Up 43 percent! If only that were our investment results, but it is not. That would have been the increase in Iron Capital’s health insurance premiums if we had renewed our policy on schedule in January. Fortunately we have a good agent who advised us to renew early, giving us almost one more year before we have to be fully compliant with the Affordable Care Act. People across the country are getting such notices if not having their policies cancelled. In the meantime I have noticed that the service I get from my doctors has gotten worse; I seem to be waiting longer and being treated more rudely, if that is possible.
Please do not misunderstand my perspective; I personally believe we need health care reform. The problem, as I see it, is that every attempt to reform health care, from both sides of the political aisle, is focused on the symptoms of our problems and not the cause. Granted this is a complicated issue, but most of what is wrong with health care today can be summed up in one sentence: The patient is not the doctor’s customer. Doctors work for the insurance company, not for their patients. That is obvious when you walk in their office. They have a team of people coordinating with insurance companies, while you get a clipboard and a sign that reads, “Please sign in.” Most of the things we complain about are caused by that one fact.
To truly fix our health care system we need to be asking how we make the patient the customer. But that is not the question that most ask when trying to come up with reform ideas. They may very well come up with great answers to the questions they do ask – how can we get more people insurance, for example – but the correct answer to the wrong question is still not a workable solution. Getting more people insured is a worthy goal, but if, as I believe, the uninsured are a symptom of our problem and not the problem itself, then we are not correcting the actual problem, and that will be the ultimate downfall of any such reforms.
One has to be sure that they are asking the correct questions. This is just as crucial to investing success as it is to public policy. The other day a well-meaning and very nice acquaintance asked me, “What are you telling your clients for 2014?” I am sure that many traditional advisers love these kinds of questions because it is an opportunity for a sales pitch. However, the fact that the calendar moves one more day and we call it another year means very little to the true long-term investor. Questions like this are encouraged by Wall Street firms because they are good for business. If one believes he must do something differently in 2014 than he did in 2013 that means transactions, and transactions are what Wall Street is all about. One should ask about process and fundamentals, and those things don’t change with the flip of a calendar.
Focusing on what is really important is not always that easy. We have to know the right questions. Do we care that everyone has insurance, or is it more important that everyone has good care for their health? Do we want to know what someone is saying about 2014, or do we need a long-term, goal-oriented path to investing success?
If there is ever a time when we should be mindful of what really matters it should be now as we celebrate our national day of thanks. We all have much for which to be thankful, and as is our tradition here is my list.
1. I am thankful for a good health insurance and an agent who helped us keep it.
2. I am thankful for the opportunity to coach my son and his teammates (the Sharks) in basketball, a sport I actually played and understand.
3. I am thankful that I can pull for the Sharks while my beloved Wake Forest Demon Deacons go through yet another year of a seemingly never-ending “rebuilding project.”
4. I am thankful for my family, immediate and extended.
5. I am thankful for loved ones lost and the time we did have together.
6. I am still grateful for Mama’s pumpkin cheese cake and my loose-fitting pants that make the enjoyment of said cheese cake possible.
7. Last but certainly not least, I am thankful for you, our clients and friends of the firm. Your trust in Iron Capital is our greatest asset and we value you every day of the year.
Chuck Osborne, CFA