What Is the Healthcare Sector?
The healthcare sector consists of companies that provide medical services, manufacture medical equipment or drugs, provide medical insurance, or otherwise facilitate the provision of healthcare to patients.
Understanding the Healthcare Sector
The healthcare sector is one of the largest and most complex in the U.S. economy, accounting for close to a fifth of overall gross domestic product (GDP), according to the OECD. Some of the highest-quality care in the world can be found in the U.S., but in terms of the population's overall health the U.S. lags other wealthy, developed countries. Life expectancy is 78.8 years, according to the OECD, below the club's average of 80.6 (the OECD's 35 members are mostly rich, industrialized countries in Europe and North America).
Despite these subpar results, the U.S. spends far more than any other country on healthcare, measured per head of population: $9,892 (compared to per-person GDP of $52,321.6), two-and-a-half times the OECD average.
This situation has led to a number of national reform efforts: a failed attempt by Democrats during the Clinton administration, a sweeping overhaul passed by the same party during the Obama administration (the Affordable Care Act), and a number of (so far) unsuccessful Republican efforts during the early months of the Trump administration. Investors in the health care sector face considerable political risk as a result of this push-and-pull: in the medium term, the U.S. could plausibly transition to a single-payer health system in which the federal government becomes the sole insurance provider, or a decentralized system in which states have far more leeway to structure and regulate their own health systems.
At the same time, the healthcare sector enjoys near-inelastic demand: because their health and potentially lives are at stake, patients are willing to pay almost any price for treatment, allowing many companies in the sector to earn high margins.
Industries Within the Healthcare Sector
The healthcare sector contains a diverse array of industries, with activities ranging from research to manufacturing to facilities management.
Drug manufacturers can further be broken down into biotechnology firms, major pharmaceuticals firms, and makers of generic drugs. The biotech industry consists of companies that engage in research and development to create new drugs, devices and treatment methods. Many of these companies are small and lack dependable sources of revenue. Their market value may depend entirely on the expectation that a drug or treatment will gain regulatory approval, and FDA decisions or rulings in patent cases can lead to sharp, double-digit swings in share prices. Examples of (larger) biotech firms include Gilead Sciences Inc. (GILD) and Celgene Corp. (GELG).
Major pharmaceuticals firms also engage in research and development, but tend to focus more on manufacturing and marketing an existing portfolio of drugs than the typical biotech firm. These companies tend to have more dependable streams of revenue and a more diversified "pipeline" of drugs in the research and development stages, making them less dependent on make-or-break drug trials and their shares less volatile. Examples of major pharmaceutical firms include Novartis AG (NVS) and GlaxoSmithKline plc (GSK).
Some pharmaceutical firms specialize in generic drugs, which are identical to name-brand drugs but no longer enjoy patent protection. As a result, there is often competition to manufacture identical drugs, leading to lower prices and thinner profit margins. An example of a generic drugs firm is Teva Pharmaceutical Industries Ltd. (TEVA).
Medical equipment makers range from firms that manufacture standard, familiar products – scalpels, forceps, bandages, gloves – to those that conduct cutting-edge research and produce expensive, high-tech equipment such as MRI machines and surgical robots. Medtronic plc (MDT) is an example of a medical equipment maker.
Managed healthcare companies provide health insurance policies. The "Big Five" firms that dominate the industry are UnitedHealth Group Inc. (UNH), Anthem Inc. (ANTM), Aetna Inc. (AET), Humana Inc. (HUM) and Cigna Corp. (CI).
Health care facilities firms operate hospitals, clinics, labs, psychiatric facilities and nursing homes. Examples include Laboratory Corp. of America Holdings (LH), which operates facilities that perform blood tests and other analysis; and HCA Healthcare Inc. (HCA), which operates hospitals and other healthcare facilities in the U.S. and UK.