Mr. Shove: I cover the managed care companies - I tend to call them health insurers - and I cover the PBMs (pharmacy benefit managers), which are sort of like drug insurers but they don't actually insure. They administer the payment of our claims.
TWST: What companies specifically do you cover?
Mr. Shove: I cover Aetna, CIGNA, Coventry Health Care, UnitedHealth Group, WellPoint, Health Net, Amerigroup, Centene, HealthSpring, Humana, Universal American - those are all health insurers. And then in the PBM space, we cover Express Scripts, Medco, Catalyst Health Solutions and CVS Caremark.
TWST: What are the big trends that affect the sectors you cover at the moment, given the economy and the health care plan?
Mr. Shove: There are a couple of things. One is politics, and we will set that aside because I don't know if that's a trend or an event. There is an awful lot of political activity across health care with the President's reform proposals and all the other reform proposals. If we put that aside, a couple of things are happening related to the macro economy and a couple of things are happening related to trends in health care. On the macroeconomic side, one is less people are getting insurance, and that's because most people who have insurance get it through their boss, and employers are continuing to layoff employees and unemployment is rising. So less and less people have insurance. A piece of that is also related to some secular health care trends, and that is that the cost of health care and health insurance continues to go up rapidly. More and more people cannot afford health insurance. So the number of uninsured is rising for two reasons, one is the price and the second is the economy. The other thing that's happening and is sort of the inverse is more and more people are going on government programs; it's the inverse of what's been happening in the employer sector. It isn't enough to stop the loss of the uninsured, but more and more people are going on Medicaid. And of course we are aging, and so the number of people on Medicare is rising. Americans are looking at more and more private options in those programs. So there are companies that are subcontracting to both Medicaid and Medicare that cover people in those programs. Those programs are growing in terms of the number of people under them, but the earnings are under pressure because those programs' budgets are under pressure.
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