Issue 3: Jan. 18, 2021
Fourth quarter earnings season is now in full swing, throwing more light on how the U.S. economy is performing. A number of bank giants presented last week, relieved that 2020 turned out much better than initially feared. Companies and consumers continue to repay their loans, more or less. On the other hand, they’re not taking on too many new loans. And that could herald a future of underinvestment and underconsumption.
To avoid such a plight, Joe Biden, who assumes the Presidency this week, proposed another big federal stimulus. It aims to address multiple challenges, from vaccine distribution to state and local government budget distress. But more generally, it seeks to bridge the gap between now and perhaps this summer or fall, when vaccinations hopefully end the Covid threat once and for all. If and when that happens, the economy looks well poised to recover on its own. As travel companies like Delta and Carnival made clear in their Q4 calls, American wallets are swelling with pent-up demand.
Getting through the next few months, though, won’t be easy. The latest reports tracking retail sales and employment show the economy weakening this winter. Covid death and illness rates remain tragically high. Helpfully, the stock market remains near record highs, with interest rates near record lows. But stocks did fall last week, and interest rates did rise. Is there a bubble in stocks? A bubble in government debt? Nobody knows. But everyone’s asking.
This week: More from the crucial finance sector as giants like Bank of America and Goldman Sachs take the earnings stage. United the health insurance company—and United the airline—both report. So will Netflix, Proctor and Gamble and IBM, to name just a few.
Copper and lithium are both essential to the global economy. Copper is used in electronics and construction. Lithium is needed for batteries. Their importance, moreover, will likely increase with the adoption of electric cars and other staples of a greener and cleaner economy. A Barron’s article last week discussed more about copper’s role. A Reuters article, meanwhile, profiled concerns at the North Carolina company Albemarle. It worries that lithium supplies might not be sufficient to meet the economy’s future needs. Australia, for the record, is the world’s leading lithium producer. Chile is tops for copper.
Amazon: It started with books. It’s now the everything store. Amazon is today America’s second largest company with $348b in revenues for the 12 months that ended in September. That was a striking 31% more than it generated in the preceding 12 months. Nationwide, only Amazon’s retail rival Walmart is a bigger company. Both firms, incidentally, are profitable but with low margins. The mass-market retail business model is about constantly driving down prices and making money on volume. For the record, Amazon’s operating margin was just 6% during the first nine months of 2020. It’s certainly had its failures, from the Fire phone to its inability to crack the China market. But these are mere footnotes on its path to becoming a leviathan. Today, Amazon employs more than 1m people (including seasonal workers), having created more jobs than any other U.S. company in the past decade. But this still understates its influence in the labor market. Because other companies selling their products on the Amazon Marketplace employ another 830,000 people. What’s more, according to the Progressive Policy Institute, Amazon now spends more on capital investment than any other U.S. company (it’s even buying its own airplanes now, never mind its fleet of 30,000 delivery trucks). Brands and products include Whole Foods, Kindle, Twitch and Audible. Hundreds of millions of Alexa-enabled devices are in use. Journalist Brad Stone, in his 2013 book “The Everything Store,” chronicles the company’s rise from its days as a book-selling internet startup in 1994. After books came music, and then one category of products after another. Amazon lost money most years, but investors believed in founder Jeff Bezos, giving him time and space to develop his longterm vision. Among his core beliefs: focus more on customers than competitors. Its pioneering use of customer data explains much of Amazon’s success. Bezos understood early the power of personalization enabled by big data. The right data about a person, more to the point, could predict and influence buyer behavior. In addition, he understood the potential of “platform” economics, in other words, a business that other businesses need to reach customers. It was almost an afterthought at first. But Amazon Web Services (AWS) is today the leading provider of cloud computing solutions for companies. And it earns strong profit margins. After surviving the scare of the dot.com bust in 2000, Amazon mostly benefited from the economic crisis of 2008/09 as brick-and-mortar rivals like Borders Books and Circuit City disappeared. During the current Covid crisis, it’s become more important to the economy than ever, delivering essential goods directly to people’s homes. Mastering the art of delivery and logistics, incidentally, is another critical part of the Amazon success story. Still another is its immensely popular Amazon Prime service, in which customers pay an annual fee to get fast and free shipping, special discounts, access to free media (songs, movies, books, etc.) and other perks. Lately, advertising has been a fast-growing revenue source, trailing only Google and Facebook in its size. To be clear, the company also spends a lot of money to buy Google and Facebook ads (it’s Google’s largest customer in fact). Amazon is constantly looking for ways to make order fulfillment more efficient, using robots more extensively, for example (It purchased the robotics firm Kiva for nearly $800m in 2012). Most recently (last month), it said it would buy the podcast company Wondery to expand its media offerings. An effort to reinvent health insurance with JP Morgan and Berkshire Hathaway didn’t work. But health care remains an enticing if daunting target; Amazon launched an online pharmacy last fall. Another enticing market: the giant auto sector. Aside from embedding its Alexa software in vehicles, it owns a big stake in the electric car startup Rivian.
Amazon, of course, as big and powerful as it’s become, is not without challenges and controversy. A Wall Street Journal article last month examined some of its aggressive business tactics, and why it’s becoming a target among regulators and politicians. The controversies are many, including criticisms of its labor, privacy and tax avoidance practices. What’s getting the attention of competition watchdogs, however, is its alleged abuse of data gleaned from companies that sell through its platform. If Amazon sees some other company’s product selling well, the allegation goes, it will readily launch a nearly identical product and sell it for less. Often, it simply buys emerging rivals; one it’s now watching closely is Shopify, a rival platform appealing to retailers upset with Amazon’s practices. According to the Journal piece, citing data from the Institute for Local Self-Reliance, Amazon takes a full 30% of each third-party sale (it was 19% five years ago) compared to Shopify’s 3%, plus a 30-cent flat fee. To burnish its public image and fend off regulatory threats, Amazon points to investments in affordable housing and efforts to fight climate change. In 2108, it raised its starting minimum wage to $15 an hour. Besides, Jeff Bezos told a Congressional hearing last year, Amazon accounts for less than 1% of the $25t global retail market, and less than 4% of U.S. retail. He also pointed to the 1.7m small- and medium-sized businesses that depend on Amazon’s marketplace. That’s where they find their customers, with an option for Amazon to handle the shipping.
Thrasio: Speaking of the many small- and medium-sized businesses selling on Amazon, the investment firm Thrasio earns a living by buying them. Co-founder Carlos Cashman, speaking on a podcast “Invest Like the Best,” said he’s bought companies selling all sorts of items, from blenders to socks. It’s not an uncommon practice these days. A number of investment firms are on the lookout for entrepreneurs successfully selling through Amazon. They typically bring financial muscle, marketing expertise and tech skills. Cashman explains how easy it’s become for anyone with a product idea to become a retailer: Just find a Chinese manufacturer to produce your item (typically via Alibaba.com) and use Amazon to reach customers and handle fulfillment.
Delta was America’s largest airline before the pandemic. It was also the strongest and most profitable among the country’s Big Three, the others being American and United. Nevertheless, Delta could not escape the ravages of the Covid crisis, losing a colossal $9b in 2020. Revenues were just 30% of what they were in 2019. Nevertheless, U.S. airlines had little problem raising enough funds to avert bankruptcy (where Delta, American and United had all been before). But to raise money, they borrowed huge sums of money. They received some government aid too, including funds specifically earmarked for wages. Delta, for its part, has a large intercontinental network and typically carries lots of big-spending premium travelers on corporate accounts. Will those passengers return? Or have Zoom calls become an adequate substitute for business travel? It’s a giant question for the industry, not to mention key suppliers like Boeing. Also watching closely is Delta’s close partner American Express—the two offer highly profitable credit cards that reward users with frequent flier miles. On an optimistic note, Delta managed to greatly cut costs during the year, and industry capacity will be down sharply from its pre-pandemic levels. Fuel remains pretty cheap. Flight searches are up. And vaccinations could reach critical mass by the peak summer season. Delta, by the way, earns a big chunk of its profits from Atlanta, its home city, and one impeccably situated for traffic flows in all directions (Atlanta’s airport is the world’s busiest). Delta also operates hubs in Detroit, Minneapolis, Salt Lake City, New York, Los Angeles and Seattle.
Carnival: As rough as things are for airlines, they’re even worse for cruise companies. Their ships, after all, are dangerous places to be when a deadly virus is spreading. Then again, Carnival, unlike Delta, doesn’t have to worry about the future of business travel. All of its customers are travelling for leisure, and leisure activities are poised to surge once it’s safe enough for Americans to release their pent-up demand. Sure enough, Carnival, even before restarting operations, is seeing strong demand for future cruises. Fuel, still pretty cheap despite oil’s recent ascent, will be another tailwind. The company is also cutting capacity, recognizing that most of its customers in the near-term will likely be regulars rather than first-timers. As Skift’s Dennis Schaal points out, there’s a sizeable contingent of Americans—many of them retirees—who are passionate about cruising.
KB Homes, an L.A. homebuilder, said in its earnings call that nearly 60% of its buyers are millennials (people born in the 1980s or early 1990s). It’s seeing strong demand more generally, unsurprising given the well-documented flight from cities to suburbs during the pandemic. KB is also seeing a lot of Californians leaving their homes. But hardly all are leaving the state. Many are moving within the Golden State, to areas like the so-called Inland Empire, a hot housing market east of Los Angeles. KB also mentioned Seattle, Charlotte and Raleigh-Durham as places where it’s expanding. One thing to remember about the U.S. housing market: It depends heavily on the availability of buyer-friendly 30-year fixed interest rate mortgages. And that availability in turn depends heavily on government guarantees to mortgage lenders, via Fannie Mae and Freddie Mac. Both remain under government ownership, a legacy of the 2008-09 housing crisis.
Finance: It was a more or less solid year and fourth quarter for America’s banking sector. That’s the takeaway from big banks like JPMorgan, Wells Fargo and Citigroup, all of which reported earnings last week. Banks, remember, were badly wounded by the 2008-09 housing crisis. And early on in the Covid crisis, it looked like things would be rough again, notwithstanding much healthier bank balance sheets this time around. Would large numbers of clients start defaulting on loans? Would new lending opportunities—for homes, autos, education, credit card purchases, small business startups, etc.—diminish? What about business activities like raising new capital for companies or advising on mergers and acquisitions? Happily for the banks, things turned out much better than expected. Demand for new loans, to be sure, was and remains weak—that’s true for both companies and consumers. But loan losses were much less than feared. Some areas of lending (like mortgages) were strong. And Wall Street turned ultra-bullish, creating a boom in investment banking (think of all those companies doing IPOs). JPMorgan, which reported gargantuan profits, noted the $3 trillion increase in domestic deposit growth across all U.S. banks, the result of government stimulus and high rates of household savings. Combine this with the weakness in new loan demand, and what you get is a less risky banking system with tons of capital on hand. That’s good yes, but for an economy to really grow, banks need to be lending to businesses so they can invest and consumers so they can spend. Keep in mind, however, as JPMorgan CEO Jamie Dimon often says, banks are becoming a smaller part of the U.S. economy, with non-bank lenders assuming a larger role. Think of “shadow banks” like Quicken Loans, which is now the country’s largest home lender. Frighteningly for banks, Silicon Valley wants in, on lending yes, but financial services more generally (especially payment processing). Google, Apple, PayPal, Stripe, new startups like Affirm… they’re all involved, deploying the latest data crunching and artificial intelligence tools to analyze risk. Last week, even Walmart launched a new fintech joint venture. The banks, to be sure, are investing in new tech tools as well. Wells Fargo, for one, is closing bank branches as it develops digital solutions (it’s also incidentally exiting the student loan business). In sum, it was a better-than-expected 2020 for America’s big banks. But high levels of uncertainty linger. Unemployment is still high. So are Covid infection rates. Vaccine distribution is off to a rocky start. Another proposed round of fiscal stimulus might or might not pass. And importantly, longterm interest rates are extremely low, which isn’t good for banks. Their core business, after all, is earning profits through interest collected on loans.
Finance: As Washington pumps more money into people’s pockets, much of it is ending up in bank accounts. But banks aren’t the only beneficiaries. So are asset managers, none larger than New York’s Blackrock. During its earnings call last week, executives indeed said lots of stimulus money is flowing into the funds it offers. It happens to be the largest seller of exchange-traded funds (ETFs), an increasingly popular way for everyday people to save for retirement. ETFs account for roughly 40% of the funds BlackRock takes in. Another 10% goes to more traditional index funds. And much of the rest is in funds where Blackrock’s investment professionals are actively managing the money. Blackrock CEO Larry Fink speaks often about what he calls the “silent crisis”: that large numbers of Americans simply aren’t saving enough to fund their retirement years. Low interest rates don’t help. Longer life spans complicate the problem. Yes, government social security helps. But not nearly enough for most.
Finance: A final word on the financial sector involves James Simons, who’s retiring as chairman of Renaissance Technologies, perhaps the world’s most successful hedge fund. As the Wall Street Journal wrote, “Simons is considered the most successful moneymaker in the history of modern finance.” His record, indeed, tops even those of Warren Buffett, George Soros, Peter Lynch, Steve Cohen and Ray Dalio. How did he do it? Again from the Journal: “He and his colleagues—all from the worlds of math and science—built predictive models capable of uncovering unrecognized market patterns, partly using early versions of machine learning.” Interestingly, Simons is a major supporter of Democratic candidates like Joe Biden, while former Renaissance chief Robert Mercer was one of Donald Trump’s biggest financial backers. Whatever their political preferences, their giving does raise the thorny issue of billionaires having arguably outsized influence on U.S. political outcomes.
Semiconductors: Bernstein Research analyst Stacy Rasgon calls them the most technologically advanced products that humanity has ever devised. He’s talking about semiconductor chips, the ingredient essential to computers, smart phones, consumer electronics, servers and increasingly cars. For decades, Silicon Valley’s Intel was the global leader in both the design and production of semiconductor chips. Its products were a staple of every Windows-running PC. It was virtually alone in mastering the extremely complex chip manufacturing process—potential rivals were deterred by the gargantuan startup costs necessary to enter the business. But as Rasgon and Harvard professor Willy Shih explain in a series of Bloomberg Odd Lots podcasts, Intel’s fortunes have sharply declined. To be clear, it’s still highly profitable, earning a $5b operating profit on $18b in revenues during 2020’s third quarter. But its once struggling rival AMD decided—with success—to hive off its manufacturing operation into a separate company, so it can focus on design. Other specialized chipmakers like Qualcomm, Apple and Nvidia are also involved just with design, outsourcing the lower-margin manufacturing to Taiwan (which Rasgon calls the most strategically important place in the world given its semiconductor expertise and capabilities). Mainland China, incidentally, hasn’t yet mastered the arts of ultra-advanced chip manufacturing—it could take many years if ever for it to do so. Only Intel, Taiwan’s TSMC and Korea’s Samsung currently have the know-how. As Intel continues to build chips in-house, it faces competitive threats from more specialized chips, including Apple’s new M1 technology (Apple currently uses Intel chips for its Mac computers). Last fall, Nvidia said it would buy Arm, which specializes in mobile phone chips. Microsoft, Amazon and Google are starting to design their own chips as well, especially those focused on artificial intelligence. Last week, Intel appointed a new CEO to tackle these new competitive threats. Will he outsource more manufacturing? Demand for chips won’t be a problem. If anything, there’s a global shortage right now, in part because of Intel’s delays in getting new chips to market. In the meantime, Washington is watching with interest, and with some nervousness. Does it really want such a strategic industry to be so dependent on Asian manufacturers? After all, America’s advanced semiconductor technology is crucial to the military. In fact, it was the defense department (and NASA) that originally nurtured Silicon Valley and its fledgling semiconductor industry many years ago; there were few private sector customers early on. The business, keep in mind, is also a giant export engine. According to the Semiconductor Industry Association, the U.S. exported $46b worth of semiconductors in 2019. Only airplanes, refined oil, crude oil and automobiles produced more export dollars.
Video Games/eSports: Would you believe that the “League of Legends” world championships—a video game tournament—consistently attracts more viewers than the Super Bowl? It’s true, if often overlooked by anyone over 40. The Morning Brew’s Business Causal podcast talks to John Robinson, who runs an eSports company called 100 Thieves. It has teams competing in various tournaments, earning most of its money from brand sponsorships. The restaurant chain Chipotle is one of its sponsors. Another is Rocket Mortgage, whose owner Dan Gilbert is also an investor (and also the owner of the Cleveland Cavaliers basketball team). The rapper Drake, Salesforce founder Marc Benioff and the famed venture capital firm Sequoia are investors in 100 Thieves as well. Robinson said the core eSports audience ranges between ages 15 and 35, with a large number in their late 20s. The competition isn’t other sports, he insists. The competition is alternative entertainment options like Netflix and TikTok. Gaming, he adds, is the second biggest category of viewership on YouTube, behind only music. What’s more, eSports is a global industry, and one that flourished in 2020 as Covid kept people indoors. In some cases, other sports are getting into the action. The National Basketball League, for example, now has its own eSports joint venture with gaming developer Take-Two. Last year, after their season was temporarily halted, Major League Baseball and its players teamed with Sony to launch an eSports video baseball tournament streamed through platforms like Google’s YouTube and Amazon’s Twitch. But big sports leagues have to be careful. If they put too much of their content online, they could jeopardize their huge television contracts.
Guns: It’s a good time to be a gun seller. The Economist, citing Jurgen Brauer of Small Arms Analytics, says industry sales of handguns and long guns rose to a record 22.7m last year, up a massive 63% from 2019. Guns and efforts to limit their ownership is a central issue in America’s culture wars. The fact that it’s such a lucrative industry adds an extra layer of complexity when trying to devise policies acceptable to all.
Oil prices are headed up: If Jeff Currie were a professional basketball player, he’d play for the Bulls. Because he’s nothing if not bullish about oil. Prices are bound to rise, says the Goldman Sachs analyst, as the economy emerges from the Covid downturn (and responds to government stimulus measures). In fact, oil is already rising, and so are other commodities like metals and grains. Saudi Arabia’s recent decision to cut output is contributing to the trend. So is strong demand from China. So is a weakening U.S. dollar, which makes oil cheaper for foreign buyers (oil is priced in dollars no matter where it’s bought and sold). The dollar, by the way, might well weaken further as Washington greatly increases the dollar supply to fund Covid relief. Currie also points to underinvestment in the sector, with oil majors pressured by environmental concerns. U.S. shale producers, for their part, were devastated by last spring’s price crash. Yes, the world is moving away from oil. But as analyst Daniel Yergin explains, it’s not like all those gas-fueled cars will go away tomorrow. The transition will take years. In fact, prices have already broken the $40-to-$50 “virus alley” he wrote about in December. Yergin, by the way, authored “The Prize,” a seminal work on the history of the oil industry.
Oil prices are headed down: Yes, the economy is coming back. But it will take years before the world recovers to 2019-levels of output. Just think of all the planes airlines have permanently grounded and what that will do to jet fuel demand. Saudi Arabia’s output cuts notwithstanding, there’s still an enormous incentive for virus-ravaged exporting nations to increase production. The incoming Biden administration could ease sanctions on Iranian oil in exchange for revived nuclear concessions. Perhaps tensions with Venezuela might ease as well. As Yergin explained in a recent Wall Street Journal piece, U.S. oil production is still double today what it was in 2008, when the shale revolution was just getting started. (The U.S. is now the world’s largest oil producer, ahead of Russia and Saudi Arabia). At the current price of more than $50 a barrel, more independent producers will find it economical to increase output. And true, the move toward electric cars won’t happen overnight. But it is happening. Citigroup’s Ed Morse, tells The Economist about the waning influence of urbanization, infrastructure investment and rising emerging market middle classes—these were key forces in driving up oil prices between 2000 and 2015. There’s still a lot of oil still in storage too. And for all the happy talk about vaccinations, the Covid virus continues to badly disrupt economies.
President-elect Biden unveiled a $1.9 trillion stimulus plan last week. But can he get it through Congress? Democrats will control both the House and Senate but with ultra-thin margins (a mere one vote in the Senate). The plan includes big money for vaccine distribution, health care, schools, unemployment insurance, small business relief and state and local governments. It will also provide $1,400 checks to qualifying individuals. Can the heavily indebted U.S. government afford another $1.9 trillion in spending? That’s a big debate topic, with supporters pointing to ultra-low borrowing costs and opponents concerned about inflation and dollar devaluation (see last week’s issue on Modern Monetary Theory).
Fed chairman Jerome Powell, speaking last week with Princeton University, downplayed the risk of inflation. He mentioned labor market slack and demand weakness abroad as two reasons why. The Fed will not, he insisted, tighten monetary policy any time soon. If inflation does emerge as a problem? The Fed has plenty of tools left to address it. Powell compared the current crisis with the 2008-09 downturn, both very different in his eyes. Back then, there was an unsustainable housing bubble made worse by an undercapitalized banking system and high rates of household debt. This time is more like a natural disaster, inflicted on a well-balanced economy with healthy banks and households. Non-finance companies did enter this crisis with lots of debt. But surprisingly few of them have defaulted. Though not his domain, Powell generally supports an expansionary fiscal response, having seen the drag that fiscal contraction caused after the last crisis (Congress passed a $787b stimulus bill during the crisis but pursued a more austere path in the first half of the 2010s; state and local governments cut spending as well). As for the Fed’s monetary policy last year, it was fast and forceful—the bank adopted a more tolerant inflation policy, it lowered rates, it bought more Treasury bonds, it stabilized Treasury markets, it backstopped corporate bonds, it created new direct lending facilities, it established dollar swap lines for foreign central banks and so on. So what now? Powell says he’s most focused on avoiding long-term labor scarring, the phenomenon in which workers lose their skills because they’ve been out of a job for so long. More inclusive growth is another goal. The Fed meanwhile, is actively studying the hot topic of central bank digital currencies (CBDCs), something China is actively pursuing. But there’s no rush—any decisions on that will be measured in years not months. There are however efforts to devise new regulations for private-sector digital coins. By the way, does the U.S. government have too much debt? Powell isn’t alarmed by the current level. But the longterm trajectory, he warns, is indeed unsustainable.
The U.S. federal deficit—that’s the difference between how much Uncle Sam spends each year and how much revenue he takes in—widened to $572b during the final quarter of 2020 (October to December). That’s up 60% from the same period a year earlier. Washington is spending more, of course, to provide relief from the Covid crisis. Outlays jumped 18% y/y. Incoming revenues were actually flat. The government’s six largest categories of spending were social security benefits, defense, Medicare, Medicaid, interest on debt and unemployment compensation. The two big categories of revenue sources are taxes on individuals (income taxes and social insurance payroll taxes) and companies.
Austin, the next Silicon Valley? Not so fast, writes Texas Monthly. Citing the Computing Technology Industry Association, Austin’s tech sector generated $33b in gross product in 2019. The combined San Francisco and San Jose Bay Area’s figure was ten times that. In other words, Austin has a long way to go. That said, the Texas capital has lots of momentum, attracting companies like Oracle, which just moved there from the Bay Area. The city’s most famous tech company is Dell, founded there in 1984. Austin also happens to be the fastest-growing big city in the country in terms of population (see chart).
Seattle, like Austin, is a technology boomtown—so much so that it just passed Atlanta to become the tenth largest regional economy in the nation. That’s according to Greater Seattle Partners, which analyzed Census data. The website Geekwire, reporting on the study, said Seattle-area GDP grew 5% in 2019, only about a point less than China’s GDP increase that year. As this week’s chart shows (see below), Seattle has only the 15th largest metro area by population. New York City is still the largest regional economy in America, followed by Los Angeles. San Francisco and San Jose, if you count them together, would rank third ahead of Chicago. Next on the Greater Seattle Partners list are Washington, Dallas-Fort Worth, Houston, Boston and Philadelphia. Note also that U.S. economic output is heavily concentrated in large metros. The top 25, in fact, account for more than half of national GDP.
Delaware, the first state to ratify the U.S. Constitution in 1787, will soon have its first home-state president: Joseph Biden, a longtime resident of Wilmington. A November Wall Street Journal article looked at his relationship with DuPont, for many years Delaware’s largest employer but today just its 12th largest. The chemical company’s misfortunes, stemming in part from Asian competition, led to an investor’s campaign for a restructuring, which in turn contributed to mass job cutting and a 2017 merger with Michigan rival Dow. The article examines the influence of Dupont’s fate on Biden’s opinions about the economy—it seems to have convinced him that the form of capitalism currently practiced in the U.S. favors investors over workers and their communities. We’ll see how that colors his future policies and proposals. But what does Delaware’s economy look like today? It’s also lost some big auto plants in recent decades. In 2005, Bank of America bought Delaware’s largest financial firm MBNA. Nevertheless, Wilmington remains a major financial center, specifically for credit cards. While it’s not home to many corporate headquarters, Delaware is where most major U.S. firms are legally incorporated—that’s simply because its corporate laws and courts are very business-friendly. Who’s the state’s top employer today? That would be Christiana Care, yet another manifestation of health care’s increasingly omnipresent role in the U.S. economy.