According to data submitted in the state Assembly by Health Minister Veena George, the number of dialysis patients has gone up from 43,740 in 2020 to 1,93,281 in 2023 – an alarming growth of 341 per cent in three years... Currently, 105 hospitals under the Kerala health department, from district hospitals to family health centres or FHCs (previously called primary health centres or PHCs), besides the tertiary care hospitals, have dialysis units. Apart from the government centres, there are roughly around 200 private dialysis centres across the state... According to state-wise data of the Pradhan Mantri National Dialysis Programme (PMNDP), as on October 31, Kerala has 107 dialysis centres and 1,271 functional dialysis machines. Gujarat, a much bigger state, tops this list with 272 dialysis centres and 1,286 dialysis machines. In comparison, Uttar Pradesh has only 78 centres and 884 machines... the cost of a single dialysis ranges from Rs 1,200-2,500 in private hospitals... A patient typically needs 8-12 dialysis in a month and must shell out at least 15,000/month towards it.
2. US equity market exceptionalism
Since the beginning of 2010, in the 15 years till the end of 2024, the US markets have outperformed MSCI World equities in 14 of the 15 years. The only exception is 2017 (the first year of the Trump administration). Since 2010, US equities have outperformed MSCI Developed and EMs (ex-US) by 3.5 times. Over the past 10 years, the S&P 500 has outperformed European equities by 7.7 per cent annually and EM equities by 9.7 per cent annually. Truly exceptional numbers! The US today accounts for about 67 per cent of the MSCI World equity indices, meaning that corporate America is worth more than twice all other markets combined! The next biggest market is Japan, with an index weighting of only 5 per cent... If we look at the S&P493 (ex-Magnificent 7), and compare them to European Union equities, there is a valuation premium US companies enjoy across every major sector. This valuation premium is linked to structurally higher returns on equity.
3. The global volume of structured finance debt (which excludes real estate and traditional corporate loans) has hit $380 bn in 2024, the highest since 2007.
The boom in complex — and often riskier — deals highlights how buoyant markets and persistent US economic strength are allowing bankers to sell more esoteric products to investors keen to lock in high fixed returns... Deals in recent weeks have been tied to franchisee fee revenue of the US restaurant chain Wingstop, oil sales from ExxonMobil-backed wells and the demand for computing power and space provided by data centre operator CloudHQ... Other recent deals have required investors to scrutinise the finances of US homeowners who have installed Tesla solar panels and the music catalogues of Shakira, Bon Jovi and Fleetwood Mac...Structured finance has been a boon to Wall Street at a time when other parts of the investment banking business remain muted, with fees rebounding but still down from where they were a few years ago. Underwriting fees, as a percentage of deal size, for structured products tend to be higher than government bonds and plain-vanilla corporate debt. Such deals are also alluring to investors because they typically offer higher yields than traditional bonds while still locking in returns. Meanwhile, insurance companies and other professional investors have been seeking places to deploy the wave of assets coming from retirees and others seeking income-producing investments.
4. Taylor Swift wraps up her epochal Eras tour.
Through its 149th and final show, which took place in Vancouver, British Columbia, on Sunday, Swift’s tour sold a total of $2,077,618,725 in tickets. That’s... double the gross ticket sales of any other concert tour in history... Coldplay had set an industry record with $1 billion in ticket sales for its 156-date Music of the Spheres World Tour — a figure that is just half of Swift’s total for a similar stretch of shows in stadiums and arenas... Every date on the Eras Tour was sold out, and spare tickets were scalped at eye-popping prices — or traded within the protective Swiftie fan community, often at face value. According to Swift’s touring company, a total of 10,168,008 people attended the concerts, which means that, on average, each seat went for about $204. That is well above the industry average of $131 for the top 100 tours around the world in 2023, according to Pollstar, a trade publication...They exclude her extraordinary merchandise sales, for example, a product line so in demand that Swift opened stadium sales booths a day early in some markets to sell T-shirts, hoodies and Christmas ornaments to fans, ticketed or not... In October 2023, she released “Taylor Swift: The Eras Tour,” a nearly three-hour concert film, released through a direct distribution deal with AMC Entertainment, the world’s largest theater operator. It sold about $93 million in tickets during its opening weekend, and ended up with $261 million in worldwide grosses, according to Box Office Mojo. The next step was a streaming deal with Disney+. A 256-page hardcover tour book, released last month through Target stores, sold 814,000 print copies in its first two days on sale.
5. The US stock markets have been on a tear.
John Hussman has some words of caution
It may be surprising... that US non-financial profit margins before interest and taxes have been nearly unchanged for 70 years. The drivers of rising profit margins have been reductions in corporate tax and interest rates. Most of the impact of tax cuts was in place by the mid-1980s. Since 1990, the ratio of interest expense to gross value-added has plunged. S&P 500 operating profit margins have moved inversely to declining Baa-rated bond yields, a benchmark of corporate interest costs. A wave of debt refinancing in 2020 and 2021 has deferred the impact of the recent advance in interest rates until now. That bill is coming due. Despite all the society-changing innovations in recent decades, real US GDP growth has averaged just 2.1 per cent annually since 2000, compared with 3.7 per cent during the preceding half-century. Without accelerated population and labour force growth, even restoring the productivity growth of the pre-2000 period would boost real GDP growth by just 0.5 percentage points annually. Meanwhile, real US GDP currently stands 2.6 per cent above the Congressional Budget Office estimate of full-employment potential. Such gaps are common late in economic expansions, and their typical erosion over the next 2-4 years tends to be a headwind to growth. Given prevailing labour force demographics, trends in productivity and the current gap between GDP and its potential output, a reasonable baseline for four-year US real economic growth may be well below 2 per cent annually. The latest new era is only part of an endless cycle. Extremes such as the present have been extraordinarily rare in history, and provide investors with the opportunity to examine their exposure and tolerance for risk. At such moments, it may be helpful to exchange extraordinary optimism for a calculator.
6. Alan Beattie argues that despite all the gloom about rising protectionism and deglobalisation, countries generally remain open to trade and atleast keen on exports, and thus subject their companies to compeition.
7. Martin Wolf has two important graphics. First on the declining economic growth rates in the developed world.
8. Since opening its real estate division in India in 2007, Blackstone has risen to become the country's largest landlord, and its India portfolio is the third largest in the world (after US and UK). It has the largest office space portfolio, (111 million sq ft), second-largest shopping mall portfolio, and second-largest industrial real estate developer (50 million sq ft).
9. Finally, for all talk of sustainable investing, investors seem to find fossil fuel companies more attractive bets than those pursuing climate change mitigation. NYT has an article that compares the contrasting stock market performances of Exxon with that of green-transition friendly companies BP and Shell.
BP pledged in 2020 to cut its oil and gas production 40 percent by the end of the decade. Less than three years later, it backtracked and said it would increase spending on fossil fuels. The company wrote off $1.1 billion in offshore wind investments last year and recently said it wanted to sell other wind assets, though it continues to invest in renewable energy... Shell has softened or discarded some of its emissions-reduction targets, as it scaled back growth expectations for its renewable power business.
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