Not a day goes by that healthcare costs aren’t being discussed across each corner of media. With the 2020 election now underway, politicos are ratcheting up the rhetoric over healthcare costs and the political ads are already spinning the topic. And all of this is for good reason. Healthcare costs in the U.S. are high and rapidly rising, especially if you’re of retirement age. According to the U.S. Centers for Medicare and Medicaid Services (CMS) — healthcare spending increased in 2017 by 3.90% to $3.9 trillion or $10,739 per person. This represents 17.90% of the then gross domestic product of the U.S. (GDP). In fact, in a recently published book, More than Medicine: The Broken Promise of American Health by Bob Kaplan, he argues that the U.S. pays way more than its mature economic peers.
For example, the U.S. pays 18% of its gross domestic product (GDP) on healthcare whereas the European Union (E.U.) only pays 10% of its combined GDP. And, to make it worse, the U.S. has a lower life expectancy than many nations around the globe. Add in a high poverty rate, which can lead to further health challenges for young and old and other factors showing health troubles, including infant mortality, and the nation doesn’t look too healthy. American healthcare may well get even more expensive, as the U.S. ages and becomes less healthy by the day. This isn’t a good mix for one of the leading economies of the planet.
In a recent study by the U.S. Department of Commerce and the U.S. Census, by 2035, it is projected that 78 million folks will be 65 years or older. That same year, those at or under the age of 18 years will number just 76 million. America is becoming a nation of the elderly — a significant change in the demographics of a nation traditionally known for its healthy and able folks. It’s a shift that leaves many wondering where our economic productivity gains will come from. And, as we know, the elderly population requires the most attentive healthcare … no wonder healthcare spending is climbing.
While this sounds bleak, there is a silver lining here for us as investors. And no, I’m not suggesting that we look at gym companies (although I am poking around at that market with some innovations that I’ll be writing about in Profitable Investing in the near future). Rather, I’m suggesting that investing in healthcare stocks that pay dividends is a smart source for capital gains …
One healthcare stock, in particular, comes to mind … I’m referring to WP Carey (NYSE:WPC), which I’ve written about extensively for InvestorPlace.
WP Carey is a REIT, which since coming to the public market, has generated a return of 1,348.28% for an average annual equivalent return of 13.46%. That’s not too shabby any way you cut it. The business itself is a curious one: WP Carey doesn’t operate its properties, and it doesn’t pay for maintenance, insurance, or taxes. Instead, it executes “triple net leases.” This means that it locks up long-term cashflows with less risk in rising costs for the properties and the vagrancies of tax rates.
Its tenants pay for all of that, thus WP Carey profits from other peoples’ money.
In the healthcare market, there is a specific equivalent in the following security. Well, this next security is technically a real estate investment trust (REIT) that owns and acquires healthcare facilities including inpatient and outpatient facilities as well as surgical centers and specialty healthcare facilities. Their properties amount to more than 120 properties in 25 states as well as some newer innovative investments in Germany. Scroll down to discover what it is …
Medical Properties Trust (MPW)
Medical Properties Trust (NYSE:MPW) has properties that are leased on a net basis to operators that run the facilities and pay rent month after month for years. The portfolio has expanded dramatically over the recent year with only a small pause in the past year. But it continues to look to expand its portfolio with the right properties in an ever-expanding market.
Revenues are climbing with gains running at over 11.30% in just the trailing year. And the funds from operations (FFO) which measures just the return rate from the cashflows from the property portfolio is ample at 11.60%, which is impressive for the REIT space. This contributes to an impressive return on its assets at 11.40% and is what delivers for shareholders with a return on equity of 24.30%.
And the stock continues to reflect its performance as a company. Over the past ten years, the stock has delivered a total return of 994.12% for an average annual equivalent of 26.79%. It is a disciplined company when it comes to debt and leverage as its debt to capital is at only 47.00%. This provides the ability to easily service its current debts and provides eased access for credit to fund additional acquisitions. Valued at only 1.49 times its book value, MPW is a steal from a price-book (P/B) perspective. This ratio has climbed significantly over the trailing year, from 1.14 times back in October 2018.
But it isn’t just the P/B ratio that’s rising, but the actual value of the assets. Over the past five years alone, the underlying book value per share has gone from $7.98 to a current $12.27, which represents an impressive gain of 53.76%. This is important as it shows genuine growth in the underlying company and not just the stock price. The dividend is currently at 25 cents per share and has been climbing in distribution by an average annual rate of 4.30% over the past five years. This equates to a current yield of 5.48%.
Medical Properties Trust makes for a great buy in the healthcare market (which should be purchased in a taxable account). This is due to the Tax Cuts and Jobs Act (TCJA) which provides a tax deduction of 20% of the dividend distribution for U.S. individual investors making the taxable equivalent yield even higher.
Other Stocks to Play Healthcare
Inside the Profitable Investing model portfolios, I have the overall market for healthcare synthetically invested in the Vanguard Healthcare ETF (NYSEARCA:VHT), which remains a buy in a tax-free account. Then, in my Incredible Dividend Machine portfolio inside Profitable Investing, I have three more plays on healthcare …
I have the drugmaker Merck (NYSE:MRK), which continues to perform for shareholders. And I have another drugmaker in Pfizer (NYSE:PFE), which follows the success of Merck. Further, I also have Ventas (NYSE:VTR), which as a real estate investment trust (REIT) that owns a series of senior healthcare and related housing care facilities. VTR is doing quite well with the general REIT sector as we move further into 2019.
One of the smartest investment lessons that I learned, from one of my best stocks within Profitable Investing, is to capitalize when the opportunity arises. That is, take risks while you lock in revenues! And the aforementioned stocks should continue to position themselves into the thick of the rising healthcare spending market while paying out an ample and rising dividend.
Neil George is the editor of Profitable Investing and does not have any holdings in the securities mentioned above.