, when you look at the price, there is a little bit of a spread between them in the public mark, but I own the Heico Corporation management team owns both.

Transcript continues.

The post Shree Viswanathan: Opportunities In Heico Corporation appeared first on ValueWalk.

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Copper Soars, Iron Ore Tumbles As Goldman Says “Copper’s Time Is Now”

Copper Soars, Iron Ore Tumbles As Goldman Says "Copper’s Time Is Now"

After languishing for the past two years in a tight range despite recurring…

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Copper Soars, Iron Ore Tumbles As Goldman Says "Copper's Time Is Now"

After languishing for the past two years in a tight range despite recurring speculation about declining global supply, copper has finally broken out, surging to the highest price in the past year, just shy of $9,000 a ton as supply cuts hit the market; At the same time the price of the world's "other" most important mined commodity has diverged, as iron ore has tumbled amid growing demand headwinds out of China's comatose housing sector where not even ghost cities are being built any more.

Copper surged almost 5% this week, ending a months-long spell of inertia, as investors focused on risks to supply at various global mines and smelters. As Bloomberg adds, traders also warmed to the idea that the worst of a global downturn is in the past, particularly for metals like copper that are increasingly used in electric vehicles and renewables.

Yet the commodity crash of recent years is hardly over, as signs of the headwinds in traditional industrial sectors are still all too obvious in the iron ore market, where futures fell below $100 a ton for the first time in seven months on Friday as investors bet that China’s years-long property crisis will run through 2024, keeping a lid on demand.

Indeed, while the mood surrounding copper has turned almost euphoric, sentiment on iron ore has soured since the conclusion of the latest National People’s Congress in Beijing, where the CCP set a 5% goal for economic growth, but offered few new measures that would boost infrastructure or other construction-intensive sectors.

As a result, the main steelmaking ingredient has shed more than 30% since early January as hopes of a meaningful revival in construction activity faded. Loss-making steel mills are buying less ore, and stockpiles are piling up at Chinese ports. The latest drop will embolden those who believe that the effects of President Xi Jinping’s property crackdown still have significant room to run, and that last year’s rally in iron ore may have been a false dawn.

Meanwhile, as Bloomberg notes, on Friday there were fresh signs that weakness in China’s industrial economy is hitting the copper market too, with stockpiles tracked by the Shanghai Futures Exchange surging to the highest level since the early days of the pandemic. The hope is that headwinds in traditional industrial areas will be offset by an ongoing surge in usage in electric vehicles and renewables.

And while industrial conditions in Europe and the US also look soft, there’s growing optimism about copper usage in India, where rising investment has helped fuel blowout growth rates of more than 8% — making it the fastest-growing major economy.

In any case, with the demand side of the equation still questionable, the main catalyst behind copper’s powerful rally is an unexpected tightening in global mine supplies, driven mainly by last year’s closure of a giant mine in Panama (discussed here), but there are also growing worries about output in Zambia, which is facing an El Niño-induced power crisis.

On Wednesday, copper prices jumped on huge volumes after smelters in China held a crisis meeting on how to cope with a sharp drop in processing fees following disruptions to supplies of mined ore. The group stopped short of coordinated production cuts, but pledged to re-arrange maintenance work, reduce runs and delay the startup of new projects. In the coming weeks investors will be watching Shanghai exchange inventories closely to gauge both the strength of demand and the extent of any capacity curtailments.

“The increase in SHFE stockpiles has been bigger than we’d anticipated, but we expect to see them coming down over the next few weeks,” Colin Hamilton, managing director for commodities research at BMO Capital Markets, said by phone. “If the pace of the inventory builds doesn’t start to slow, investors will start to question whether smelters are actually cutting and whether the impact of weak construction activity is starting to weigh more heavily on the market.”

* * *

Few have been as happy with the recent surge in copper prices as Goldman's commodity team, where copper has long been a preferred trade (even if it may have cost the former team head Jeff Currie his job due to his unbridled enthusiasm for copper in the past two years which saw many hedge fund clients suffer major losses).

As Goldman's Nicholas Snowdon writes in a note titled "Copper's time is now" (available to pro subscribers in the usual place)...

... there has been a "turn in the industrial cycle." Specifically according to the Goldman analyst, after a prolonged downturn, "incremental evidence now points to a bottoming out in the industrial cycle, with the global manufacturing PMI in expansion for the first time since September 2022." As a result, Goldman now expects copper to rise to $10,000/t by year-end and then $12,000/t by end of Q1-25.’

Here are the details:

Previous inflexions in global manufacturing cycles have been associated with subsequent sustained industrial metals upside, with copper and aluminium rising on average 25% and 9% over the next 12 months. Whilst seasonal surpluses have so far limited a tightening alignment at a micro level, we expect deficit inflexions to play out from quarter end, particularly for metals with severe supply binds. Supplemented by the influence of anticipated Fed easing ahead in a non-recessionary growth setting, another historically positive performance factor for metals, this should support further upside ahead with copper the headline act in this regard.

Goldman then turns to what it calls China's "green policy put":

Much of the recent focus on the “Two Sessions” event centred on the lack of significant broad stimulus, and in particular the limited property support. In our view it would be wrong – just as in 2022 and 2023 – to assume that this will result in weak onshore metals demand. Beijing’s emphasis on rapid growth in the metals intensive green economy, as an offset to property declines, continues to act as a policy put for green metals demand. After last year’s strong trends, evidence year-to-date is again supportive with aluminium and copper apparent demand rising 17% and 12% y/y respectively. Moreover, the potential for a ‘cash for clunkers’ initiative could provide meaningful right tail risk to that healthy demand base case. Yet there are also clear metal losers in this divergent policy setting, with ongoing pressure on property related steel demand generating recent sharp iron ore downside.

Meanwhile, Snowdon believes that the driver behind Goldman's long-running bullish view on copper - a global supply shock - continues:

Copper’s supply shock progresses. The metal with most significant upside potential is copper, in our view. The supply shock which began with aggressive concentrate destocking and then sharp mine supply downgrades last year, has now advanced to an increasing bind on metal production, as reflected in this week's China smelter supply rationing signal. With continued positive momentum in China's copper demand, a healthy refined import trend should generate a substantial ex-China refined deficit this year. With LME stocks having halved from Q4 peak, China’s imminent seasonal demand inflection should accelerate a path into extreme tightness by H2. Structural supply underinvestment, best reflected in peak mine supply we expect next year, implies that demand destruction will need to be the persistent solver on scarcity, an effect requiring substantially higher pricing than current, in our view. In this context, we maintain our view that the copper price will surge into next year (GSe 2025 $15,000/t average), expecting copper to rise to $10,000/t by year-end and then $12,000/t by end of Q1-25’

Another reason why Goldman is doubling down on its bullish copper outlook: gold.

The sharp rally in gold price since the beginning of March has ended the period of consolidation that had been present since late December. Whilst the initial catalyst for the break higher came from a (gold) supportive turn in US data and real rates, the move has been significantly amplified by short term systematic buying, which suggests less sticky upside. In this context, we expect gold to consolidate for now, with our economists near term view on rates and the dollar suggesting limited near-term catalysts for further upside momentum. Yet, a substantive retracement lower will also likely be limited by resilience in physical buying channels. Nonetheless, in the midterm we continue to hold a constructive view on gold underpinned by persistent strength in EM demand as well as eventual Fed easing, which should crucially reactivate the largely for now dormant ETF buying channel. In this context, we increase our average gold price forecast for 2024 from $2,090/toz to $2,180/toz, targeting a move to $2,300/toz by year-end.

Much more in the full Goldman note available to pro subs.

Tyler Durden Fri, 03/15/2024 - 14:25

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The millions of people not looking for work in the UK may be prioritising education, health and freedom

Economic inactivity is not always the worst option.

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Taking time out. pathdoc/Shutterstock

Around one in five British people of working age (16-64) are now outside the labour market. Neither in work nor looking for work, they are officially labelled as “economically inactive”.

Some of those 9.2 million people are in education, with many students not active in the labour market because they are studying full-time. Others are older workers who have chosen to take early retirement.

But that still leaves a large number who are not part of the labour market because they are unable to work. And one key driver of economic inactivity in recent years has been illness.

This increase in economic inactivity – which has grown since before the pandemic – is not just harming the economy, but also indicative of a deeper health crisis.

For those suffering ill health, there are real constraints on access to work. People with health-limiting conditions cannot just slot into jobs that are available. They need help to address the illnesses they have, and to re-engage with work through organisations offering supportive and healthy work environments.

And for other groups, such as stay-at-home parents, businesses need to offer flexible work arrangements and subsidised childcare to support the transition from economic inactivity into work.

The government has a role to play too. Most obviously, it could increase investment in the NHS. Rising levels of poor health are linked to years of under-investment in the health sector and economic inactivity will not be tackled without more funding.

Carrots and sticks

For the time being though, the UK government appears to prefer an approach which mixes carrots and sticks. In the March 2024 budget, for example, the chancellor cut national insurance by 2p as a way of “making work pay”.

But it is unclear whether small tax changes like this will have any effect on attracting the economically inactive back into work.

Jeremy Hunt also extended free childcare. But again, questions remain over whether this is sufficient to remove barriers to work for those with parental responsibilities. The high cost and lack of availability of childcare remain key weaknesses in the UK economy.

The benefit system meanwhile has been designed to push people into work. Benefits in the UK remain relatively ungenerous and hard to access compared with other rich countries. But labour shortages won’t be solved by simply forcing the economically inactive into work, because not all of them are ready or able to comply.

It is also worth noting that work itself may be a cause of bad health. The notion of “bad work” – work that does not pay enough and is unrewarding in other ways – can lead to economic inactivity.

There is also evidence that as work has become more intensive over recent decades, for some people, work itself has become a health risk.

The pandemic showed us how certain groups of workers (including so-called “essential workers”) suffered more ill health due to their greater exposure to COVID. But there are broader trends towards lower quality work that predate the pandemic, and these trends suggest improving job quality is an important step towards tackling the underlying causes of economic inactivity.

Freedom

Another big section of the economically active population who cannot be ignored are those who have retired early and deliberately left the labour market behind. These are people who want and value – and crucially, can afford – a life without work.

Here, the effects of the pandemic can be seen again. During those years of lockdowns, furlough and remote working, many of us reassessed our relationship with our jobs. Changed attitudes towards work among some (mostly older) workers can explain why they are no longer in the labour market and why they may be unresponsive to job offers of any kind.

Sign on railings supporting NHS staff during pandemic.
COVID made many people reassess their priorities. Alex Yeung/Shutterstock

And maybe it is from this viewpoint that we should ultimately be looking at economic inactivity – that it is actually a sign of progress. That it represents a move towards freedom from the drudgery of work and the ability of some people to live as they wish.

There are utopian visions of the future, for example, which suggest that individual and collective freedom could be dramatically increased by paying people a universal basic income.

In the meantime, for plenty of working age people, economic inactivity is a direct result of ill health and sickness. So it may be that the levels of economic inactivity right now merely show how far we are from being a society which actually supports its citizens’ wellbeing.

David Spencer has received funding from the ESRC.

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Illegal Immigrants Leave US Hospitals With Billions In Unpaid Bills

Illegal Immigrants Leave US Hospitals With Billions In Unpaid Bills

By Autumn Spredemann of The Epoch Times

Tens of thousands of illegal…

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Illegal Immigrants Leave US Hospitals With Billions In Unpaid Bills

By Autumn Spredemann of The Epoch Times

Tens of thousands of illegal immigrants are flooding into U.S. hospitals for treatment and leaving billions in uncompensated health care costs in their wake.

The House Committee on Homeland Security recently released a report illustrating that from the estimated $451 billion in annual costs stemming from the U.S. border crisis, a significant portion is going to health care for illegal immigrants.

With the majority of the illegal immigrant population lacking any kind of medical insurance, hospitals and government welfare programs such as Medicaid are feeling the weight of these unanticipated costs.

Apprehensions of illegal immigrants at the U.S. border have jumped 48 percent since the record in fiscal year 2021 and nearly tripled since fiscal year 2019, according to Customs and Border Protection data.

Last year broke a new record high for illegal border crossings, surpassing more than 3.2 million apprehensions.

And with that sea of humanity comes the need for health care and, in most cases, the inability to pay for it.

In January, CEO of Denver Health Donna Lynne told reporters that 8,000 illegal immigrants made roughly 20,000 visits to the city’s health system in 2023.

The total bill for uncompensated care costs last year to the system totaled $140 million, said Dane Roper, public information officer for Denver Health. More than $10 million of it was attributed to “care for new immigrants,” he told The Epoch Times.

Though the amount of debt assigned to illegal immigrants is a fraction of the total, uncompensated care costs in the Denver Health system have risen dramatically over the past few years.

The total uncompensated costs in 2020 came to $60 million, Mr. Roper said. In 2022, the number doubled, hitting $120 million.

He also said their city hospitals are treating issues such as “respiratory illnesses, GI [gastro-intenstinal] illnesses, dental disease, and some common chronic illnesses such as asthma and diabetes.”

“The perspective we’ve been trying to emphasize all along is that providing healthcare services for an influx of new immigrants who are unable to pay for their care is adding additional strain to an already significant uncompensated care burden,” Mr. Roper said.

He added this is why a local, state, and federal response to the needs of the new illegal immigrant population is “so important.”

Colorado is far from the only state struggling with a trail of unpaid hospital bills.

EMS medics with the Houston Fire Department transport a Mexican woman the hospital in Houston on Aug. 12, 2020. (John Moore/Getty Images)

Dr. Robert Trenschel, CEO of the Yuma Regional Medical Center situated on the Arizona–Mexico border, said on average, illegal immigrants cost up to three times more in human resources to resolve their cases and provide a safe discharge.

“Some [illegal] migrants come with minor ailments, but many of them come in with significant disease,” Dr. Trenschel said during a congressional hearing last year.

“We’ve had migrant patients on dialysis, cardiac catheterization, and in need of heart surgery. Many are very sick.”

He said many illegal immigrants who enter the country and need medical assistance end up staying in the ICU ward for 60 days or more.

A large portion of the patients are pregnant women who’ve had little to no prenatal treatment. This has resulted in an increase in babies being born that require neonatal care for 30 days or longer.

Dr. Trenschel told The Epoch Times last year that illegal immigrants were overrunning healthcare services in his town, leaving the hospital with $26 million in unpaid medical bills in just 12 months.

ER Duty to Care

The Emergency Medical Treatment and Labor Act of 1986 requires that public hospitals participating in Medicare “must medically screen all persons seeking emergency care … regardless of payment method or insurance status.”

The numbers are difficult to gauge as the policy position of the Centers for Medicare & Medicaid Services (CMS) is that it “will not require hospital staff to ask patients directly about their citizenship or immigration status.”

In southern California, again close to the border with Mexico, some hospitals are struggling with an influx of illegal immigrants.

American patients are enduring longer wait times for doctor appointments due to a nursing shortage in the state, two health care professionals told The Epoch Times in January.

A health care worker at a hospital in Southern California, who asked not to be named for fear of losing her job, told The Epoch Times that “the entire health care system is just being bombarded” by a steady stream of illegal immigrants.

“Our healthcare system is so overwhelmed, and then add on top of that tuberculosis, COVID-19, and other diseases from all over the world,” she said.

A Salvadorian man is aided by medical workers after cutting his leg while trying to jump on a truck in Matias Romero, Mexico, on Nov. 2, 2018. (Spencer Platt/Getty Images)

A newly-enacted law in California provides free healthcare for all illegal immigrants residing in the state. The law could cost taxpayers between $3 billion and $6 billion per year, according to recent estimates by state and federal lawmakers.

In New York, where the illegal immigration crisis has manifested most notably beyond the southern border, city and state officials have long been accommodating of illegal immigrants’ healthcare costs.

Since June 2014, when then-mayor Bill de Blasio set up The Task Force on Immigrant Health Care Access, New York City has worked to expand avenues for illegal immigrants to get free health care.

“New York City has a moral duty to ensure that all its residents have meaningful access to needed health care, regardless of their immigration status or ability to pay,” Mr. de Blasio stated in a 2015 report.

The report notes that in 2013, nearly 64 percent of illegal immigrants were uninsured. Since then, tens of thousands of illegal immigrants have settled in the city.

“The uninsured rate for undocumented immigrants is more than three times that of other noncitizens in New York City (20 percent) and more than six times greater than the uninsured rate for the rest of the city (10 percent),” the report states.

The report states that because healthcare providers don’t ask patients about documentation status, the task force lacks “data specific to undocumented patients.”

Some health care providers say a big part of the issue is that without a clear path to insurance or payment for non-emergency services, illegal immigrants are going to the hospital due to a lack of options.

“It’s insane, and it has been for years at this point,” Dana, a Texas emergency room nurse who asked to have her full name omitted, told The Epoch Times.

Working for a major hospital system in the greater Houston area, Dana has seen “a zillion” migrants pass through under her watch with “no end in sight.” She said many who are illegal immigrants arrive with treatable illnesses that require simple antibiotics. “Not a lot of GPs [general practitioners] will see you if you can’t pay and don’t have insurance.”

She said the “undocumented crowd” tends to arrive with a lot of the same conditions. Many find their way to Houston not long after crossing the southern border. Some of the common health issues Dana encounters include dehydration, unhealed fractures, respiratory illnesses, stomach ailments, and pregnancy-related concerns.

“This isn’t a new problem, it’s just worse now,” Dana said.

Emergency room nurses and EMTs tend to patients in hallways at the Houston Methodist The Woodlands Hospital in Houston on Aug. 18, 2021. (Brandon Bell/Getty Images)

Medicaid Factor

One of the main government healthcare resources illegal immigrants use is Medicaid.

All those who don’t qualify for regular Medicaid are eligible for Emergency Medicaid, regardless of immigration status. By doing this, the program helps pay for the cost of uncompensated care bills at qualifying hospitals.

However, some loopholes allow access to the regular Medicaid benefits. “Qualified noncitizens” who haven’t been granted legal status within five years still qualify if they’re listed as a refugee, an asylum seeker, or a Cuban or Haitian national.

Yet the lion’s share of Medicaid usage by illegal immigrants still comes through state-level benefits and emergency medical treatment.

A Congressional report highlighted data from the CMS, which showed total Medicaid costs for “emergency services for undocumented aliens” in fiscal year 2021 surpassed $7 billion, and totaled more than $5 billion in fiscal 2022.

Both years represent a significant spike from the $3 billion in fiscal 2020.

An employee working with Medicaid who asked to be referred to only as Jennifer out of concern for her job, told The Epoch Times that at a state level, it’s easy for an illegal immigrant to access the program benefits.

Jennifer said that when exceptions are sent from states to CMS for approval, “denial is actually super rare. It’s usually always approved.”

She also said it comes as no surprise that many of the states with the highest amount of Medicaid spending are sanctuary states, which tend to have policies and laws that shield illegal immigrants from federal immigration authorities.

Moreover, Jennifer said there are ways for states to get around CMS guidelines. “It’s not easy, but it can and has been done.”

The first generation of illegal immigrants who arrive to the United States tend to be healthy enough to pass any pre-screenings, but Jennifer has observed that the subsequent generations tend to be sicker and require more access to care. If a family is illegally present, they tend to use Emergency Medicaid or nothing at all.

The Epoch Times asked Medicaid Services to provide the most recent data for the total uncompensated care that hospitals have reported. The agency didn’t respond.

Continue reading over at The Epoch Times

Tyler Durden Fri, 03/15/2024 - 09:45

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