5 important lessons from the Aston Martin share price crash

first_img5 important lessons from the Aston Martin share price crash Image source: Getty Images Simply click below to discover how you can take advantage of this. Rupert Hargreaves owns no share mentioned. The Motley Fool UK has no position in any of the shares mentioned. Views expressed on the companies mentioned in this article are those of the writer and therefore may differ from the official recommendations we make in our subscription services such as Share Advisor, Hidden Winners and Pro. Here at The Motley Fool we believe that considering a diverse range of insights makes us better investors. Renowned stock-picker Mark Rogers and his analyst team at The Motley Fool UK have named 6 shares that they believe UK investors should consider buying NOW.So if you’re looking for more stock ideas to try and best position your portfolio today, then it might be a good day for you. Because we’re offering a full 33% off your first year of membership to our flagship share-tipping service, backed by our ‘no quibbles’ 30-day subscription fee refund guarantee. I’m sure you’ll agree that’s quite the statement from Motley Fool Co-Founder Tom Gardner.But since our US analyst team first recommended shares in this unique tech stock back in 2016, the value has soared.What’s more, we firmly believe there’s still plenty of upside in its future. In fact, even throughout the current coronavirus crisis, its performance has been beating Wall St expectations.And right now, we’re giving you a chance to discover exactly what has got our analysts all fired up about this niche industry phenomenon, in our FREE special report, A Top US Share From The Motley Fool. Our 6 ‘Best Buys Now’ Shares Rupert Hargreaves | Friday, 2nd October, 2020 | More on: AML center_img “This Stock Could Be Like Buying Amazon in 1997” Click here to claim your copy now — and we’ll tell you the name of this Top US Share… free of charge! Enter Your Email Address I would like to receive emails from you about product information and offers from The Fool and its business partners. Each of these emails will provide a link to unsubscribe from future emails. More information about how The Fool collects, stores, and handles personal data is available in its Privacy Statement. I think it’s fair to say the Aston Martin (LSE: AML) share price has been an absolute disaster for long term investors. As I write, the stock is changing hands at just under 50p, compared to its IPO price of 578p.Investors who’ve held onto the stock since the company’s IPO in October 2018 have seen the value of their investments fall by around 91%. Here, I’ll look at five key lessons from this share price crash.5G is here – and shares of this ‘sleeping giant’ could be a great way for you to potentially profit!According to one leading industry firm, the 5G boom could create a global industry worth US$12.3 TRILLION out of thin air…And if you click here we’ll show you something that could be key to unlocking 5G’s full potential…Aston Martin share price crashThe performance of Aston Martin over the past two years is a good reminder of why investing in cars is generally a bad idea. Sure, some models do increase in value in the long run. But most new vehicles lose value as soon as you drive out of the showroom.Car manufacturers are no different. History is littered with bankrupt car manufacturers. Indeed, virtually the entire US car industry had to be bailed out in the financial crisis. Just as some vehicles have increased in value over the long run, some car manufacturers have outperformed the pack. Still, on average, the industry has only destroyed money for investors over the past few decades. This is a good reminder of why, before investing in a business, it’s essential to consider the fortunes of other companies in the sector. The bankruptcy problemAs noted above, many car manufacturers have flirted with bankruptcy in the past. Aston Martin is no different. The company has been bankrupt several times in the past.This could have been a warning to investors. In my experience, companies that struggle to stay afloat are generally poor investments. Ignore the headlines Some investors might have been attracted to the Aston Martin share price due to its luxury brand association. However, just because a company owns a well-known brand doesn’t mean it’s going to be a good investment. In my experience, it’s always a good idea to ignore headlines like this and focus on the fundamentals, such as profit and debt. Aston Martin share price IPO fussThe fuss around the company at the time of its IPO caused its valuation to spike to £4.3bn. As we’ve since discovered, this was far too rich. Investors were happy to pay up for the stock despite its poor track record of profitability bankruptcy. I think this is an excellent example that investing in IPOs may not be a sensible strategy. It may be a better idea to wait for a more appropriate entry point rather than getting caught up in the IPO hype. For example, as the company’s prospects start to improve, now may be a good time to buy. Cut lossesThe Aston Martin share price has fallen over the past two years as the company has lurched from disaster to disaster. Investors who have stuck with the business since its IPO might have been better off selling up and moving elsewhere. Taking a loss on a stock can seem painful at first, but doing so is often a sensible decision, especially if a company is struggling to survive. In these situations, I think it’s better to sell up and move on, rather than risk further losses. Diversify away from the position may also be a sensible course of action. See all posts by Rupert Hargreaveslast_img read more

23 Terrace / DRTAN LM Architect

first_img Year:  23 Terrace / DRTAN LM ArchitectSave this projectSave23 Terrace / DRTAN LM Architect Houses Malaysia Architects: DRTAN LM Architect Year Completion year of this architecture project photographs:  H. Lin HoPhotographs:  H. Lin HoContractor:Eco Vision Sdn BhdC&S Engineers:Perunding L&W Sdn BhdDesign Architect:Tan Loke MunProject Architect:Alvin Tham Yee Weng, Mohd. FaidinCivil Engineer:Perunding L&W Sdn BhdStructural Engineer:Perunding L&W Sdn BhdCity:Kuala LumpurCountry:MalaysiaMore SpecsLess SpecsSave this picture!© H. Lin HoRecommended ProductsDoorsSky-FrameInsulated Sliding Doors – Sky-Frame ArcDoorsC.R. LaurenceCRL-U.S. Aluminum Entice Series Entrance SystemDoorsJansenDoors – Folding and SlidingDoorsdormakabaEntrance Doors – Revolving Door 4000 SeriesText description provided by the architects. Situated in the upper middle class suburban of Taman Tun Dr. Ismail that was developed in the 70’s, 23 Terrace is a new double-storey terrace house reconfigured in place of its single-storey predecessor. During day, the façade is a typical contemporary terrace house with large openings, glass balustrade and minimalist security door grille and gate. At dusk, the house transforms into a lantern, casting surrealistic shadows on the cement rendered porch.Save this picture!© H. Lin HoIt is a simple design exercise of form follow function where the need of the occupants takes precedence. On the ground floor, the living, dining and kitchen converge in an open concept layout and a suspended split staircase made of steel occupies a minimal part of the living space. The living area has a feature wall of exposed brick wall which is one of the few remnants from the old house. The concrete ceiling is left unplastered to reduce VOC emission. A flexible guest /music room with an attached bathroom is accessible via two large panels of folding-sliding doors.Save this picture!Ground Floor PlanThe dry and wet kitchens are connected by a long stretch of marble counter top and stainless steel cabinets.  The centerpiece of the dining/living is the bespoke dining table carved out of a slab of suar timber cross section.Save this picture!© H. Lin HoOn the first floor, the split staircase branches out into the terrace roof garden on one side and the private sanctum on the other on the first floor. This arrangement allows guests to access the open space without compromising the privacy of the master bedroom. The master bedroom has an en suite bathroom set within glass enclosure, which visually amplifies the space.Save this picture!Section AAThe el fresco space on the balcony is designed to celebrate the tropical weather, with two-thirds cement rendered floor and a strip of grass just before the frameless glass balustrade. Ten feet high walls flank the entire length of the terrace, with open-faced brick walls bordering the grass strip for privacy and acoustic reasons.Save this picture!© H. Lin HoTo optimise indoor air exchange, there are two customised wind turbines combined with steel framed glazed pyramids attached to built-in vents that provide the house with “stack effect” ventilation. A 3-degree differential is enough to spin the turbines by convection.Save this picture!DiagramThe new form and height of 23 Terrace are rejuvenating revisions of the 80’s single-storey terrace. It is a baby step towards the greening of the neighbourhood, an attempt to educate the community about the importance of green retrofitting.Save this picture!© H. Lin HoProject gallerySee allShow lessBildungscampus Sonnwendviertel / PPAG architectsSelected ProjectsZeller & Moye Designs “Flower Terraces” Housing in RuichangArchitecture News Share 23 Terrace / DRTAN LM Architect Save this picture!© H. Lin Ho+ 20 Share ArchDaily 2015 CopyHouses•Kuala Lumpur, Malaysiacenter_img Year:  “COPY” Projects ShareFacebookTwitterPinterestWhatsappMailOrhttps://www.archdaily.com/643455/23-terrace-drtan-lm-architect Clipboard Photographs ShareFacebookTwitterPinterestWhatsappMailOrhttps://www.archdaily.com/643455/23-terrace-drtan-lm-architect Clipboard “COPY” 2015 CopyAbout this officeDRTAN LM ArchitectOfficeFollowProductsSteelConcreteBrick#TagsProjectsBuilt ProjectsSelected ProjectsResidential ArchitectureHousesKuala LumpurHousesMalaysiaPublished on June 19, 2015Cite: “23 Terrace / DRTAN LM Architect” 19 Jun 2015. ArchDaily. Accessed 11 Jun 2021. ISSN 0719-8884Browse the CatalogVentilated / Double Skin FacadeTechnowoodClick Façade SystemWindowsMitrexSolar WindowMetal PanelsAurubisOxidized Copper: Nordic BrownAcousticKvadrat AcousticsAcoustic Panel System in AMOREPACIFIC HeadquartersStonesCosentinoSilestone® Surfaces – Loft SeriesWoodLunawoodThermo Timber and Industrial ThermowoodLightsLouis PoulsenOutdoor Lighting – Flindt PlazaTiles / Mosaic / GresiteLove TilesPorcelain Tiles – NestAluminium CompositesMetawellAluminum Panels for Interior DesignMetallicsRHEINZINKZinc Roof Systems – Double Lock Standing SeamStoolsWilkhahnOffice Stool – Aline-SBulbs / Spots / Wall LightsUniosHorticultural Luminaire – Kobe FloMore products »Save世界上最受欢迎的建筑网站现已推出你的母语版本!想浏览ArchDaily中国吗?是否翻译成中文现有为你所在地区特制的网站?想浏览ArchDaily中国吗?Take me there »✖You’ve started following your first account!Did you know?You’ll now receive updates based on what you follow! Personalize your stream and start following your favorite authors, offices and users.Go to my streamlast_img read more

Madras HC Passes Interim Order Allowing Advocates To Apply To Post Of DRT Presiding Officer [Read Order]

first_imgNews UpdatesMadras HC Passes Interim Order Allowing Advocates To Apply To Post Of DRT Presiding Officer [Read Order] LIVELAW NEWS NETWORK31 July 2020 10:55 PMShare This – xThe Madras High Court has permitted lawyers to apply for the post of Presiding Officer of the Debt Recovery Tribunal, as notified vacant by the Central Government on June 23. The interim relief has been granted by a bench of Chief Justice AP Sahi and Justice Senthilkumar Ramamoorthy in two writ petitions challenging the constitutional validity of the Tribunal, Appellate Tribunal and…Your free access to Live Law has expiredTo read the article, get a premium account.Your Subscription Supports Independent JournalismSubscription starts from ₹ 599+GST (For 6 Months)View PlansPremium account gives you:Unlimited access to Live Law Archives, Weekly/Monthly Digest, Exclusive Notifications, Comments.Reading experience of Ad Free Version, Petition Copies, Judgement/Order Copies.Subscribe NowAlready a subscriber?LoginThe Madras High Court has permitted lawyers to apply for the post of Presiding Officer of the Debt Recovery Tribunal, as notified vacant by the Central Government on June 23. The interim relief has been granted by a bench of Chief Justice AP Sahi and Justice Senthilkumar Ramamoorthy in two writ petitions challenging the constitutional validity of the Tribunal, Appellate Tribunal and other Authorities (Qualifications, Experience and other Conditions of Service of Members) Rules, 2020. The Rules, to streamline the appointment process and harmonize the service conditions of members of various statutory Tribunals, were notified by the Central Government on February 12, 2020. The same came to be challenged before the High Court last month and the Additional Solicitor General of India was granted four weeks time on July 8, 2020 to seek instructions on the matter. One of the grounds of challenge to the Rules is that they exclude Advocates, claiming to be eligible for such appointment, from applying to the post of the Presiding Officer at DRT. “A person shall not be qualified for appointment as Presiding Officer of the Debts Recovery Tribunal, unless he, is, or has been, a District Judge,” the eligibility criteria provided under the Schedule annexed to the 2020 Rules stipulate. When the matter was first heard, the bench had ordered that any selection which shall be made, shall be subject to the outcome of the writ petition. “This order was passed in anticipation that the matter would be heard and disposed of. But, till date we find that no response has come forward from the respondents either by way of a counter affidavit or otherwise,” the bench remarked on Friday. Under these circumstances, given that the last date for applications to the said post is around the corner, i.e. August 3, 2020, the High Court has permitted Advocates to apply to the said post. “We direct that the respondents shall also accept the applications that may be filed by Advocates, who claim to be eligible for such appointment and also show cause as to why such applicants be not considered eligible for the posts in question,” the bench ordered. It has however clarified that the participation of Advocates will not create any right in their favour and selection, if any, and the final selections shall not be announced except with the leave of the Court. The matter is now posted for hearing on August 28, within which time the Centre may file its response.Last month, the High Court of Kerala had issued notice in a challenge raised against Tribunal Rules 2020 on the ground that it excluded practising Advocates from appointment as judicial members in Administrative Tribunals.Also Read: Tribunal Rules 2020 : Old Wine In New Bottle? Case Details: Case Title: Revenue Bar Association v. Union Ministry of Finance & Anr. Case No.: WP No. 6037/2020 and another connected matter Quorum: Chief Justice AP Sahi and Justice Senthilkumar Ramamoorthy Appearance: Advocate Rahul Unnikrishnan (for Petitioner); SPCGSC AP Srinivas and Advocate D. Venkataswamy Babu (for Respondents) Click Here To Download Order Read Order Next Storylast_img read more

Milford to Ballyare Road reopens

first_img Pinterest Journey home will be easier – Paul Hegarty Twitter Previous articleMilford to Ballyare road closed following crashNext articleFull Capacity Protocol in place at LUH News Highland Facebook RELATED ARTICLESMORE FROM AUTHOR Twitter By News Highland – July 30, 2018 WhatsApp News, Sport and Obituaries on Monday May 24th Arranmore progress and potential flagged as population grows Harps come back to win in Waterford center_img WhatsApp Google+ The Milford to Ballyare Road has reopened following an earlier collision.One person was removed to hospital after the crash involving a car and a tractor at about 2 o’clock this afternoon.Gardai say the person’s injuries are not believed to be serious. Pinterest Milford to Ballyare Road reopens Google+ Facebook DL Debate – 24/05/21 Important message for people attending LUH’s INR clinic Homepage BannerNewslast_img read more

Storms in the South kill three as Northeast braces for coldest air of the season

first_imgABC News(NEW YORK) — The coldest air of the season is heading to the Northeast after at least three people were killed from rough storms in the South.A husband and wife died in Lawrence County, Ala., according to the coroner, and a 59-year-old woman was killed in her mobile home in Vernon Parish, La., according to the sheriff, when reported tornadoes struck the region.Up to 27 tornadoes were reported in Alabama, Mississippi and Louisiana on Monday and at least one tornado was confirmed in Georgia on Tuesday.A tornado watch remains in effect in Florida and Georgia through Tuesday night.That storm is now stretching from the Gulf Coast to New England, and 17 states from Illinois to Maine are under snow, ice and flood alerts.On Tuesday, freezing rain is hitting Pennsylvania, New Jersey, New York’s Hudson Valley and Boston.Ice accumulation is possible on trees and power lines, and the icy mess will make driving treacherous throughout the day.Some snow is going to fall north of the freezing rain in upstate New York, Massachusetts, Vermont, New Hampshire and Maine.As the storm moves out of the Northeast by late Tuesday night, an arctic cold front will move in on Wednesday afternoon, which will send temperatures plunging Wednesday night.Thursday morning will bring the coldest air of the season for the Northeast. Wind chills are forecast to fall to minus 8 degrees in Syracuse, minus 4 degrees in Boston, 0 degrees in New York City and 11 degrees in Washington, D.C.Copyright © 2019, ABC Audio. All rights reserved.last_img read more

Job cuts fuel Midlands crisis

first_imgRelated posts:No related photos. Previous Article Next Article Comments are closed. Job cuts fuel Midlands crisisOn 28 Mar 2000 in Personnel Today A leading partner in the Government’s Longbridge task force has expressed doubts over its ability to find new jobs for Rover staff.The task force will use £129m from the Government to tackle the aftermath of BMW’s decision to break up the Rover group.But Louise Beard, policy director at Birmingham Chamber of Commerce, says the Midlands economy simply cannot absorb so many people at once.The plant employs 8,500 staff, and a further 50,000 jobs in the supply chain are also at risk.Beard said, “You could say that the West Midlands has run out of opportunities. We have done so much to absorb people over the past three to five years, there is little chance we can absorb tens of thousands of workers.”“What the economy is not ready to do is to take on 8,500 people plus the others.”The Chamber of Commerce will play a leading role in the task force along with the Tecs, the employment service and the West Midlands government office.last_img read more

Ohio State football coach placed on leave amid domestic violence investigation

first_img FacebookTwitterLinkedInEmailRonald Martinez/Getty Images(COLUMBUS, Ohio) — Ohio State University placed head football coach Urban Meyer on administrative leave Wednesday after a woman claimed he knew about domestic abuse allegations levied against an assistant football coach.Meyer, scheduled to make $7.6 million this season, was placed on paid leave, the school announced Wednesday evening, just hours after Courtney Smith, ex-wife of former Ohio State assistant football coach Zach Smith, claimed Meyer knew about her 2015 domestic violence claim against her then-husband.“I do believe he knew, and instead he chose to help the abuser and enable the abuser and believe whatever story Zach was telling everybody,” Smith said in an interview with Stadium, a sports network, on Wednesday. “When somebody is crying out for help, I believe the coach, along with the coach’s wife, have a duty. They have a duty to do something to help.”Courtney Smith also claimed she shared photos of bruises from the alleged abuse with Meyer’s wife, Ohio State nursing instructor Shelley Meyer, and asked her to tell her husband. Courtney Smith said Shelley Meyer agreed to notify her husband, although she never confirmed if she did.The university opened an investigation into Courtney Smith’s claims on Wednesday, and said offensive coordinator Ryan Day would act as head football coach during the probe.“We are focused on supporting our players and on getting to the truth as expeditiously as possible,” the university said in a statement.Meyer released a statement in the wake of the announcement, but it did not refer to Courtney Smith’s claims.Athletic Director Gene Smith “and I agree that being on leave during this inquiry will facilitate its completion,” his statement said. “This allows the team to conduct training camp with minimal distraction. I eagerly look forward to the resolution of this matter.”Zach Smith was fired from Ohio State last month after he was charged with misdemeanor criminal trespass during a dispute with Courtney Smith.Copyright © 2018, ABC Radio. All rights reserved. August 2, 2018 /Sports News – National Ohio State football coach placed on leave amid domestic violence investigation Written bycenter_img Beau Lundlast_img read more

Prep Sports Roundup: 11/7

first_imgNovember 7, 2020 /Sports News – Local Prep Sports Roundup: 11/7 Written by Tags: Beaver Football FacebookTwitterLinkedInEmailFootball 2-A State SemifinalsCEDAR CITY, Utah-EJ Allred ran for 105 yards and a pair of scores on 11 carries as the Beaver Beavers clobbered Enterprise 40-13 Saturday in the 2-A state semifinals at Eccles Coliseum.Treyson Hunter (4-7, 70 yards, 2 TD’s) threw scoring passes to Statler Wright (37 yards) and Conner Crum (19 yards) as the Beavers outgained the Wolves 415-176. For good measure, the Beavers averaged 7.8 yards per play.This game had plenty of intrigue as the weather outside was frightful weeks before Christmas.EJ Allred now with a 36-yard touchdown run and Beaver leads Enterprise 40-0 with 6:05 left in the 3rd Quarter. We will now have a running clock. Beaver is outgaining Enterprise 405-27. A lightning storm has been reported nearby. We are now in **weather delay** mode.— Brad James (@BradfatherSpeak) November 7, 2020Crayton Hollingshead added a 20-yard touchdown run and an interception for the Beavers and Turner Williams had a 14-yard touchdown run for Beaver.The Beavers next face Duchesne Saturday November 14 at 12:30 pm at Dixie State University in St. George for the 2-A state championship.CEDAR CITY, Utah-Brock Adams ran for 201 yards and two touchdowns on 25 carries as the Duchesne Eagles pummeled Milford 26-6 Saturday during the 2-A state semifinal at Eccles Coliseum in Cedar City.The Eagles ran for 312 yards on 54 carries (just under 5.8 yards per tote) and controlled the ball for more than 32 minutes to put the pressure on the Tigers all game long.Milford’s sole touchdown came on a 35-yard scoring strike from reserve signal-caller Blake Barnes to speedster Bret Beebe (9 touches, 124 scrimmage yards, rec TD).Duchesne improves to 11-0 on the season, setting up a matchup of unbeaten teams at Dixie State University for the 2-A state title.Duchesne prevails 26-6 as the Eagles run for 312 yards in advancing to the 2-A state title game at @DixieState_FB Saturday at 12:30 pm against Beaver pic.twitter.com/DnB2VE1M1U— Brad James (@BradfatherSpeak) November 8, 2020 Brad Jameslast_img read more

Deliveroo partners with Veggie Pret for delivery service

first_imgPret is to this week reopen its Veggie Pret stores and is launching a delivery service with Deliveroo.The 10 Veggie Pret shops in London and Manchester, which have been shut during the coronavirus pandemic, will reopen on 11 June, with safety and social distancing measures in place.They will reopen for takeaway only and will offer a reduced menu of vegan and vegetarian favourites. Seven of the 10 shops, including the Manchester site, will offer deliveries for the first time by Deliveroo.Veggie Pret was developed in 2016 and was expanded in early 2020 with three new locations.“We are excited to be reopening all 10 of our Veggie Pret shops this week,” said Clare Clough, UK managing director of Pret A Manger.“We know that many of our customers are working from home and missing their plant-based favourites, so partnering with Deliveroo means that more customers can access our veggie and vegan menu.”Deliveroo global health director Tom Peters added that his company had seen a surge in demand for more plant-based options, both from vegan customers and customers wanting to cut down on their meat intake.Pret has recently announced plans to reopen around 300 of its sites. Several shops in railway stations, such as King’s Cross, Manchester Piccadilly and Leeds, will open for takeaway from today (8 June), while a number of shops located in shopping centres around the country will begin to open from next Monday.last_img read more

Checking the pulse of Obamacare

first_img Related GAZETTE: What about the insurers who are pulling out of the program? Will that increase costs? BAICKER: The goal of having privately provided insurance through an exchange is that insurers will compete for enrollees by offering higher-quality benefits at a more affordable premium. If you don’t have competition there’s very little advantage to having a marketplace. If insurers drop out to the point that there aren’t enough competitors, that could have real negative consequences in terms of the value of the plans that are being offered. And I think we did see that some of the withdrawals were relatively new insurers with relatively small books of business who came in with low premiums — thinking that they were going to be able to provide a really lean, competitive benefit — but discovered that their premiums were too low, and that they couldn’t continue to participate in the market. That pushes premiums up and competition down. And certainly too much consolidation on either the insurer side or the provider side undermines the competitive pressures that we would like to be driving higher value benefits and lower premiums. So that’s a real concern.GAZETTE: Another critical issue is that too many young people are choosing to pay the penalty instead of signing up in the exchanges. What do you think the fix is there?BAICKER: That’s definitely a related issue. Insurers price their policies based on their guess about who is going to enroll. If young healthy people don’t enroll, then it’s going to be more expensive per enrollee to cover the people who are left, and premiums are going to be higher.What’s the fix? My suspicion is that it may not be clear to people what subsidies they are eligible for, what the advantages of being insured are, what policies are available to them at what net premium. Making sure people are aware of those benefits is necessary but may not be sufficient. Even people who are aware may not be signing up, and maybe the penalties are not high enough. It might be that the benefits of being insured are not clear enough. It’s difficult to perceive the advantages of being insured if you don’t end up using your health insurance benefits in a given year. The financial protection that insurance provides is a pretty abstract thing if you are not sick. That’s really hard for people who are young and healthy to internalize.GAZETTE: Is the public perception of the effectiveness of the ACA a concern? A recent poll by Politico and the Harvard T.H. Chan School of Public Health found that a majority of voters say the law is failing. How will that affect efforts at reform?BAICKER: There are clearly some misconceptions about what’s going on in health care markets. What policies are available and how much people have to pay for them is not very clear from the coverage that you read. Also, there are millions of people who are insured now who weren’t before. So when you asked whether the ACA is working, it depends on what your goals are. Is it working to increase health insurance coverage? Yes. Is it working to slow health care spending growth? Much less clear.GAZETTE: What are some of the things that analysts agree could be improved?BAICKER: Some states have expanded their Medicaid programs and some haven’t. There’s an opportunity for more flexible options in expanding coverage for low-income populations, whether it’s private versions of Medicaid coverage offered through things like exchanges, or other kinds of Medicaid waivers. There’s also an opportunity to improve continuity of coverage for low-income populations with variable income. Having people transition from Medicaid to subsidized exchange plans and back again creates discontinuities in coverage that are both expensive and potentially harmful for health. Those could be addressed. There are also gaps in coverage that I think were not intended by the original law, either because some states didn’t expand Medicaid or because of the specifics of drafting that may not have been intended — for example, defining the affordability of coverage based on a single policy versus a family policy. When you look at any large-scale, complicated new program — whether it’s Social Security or Medicare and Medicaid or the Affordable Care Act — there are inevitably lots and lots of things that need to be refined in the years that follow. There were lots of changes to the Medicare law after it was initially implemented. I think there are parallel changes needed in the Affordable Care Act that would make it work much better than it does now. And if there isn’t willingness to address some of the technical fixes, that’s really problematic for having it function well.Interview was edited for length and clarity. From the very beginning, the Patient Protection and Affordable Care Act (ACA), President Obama’s signature piece of legislation, has been beset with problems: bitter debate among lawmakers, a Supreme Court challenge, and crippling technical difficulties with sign-up site Healthcare.gov, to name a few. More recently, insurers have been pulling out of the law’s insurance exchanges, and just last week the federal government announced that the cost of some health care plans would jump next year by 25 percent. Still, some 20 million more people have health insurance thanks to the ACA, and the new law prohibits insurers from denying coverage to people with pre-existing health conditions. To assess the ACA landscape the Gazette spoke with Katherine Baicker, the C. Boyden Gray Professor of Health Economics at the Harvard T.H. Chan School of Public Health.GAZETTE: Do you think the Affordable Care Act has worked? Has it achieved the goals that the president and Congress set out for it?BAICKER: I think there were two goals, broadly speaking. The first was to get more people covered with affordable health insurance and the second was to slow the rate of health care spending growth.I think a lot of progress has been made toward the first goal, if not covering everyone. The number of uninsured people has been reduced through expansion of Medicaid and subsidized health insurance plans through the health insurance exchanges. That in some ways is the easier goal, even though it’s expensive and is perhaps is more expensive than some people had hoped — we fundamentally know how to get people health insurance. You have to make affordable plans available, and you have to suitably encourage people to be enrolled in those plans.The much harder goal is slowing the growth of health care spending. And really, the goal shouldn’t be to spend less on health care, the goal should be to get high value for what we are spending. We frequently talk about spending less, which is shorthand for having spending grow less quickly. And what we really mean is spending less for every unit of health we are getting. So the shorthand can sometimes be misleading about what the real goals are — improving value in the health care system. And that’s a much harder nut to crack. How do you discourage spending on care that’s of low value, while ensuring that there’s really good access to care that’s of high value, particularly for low-income populations? A number of strategies have been deployed, but they have had mixed success. It’s also much harder to know the effects of those levers — to assess what trends in health care spending can be attributed to the ACA versus not.GAZETTE: What are the main drivers of medical costs and what if anything can be done to reduce the rate of growth?BAICKER: First of all, the main driver of health insurance premiums is health care utilization. We use a lot more health care resources in the U.S. than some other countries do. We use a lot more resources in some parts of the country than we do in others. And all of that is evidence that we could be getting better value out of the system. There are pockets of the U.S. where people are getting really high-quality care at a lower cost with better outcomes. And those are models for parts of the country where we seem to be spending a lot more money and not achieving the health outcomes that we could. Part of it is the disconnect between the people who pay for health care and the people who make the decisions about the health care that’s used. And that can be about insurance and what it covers with what co-payment; it can be about providers’ decision-making; and it can be about patients not having the information they need to decide what care is really right for them.GAZETTE: Data released by the federal government indicates some premiums will rise 25 percent in 2017. In addition, a number of insurers have pulled out of the program. What do those factors mean for the ACA moving forward?BAICKER: It’s important to realize that the premium increases people are talking about are for a very specific subset of of health insurance policies: those sold on the health insurance exchanges, the non-group market. It’s not about the premiums people are paying for employer plans. It’s not about people who are covered by Medicare or Medicaid. It’s a pretty narrow slice of the population we are talking about. That doesn’t mean it’s not important — it’s just that sometimes people think that means everybody’s health care costs are going up by 25 percent and that’s just not what’s happening.Most of the people who get health insurance through the exchanges are heavily subsidized, with premium and cost-sharing subsidies. So individuals’ costs are not going up as much as the total premiums are going up. That means it’s going to be more expensive for the federal government as the subsidies are going up commensurately with premium increases.GAZETTE: So that cost falls to the taxpayers.BAICKER: Yes, more expensive for the government equals more expensive for the taxpayer — either today or tomorrow, depending on whether it’s financed through deficits or current taxes.GAZETTE: So why are these premiums going up?BAICKER: Some of it is about general rise in health care spending, but some of it is really specific to the way the health insurance exchanges were implemented and phased in. For example, because it was a new market, because insurers were entering an exchange that didn’t exist to cover a population that hadn’t been covered, there was a lot of uncertainty about how much it would really cost to deliver health insurance to that population. So the law had subsidies to protect insurers against unexpectedly high costs: reinsurance. As those subsidies phase out, premiums will necessarily go up because the cost of that insurance for very high-risk people is being transferred from the federal government to the insurance plans. Another part of it was that some insurers might have priced their premiums too low in the beginning, making guesses about who was going to be covered and how much those people were going to cost. The costs of inequality: Money = quality health care = longer life Federal insurance has helped many, but system’s holes limit gains, Harvard analysts say last_img read more