Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major...

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Forecasting Alaska’s Economy: 2016-2027 January 18, 2017 A presentation by Jonathan King

Transcript of Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major...

Page 1: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Forecasting Alaska’s Economy: 2016-2027

January 18, 2017

A presentation by Jonathan King

Page 2: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Overview

We’re in a Recession

The Timing of How We Got Here

Where We are Headed

The Next Big Thing (Our healthcare system)

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Page 3: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

When does a Recession Begin?

Layperson’s definition is two quarters of negative gross domestic or state product (GDP/GSP).

In reality, the start of national recessions are designated in retrospect by a group of economists at the National Bureau of Economic Research looking at a broad array of factors.

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Page 4: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Predicting Recessions in Alaska

Gross State Product in Alaska is:

The value of all of the goods and services produced in AK…

Largely tied to the value of oil exports…

Highly variable from quarter-to-quarter because of oil production maintenance schedules….

Highly variable from year-to-year because of the price of oil.

If we used GSP to measure recessions we’d have to acknowledge that we’re entering our fifth full year of recession.

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Page 5: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

The Value of Our Economy

20.318.8 19.3

21.222.6 23.4

25.228.0

32.5

36.7

40.9

46.9

41.4

44.7

48.950.6 49.8

47.9

42.239.5

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($U

SB)

Source: BEA 2017

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Page 6: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Looking for Consistent Year-over-Year Job Losses

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-1%

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-ove

r-Ye

ar E

mpl

oym

ent C

hang

e

Source: ADOLWD 2017

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Page 7: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Wage Growth Trend Broken

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Real

Wag

es ($

B)

Source: BEA 2017

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Page 8: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Household Confidence

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State and Local Expectations Alaska Confidence Index

Blue Skies

Mixed Reviews

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Page 9: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

-20%

-15%

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0%

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2013 2014 2015 2016

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-ove

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ar C

hang

e in

Job

s

Oil and Gas Construction Professional and Business Services

High Earning Sectors

Source: ADOLWD 2017

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Page 10: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

-20%

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e in

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s

Retail State Government

State Employment and Retail

Source: ADOLWD 2017

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Page 11: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Our Biggest Growth Sector

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hang

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Healthcare

Source: ADOLWD 2017

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Page 12: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Where Are We Headed?

2 Basic Things Determine Economic Robustness:

Money coming in….

Money going out….

Rich economies bring money in and hold onto it.

Right now we’re doing neither.

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Page 13: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Three Legged Stool

Federal GovernmentEducation and Health Care

Direct Employment

Constructions

Oil Industry Direct Investment

State Revenues

Everything ElseFishing

Tourism

Air Transport

Mining

Graphic Courtesy of FNB Alaska

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Page 14: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Dynamic Forecasting with the Alaska REMI ModelComparable to ISER’s Man in the Artic Program (MAP)

Dynamic model which forecasts policy changes over time.

Best in medium to long term applications (5 – 50 years)

Model at the State and Regional (12) level

Used by Northern Economics for larger projects with dynamic policy implications:

Shell OCS

Alaska LNG

Susitna Watana

Recession Policy Forecasting

JBER Force Reduction

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Page 15: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

2015 Fiscal Policy Forecasting

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2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Tota

l Em

ploy

men

t For

ecas

t (W

age

and

Sala

ry +

Sel

f Em

ploy

ed, 0

00s)

Employment Actuals

Source: BEA 2017 and Northern Economics’ Alaska REMI Model 2015

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Page 16: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

2017-2026 Budget and Revenue Scenarios

Scenario 1

$4.2B Unrestricted General Fund;Reduced PFD

Scenario 2

$4.2B Unrestricted General Fund; Broad Based Tax

Scenario 3

3.2B Unrestricted General Fund;Full PFD; No Taxes; Step down over 2 years

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Page 17: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Caveats and Assumptions

USEIA Oil Price Forecast

No strong recovery

Nominal Dollars

Scenarios are in $2016

Additional assumptions

No major positive economic movers such as pipelines or significant new oil production

Does not account for the eventual “pop” of the healthcare bubble

All Forecasts are Wrong

“Forecasts create the mirage that the future is knowable”

-Peter Bernstein

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Page 18: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

2017-2026 Employment Forecast under Three Budget Scenarios

Source: BEA 2017 and Northern Economics’ Alaska REMI Model 2017

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f Em

ploy

ed)

$4.2B UGF; Cut PFD $4.2B UGF; Broad Tax $3.2B UGF; Keep Full PFD

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Page 19: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

2017-2026 Population Scenarios

Source: BEA 2017 and Northern Economics’ Alaska REMI Model 2017

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2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026

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l Sta

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opul

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n (0

00's

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$4.2B UGF; Cut PFD $4.2B UGF; Broad Tax $3.2B UGF; Full PFD

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Page 20: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

REMI Summary Results: 2017-2026

Employment

Employment bottoms out in 2019-2020.

S1: -25,000 jobs

S2: -24,000 jobs

S3: -33,000 jobs

Without additional fuel for the economy, employment does not meaningfully recover between now and 2026.

Population

Population loss from baseline in 2016:

S1: -32,000 citizens

S2: -31,000 citizens

S3: -34,000 citizens

While employment starts to recover around 2019, population declines start in 2017 and continue through 2026.

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Page 21: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Key Takeaways

Without stimulus, we have years left in this recession.

In aggregate, there isn’t much difference between a PFD reduction and a broad-based personal income tax because both reduce income for all or nearly all Alaskans.

However, who pays is very different.

PFD has outsized effects in rural/poorer areas.

Income tax captures income from non-Alaskans.

There’s likely a middle ground here.

The $3.2 UGF plan has the greatest overall effects because it involves directly cutting 18,000+/- State supported jobs with indirect effects accounting for the remaining 12,000+ in losses.

People without jobs are more likely to sell homes and leave, whereas reducing everyone's’ income a little leaves a poorer, but intact economy.

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Page 22: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

ISER/NEI Forecast Comparison

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Page 23: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Shifting Gears (a bit)

Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000 lives.

There are four major groups profiting from healthcare.

Insurance companies

Drug companies

Hospitals

Providers

These are all essentially oligopolies, but insurance profits are capped.

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Page 24: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

High per Capita Expenditures

Source: Wall Street Journal April 8, 2013

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Page 25: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Driven by Higher than Average Hospital and MD Costs

Source: Wall Street Journal April 8, 2013

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Page 26: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Real Costs Are Going Up

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Sur

gery

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geon

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rges

($00

0s)

2006 CPI Adjusted Actual Charges

By 2016 AK surgeons charged nearly 160

percent of the 2006 CPI adjusted amount.

In 2006 primary surgeon charges for a knee operation where

roughly $6,000.

By 2008 surgeons charged nearly $10,000 or 25 percent more than

the change in the consumer price index.

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Source: Confidential Peer-to-Peer Communications, 2017

Page 27: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

2016 Comparative Costs

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MRI Septal Defect Repair Single KneeReplacement

Hip Replacement Rotator Cuff

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Seattle Anchorage

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Source: Confidential Peer-to-Peer Communications, 2017

Page 28: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

So Why Are Costs Higher?

Oligopoly Power

Limited competition gives price setting power

The State’s 80 Percent Rule

Radically expanded the number and type of services in state, but handed power to specialists who can cartel to avoid “networking”

Lack of Price Transparency

The state has no law regarding price transparency

Isolation

Flying to Seattle isn’t convenient, safe, or appropriate in all instances.

System not set up to accommodate it when it is.

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Page 29: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

So What?

Size in our Economy

Single largest sector by wage and salary employment (50,000+)

Very likely more than 15-20 percent of state GSP when you include private, tribal, state, federal, and local components.

Vulnerable

Customers are starting to say “no” to high costs.

Will eventually succumb to the economy in general

It’s the cost driver for schools, retirement plans, etc., but…

…no one wants to prick “the bubble” when it’s the only thing that’s growing.

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Page 30: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Key Takeaways

Without a stabilization of the amount of money flowing into the economy Alaska will stay in employment recession until the 2018-2020.

Population recession could last much longer.

The economic differences between the analyzed policy options is slight between the PFD and income tax scenarios, but the “on the ground” societal implications are quite different.

The $3.2B UGF scenario is likely to remove 20%+/- more jobs from the system than the other scenarios.

Alaska’s healthcare system is an economic driver, but it takes money away from the rest of the economy. Convenience at a very high price.

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Page 31: Forecasting Alaska’s Economy: 2016-2027Shifting Gears (a bit) Alaska healthcare costs are a major cost driver of the state’s economic crisis. The state insures roughly 400,000

Thank you from the NEI Team!

While only one presents, many hands built this presentation.

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