Commercial Real-Estate Bubble “Can Breathe Easier” after Health Bill Collapsed in Congress

To keep from deflating, property bubble needs Obamacare.

When the effort in Congress to pass a health-care bill – the American Health Care Act, designed to replace the much maligned Affordable Care Act – failed on Friday, the thing that wasn’t supposed to happen happened: The industry that had whined for years about this, that, and the other in the Obamacare law, breathed a huge sigh of relief.

On Monday, despite the general unease in the stock market, heath care stocks rallied. Well, they didn’t exactly rally, they edged up. But it made them the best-performing sector among the 11 S&P 500 sectors.

But no one apparently breathed a bigger sigh of relief than the over-indebted and teetering Commercial Real Estate sector. Investors, including the largest asset managers in the world, had experienced the rich benefits of a multi-year mega construction boom of hospitals, medical office buildings, and other health-care facilities to accommodate the ballooning industry that is taking over the US economy and provides 16% of its private-sector jobs.

Property prices had soared over the years as part of the overall commercial real estate bubble. It has gotten so huge that if it deflates, it risks taking down the banks, particularly smaller banks where CRE lending is heavily concentrated.

Even Federal Reserve governors admit its policies since the Financial Crisis have helped fuel this bubble, and it admits that it is a bubble, and references to it keep showing up in their statements and speeches as the fretting has begun. Among them, Boston Fed President Eric Rosengren, a Fed “dove,” is now worried that the commercial real-estate bubble in the US has once again become a risk to “Financial Stability.”

Just how relieved are commercial real estate investors really? Chris Muoio, Senior Quantitative Strategist, Ten-X Research, of online CRE platform Ten-X, put it this way on Monday:

We noted at the beginning of the year that the new presidential administration in D.C. potentially increased risks for certain commercial real estate sectors as proposed regulatory and legislative changes could alter the growth trajectory of industries and with that the demand for certain types of commercial real estate.

One of the sector’s that faced the most acute possible changes was medical office/retail as the new administration proposed sweeping changes to health care legislation. Hospitals and medical offices faced the prospect of lower demand for health care services as the proposed legislation would have reduced the number of insured patients and the growth pace of federal spending on health care.

Which sums up what the sector has been expecting year-in and year-out: endless growth in revenues, paid for by government entities, insurers, and the flow of premiums. Throw doubt on these endless growth stories, and health-care focused real estate quakes in its foundations. The note goes on:

Following the withdrawal of the proposed American Health Care Act, real estate investors in the medical and health care space can breathe easier as it appears this risk has dissipated.

The proposed legislation was scuttled late last week as it became clear it lacked the votes to pass the House. The current rhetoric out of Washington signals a desire to move off of the issue and towards other policy initiatives.

Commercial real estate investors should continue to monitor the machinations in Washington carefully, as the administration could revert to the issue at a later time, but for now it appears the existing fundamental story underlying health-care based real estate, which has produced uninterrupted growth in health care services, should remain intact.

CRE investors are among the biggest beneficiaries of the health care monster that has been draining consumers, businesses, and governments for years, starting way before Obamacare was even a word. And for as long, this health care monster has been cannibalizing other sectors of consumer, business, and government spending.

So it makes sense that commercial real estate investors, at the peak of this bubble, are dreading any little thing that might possibly derail that gravy train.

Booms and busts have historically been driven by speculation and over-borrowing, often triggering recessions. This time, the health care sector, after years “of unsustainable growth,” has become the biggest “systemic recession risk” to the US economy, as the debt binge that funded it, hits its limit. Read…  Health-Care Industry Debt Turns into “Systemic Recession Risk”

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  59 comments for “Commercial Real-Estate Bubble “Can Breathe Easier” after Health Bill Collapsed in Congress

  1. Willy2 says:

    – It now will only take more time before the Healthcare sector is going to break under its debt burden.

    • MoMoney says:

      Given the thumb of the gov to force everyone in to the system (for everyone’s good of course), you can be assured Healthcare will not break until the gov breaks (it should be evident the puppeteers are corralling everyone to gov controlled single-payer). Thus, the BEST place to park your money for a guaranteed and everlasting returns is healthcare. More so than real estate…that is, until a gov housing mandate is released.

  2. Justme says:

    I have never seen so many new hospitals finished, being renovated or under construction in Silicon Valley as I did after 2008. It’s astonishing. You would not think there was a near-depression going on.

    • TJ Martin says:

      Here on the front range from Colorado Springs to Fort Collins you can hardly drive by a hospital that isn’t expanding , renovating or building new campuses .

      Funny thing though is how many of those ongoing projects seem to be in a state of permanent suspension

  3. unit472 says:

    Imagine an industry that bills YOU $8000/day for your room and the police, finding a derelict passed out behind a liquor store, bring him to that hospital and the staff puts this ‘patient’ in the empty bed next to you. You are recovering from an eye injury. He is drying out and I have the pleasure of not only being responsible for my own medical bills but his too.

    We need a tiered healthcare system. Yeah, I know health care is a ‘human right’. In a pigs eye. Michael Jackson can have his own doctor and a Saudi Prince can take over the entire floor of a hospital but a gangbanger with a gunshot wound or a some idiot overdosing ( again) will get priority over YOU or your family in the ER!

    • TJ Martin says:

      That unit472 … is an over exaggeration verging on an alt right lie .

      • unit472 says:

        Unfortunately it is the truth. Happened to me twice though the second time I complained loudly to the nurse and the drunk who was admitted and he signed himself out of the hospital. An anecdote that shows how cost shifting has affected healthcare.

        In 1972 I happened to be in the car pool for the California Delegation at the 1972 Democratic Convention in Miami. A state delegate ( believe his name was Mead and had achieved some minor renown for refusing to wear a neck tie in the state assembly) became ill and requested a ride to the hospital. I drove him and he passed out enroute. At the emergency room admittance desk they wanted to know his insurance provider or who would be responsible for his medical bills. I assured him that as a member of the California Assembly he would have insurance but I did not know the details. Mead was admitted.

        While I was there a cab driver came in with the same predicament. A fare had become unconscious in his cab and the cab driver, not knowing what else to do, took him to hospital. This was the second one he had been to. No dice. Take him to a charity hospital cause he won’t be admitted here. Can’t do that today. They have to take you and cost shift the bill onto private pay or government.

        • David Calder says:

          Do you know who changed that rule?? It was Ronald Reagan in 1986.. He managed to get a law passed that hospitals turn away no one whether poor or undocumented. I’m probably a bit older than you, Unit472, and saw snake bit farm workers in Florida refused help in 1966 until we all could scrounge up the money. We all had so little but none of us were fighting off the effects of a Florida diamondback.. I can’t imagine you want to go back to those days.. You self-diagnosed your roomy as a drunk but could there have been some underlying problems that you knew nothing about?

    • Jerry Bear says:

      Could it be they are doing that because these others are in much greater danger of dying? Oh well, I guess life should be cheap or something….

  4. SH says:

    Talking to commercial developers the plan is retail on ground floor, medical facilities on the next 2 floors and above apartment rentals. When we went on a drive last weekend, I remarked to my husband what is the contingency for the medical leases with the end of Obamacare; it can cause a massive collapse in real estate locally (Brooklyn, Queens) they are literally everywhere.

  5. mvojy says:

    Walk around any city and find many empty storefronts. Each time they close it takes longer and longer to find a new tenant. I’m even seeing casual dining and fast food places close. It takes lots of tenants to pay those loans back where the owners sucked out and spent their equity. Higher debt has lead to higher rents demanded.

    • Petunia says:

      I’ve been watching some of Dan Bell’s Dead Mall Series on Youtube. It’s scary to see the demise of prime commercial real estate all over the country documented. He also does plenty of filming in Baltimore which is now another Detroit.

      • Ethan in NoVA says:

        Great series! He visits a few malls in the Norfolk VA region that I am originally from.

        The rent is too high (and ecommerce too popular.)

    • chris Hauser says:


      strikes me healthcare is so expensive in this country because so many fingers are in that pie.

      when newly minted doctors want to rent from me, and their starting salary is 270k…..ah, never mind.

      innovation, and all that.

  6. mvojy says:

    All of the stand alone practices adds to the cost of our inefficient healthcare system. Each one is paying market rents and overhead along with administrative staff and outside services which run up our healthcare costs. Other countries put ALL of their doctors and specialists under 1 roof called a “hospital” so people just go see the doctors they need to in 1 visit. No taking a day off work to see a doctor that’s just going to refer you to another where you have to take ANOTHER day off of work to see.

    • Paulo says:

      Actually, that is not exactly correct. I live in BC, under single-payer. I have had to see many specialists over the years. None of them, not any doctor…… from GP to heart surgeon, specifically see patients in a hospital setting unless they have already been admitted and are sick. They are most definitely NOT under the same roof, but a particular clinic may have a few partners who are specialists. It just depends. Rather, they simply have admitting priviliges to public facilities for belonging to the public system. Doctors are all private corporations, and are a part of, or run their own private clinics under the auspices and restraints of the public system rules, guidelines, and fee structure.

      This is how it works.

      Imagine I have booked an appt for an annual physical. At the appt. I mention that it is time for my 5 year colonoscopy screening (if the Doc doesn’t mention it first). He makes an online referral to the specialist. In my town it would be a gastrointerologist/surgeon. If it is a routine screening and not an emergency, it might take 1 month for the appt (at the surgeons own clinic), and maybe another 2 months for the proceedure to be done at the nearby hospital, (day surgery). It just depends on how busy everything is. However, if my GP decided any symptoms I might exhibit could be more serious, say colon cancer, I would get in right away to see that particular specialist. If I was referred to a urologist for something else, say, I would have to travel to another town entirely where an office of several urologists have their separate practices under one roof. If I had a heart issue, I would have to attend a different clinic in our town owned by two local heart surgeons, however, if further tests (which might be done at the public hospital) showed something more complicated, then I might have to travel to a city, several hours away. If I lived in a major city, (which I don’t), I could have anything done without leaving the area. As a rule, the more specialized a practice is, the larger centre the doctor works out of. In the nearby village where I live (rural), we have a small clinic with 2 nurse-practioners. I prefer to use my own doctor and his clinic which is a 45 minute drive. About 20 doctors own the practice which also includes a lab, pharmacy, and heart surgeon suite.

      What is the same the Province over, is the cost. Under single-payer the patient does not pay for anything at or after services are provided. In my 61 years I have had broken legs, abdominal surgery for peritonitis, cancer, herniated discs etc. I have never received a bill. I chose to leave hospital after surgery asap because I hated it, but if I had to stay there would be no bills or rush to be pushed out. I have always been in excellent health, a non-smoker, and only have an occasional drink. Our family is active and eats our own organic food that we grow oursleves. However, even healthy people can get sick or hurt…even the young. :-) My peritonitis was my own fault because I was too busy working to take time off to go to the doctor….appendix ruptured. Back problems were caused by lifting too much at work….broken leg from skiing. Now, I am smarter and get a regular physical. In fact, my cancer was caught at stage 1 and cured very quickly because it was picked up my my GP.

      If you have to travel for away medical appointments all expenses are tax deductible.

      Single-payer is the way to go. The doctors who work under it in Canada are still very well paid and wealthy compared to others in the community. They are always held in high regard, as are nurses. They also have a pension to look forward to, both doctors and nurses. The only real difference is that the single-payer system is non-profit, and the insurance skim is removed along with investor returns.

      Best of luck, because I believe the large US health insurance companies, and private hospitals, will do ANYTHING to keep the skim going. Anything.


      • The Housing Bubble says:

        Socialized health insurance doesn’t work. Never has.

        • Paulo says:

          See my comment up top, Housing Bubble. It most certainly does work well. Just ask my wife who is a 60 year old type one diabetic. She contracted the auto-immune disease when she was just 10 years old. Every day we give thanks for our single-payer system. Every day, my friend.

          The cost in Canada for health care per capita is 50% of the hybrid-private US system…with better outcomes.

          regards and with respect:

        • The Housing Bubble says:

          Of course it’s great when someone else is paying for it.

          Sorry my friend but there is no free ride.

        • Tim says:

          The US system health care system is poster child for free ride, for parasitic rent extraction. The Canadian system has cut that.

        • The Housing Bubble says:

          Both are failures.

        • 728huey says:

          On the contrary, it works quite well when resources and effort are put into it. Medicare works just fine, desire all of the biased media coverage to the contrary. Its huge issue right now is the fact that a large wave of Baby Boomers are becoming eligible for coverage, and that is putting a financial strain on the system. It certainly works a lot better than what was common before Obamacare, with families paying skyrocketing premiums for insurance that wouldn’t even cover all medical expenses and kicked people off coverage for either pre-existing conditions or paltry lifetime benefit maximums.

        • Jerry Bear says:

          Most of the advanced countries use it and it works quite well, How can you be so blind as to say that?

        • Begbie says:

          Every Canadian I have ever spoken with-I live in a border state-has nothing but good to say about their healthcare system, including very wealthy Canadians. But you can keep repeating the Fox mantra.

        • The Housing Bubble says:


      • The Housing Bubble says:

        By there very nature, it is subsidies like medicare and mandatory insurance that drives medical services to inflated levels. Remove the subisidies and the price floors are removed.

        And you guys call yourselves smart?

        • Jerry Bear says:

          You could not be more wrong. It would just make medical care unafordable for most people. Give up on your infantile libertarianism.

        • The Housing Bubble says:

          Lower prices increases affordability my friend.

        • David Calder says:

          The “subsidies” are what we are paying to the health insurance companies. My dad was Canadian from NB where all of his family had national health care. Mom was from Maine where only those who had jobs that paid for it got coverage. The difference in longevity and general welfare was stark.. Same Anglo-Saxon people and mostly related on both sides of the border but there is where any similarities ended. Health care and medicines cost less in Canada then and still today. The same drugs produced in the US and sold in Canada cost less than in the US.. I’m all for removing subsidies but that would bankrupt the insurance companies which might finally give us single payer.. You are right though, there is no free lunch but why does that mean we must pay for a CEO’s yacht or fund his offshore bank?

        • Your Good Friend says:

          Price floors are established at artificially high levels. Subisidies result in price floors. Get rid of the subsidies and the prices fall.

      • marty says:

        Oh, you get the bill Paulo. It’s called taxes.

  7. Quite Likely says:

    It’s interesting the conflicting impressions of Fed action by macroeconomist types and finance types. The more sensible economists are all huge doves, because they see that the economy is still operating way below capacity, and that it’s crazy to be ramping down stimulus in this situation. The finance types care less about that, and are hawks because they see that low rates are inflating a bubble. Of course what would be ideal is fiscal stimulus that would do what the economist know needs to be done to stimulate demand while not having the negative consequences of doing so via monetary policy. But short of that, what’s more important, deflating the bubble or boosting a still stagnant economy?

    • Wolf Richter says:

      Bubbles, when the deflate, which they always do sooner or later, have devastating and very real economic consequences. Trying to create economic growth by creating asset bubbles works for a few years, and then it all blows up.

      Bubbles are also a huge wealth transfer. The winners are those that get out in time. The rest are the losers, including taxpayers, workers with wages, and so on. We know that from experience in the US where we’ve had plenty of asset bubbles, and all of them imploded sooner or later.

      • The Housing Bubble says:

        Yet it is the elements that drive the bubble that are most damaging.

  8. Petunia says:

    Every time Madison Ave. retailers in New York City start hurting it signals a downturn. Shops there are closing and rents are dropping and this where the rich really shop.

    I also hear, from people I know in the Palm Beach area, that the president’s visits are hurting business. Almost every other weekend he’s in town, the gridlock is so severe people just stay home. Worth Ave., the main shopping street in Palm Beach, is said to be dead those weekends.

    • The Housing Bubble says:

      This is all positive economic news. Until prices fall to much lower and more affordable levels, this moribund economy will never recover.

      17 years of a disastrous economy isn’t enough for you?

    • Paulo says:

      I guess that’s what happens with a President Golf who takes every weekend off. :-)

      • Niko says:

        “I guess that’s what happens with a President Golf who takes every weekend off. :-)”

        I think he was term limited

    • steelhead says:

      Remember Italy…. snark

    • Kasadour says:

      That’s going to change soon. A very large helipad is under construction at Mar a Lago right now.

      Regarding asset bubbles: they are devastating for a number of reasons, they can’t be controlled back down to normal levels, in each case bubbles burst suddenly, subject to unknown variables, they skew prices and values, and money is wasted and/or misallocated.

      ACA is doomed to collapse. Maybe the failure of AHCA is a temp. stay for CRE, but ACA won’t last another year. The Donald may just end up forming a coalition with the democrats to “fix” ACA when it collapses since it’s obvious the republicans don’t care about a congressional majorly splitting themselves into 3 opposing factions.

      • economicminor says:

        Everything is doomed to collapse.. We are living thru multiple mega bubbles and they are all tied together.

        When the ACA collapses, it will take out debt on medical CREs and the CRE’s are all tied together in CMBS and underwritten by derivatives and all that is held by only a few shaky institutions with no contingency (held back disaster) funds.

        It isn’t that this sector or that sector will collapse because we all know that all these parasitic entities are feeding off a host that is dying > The American Middle Class is being sucked into this black hole of exponential debt.

  9. economicminor says:

    Thanks Wolf! Very interesting insight.. I have noticed that Southern Oregon has had the same build out of medical facilities too. Our small regional hospital complex has had a new urgent care center with lots of additional office space, a Woman’s Health Center, a Chemo center and many new doctor and dentist offices. All since 2008. The main hospital in Medford has also expanded a lot. I didn’t really relate any of that to Obamacare. I just thought it was because of the cheap easy monetary policies.

    Sure are a lot of bubbles everywhere

    • Kasadour says:

      Ah, a fellow Jeffersonite. Yes, I’ve noticed the same thing in the 51st state of Jefferson, Illinois River Valley.

  10. JB says:

    It is egregious that healthcare has contributed so much to GDP growth over the years . It’s contribution to GDP growth has been almost 1 % in some periods fostered in part from obamacare . Are Americans getting sicker ? I don’t know much about economics but this can’t be good.

  11. Wilbur58 says:

    A lot is being made of the Republicans failing to pass a replacement for Obamacare. Mainly, it’s being blamed on ‘obstructionists’ in some vague kind of way. “They just like saying ‘no’.”

    In the way of Occam’s Razor, isn’t it most likely that the health insurance industry simply bribed enough Republicans into maintaining the status quo? You know, these would be the same health insurance folks who got the Democrats to pass the less-than-stellar Obamacare. “Yeah, we’ll do the pre-existing conditions thing and kids can stay on the parents’ plan longer. But in return, we want everyone paying us some serious premiums, including people previously uninsured. In return, we’ll give each of you Democrats $2 million dollars!”

    • chris Hauser says:

      anybody who thinks lobbyists et al were shut out of the recent “legislative package” is, well, um, ah, correct?

      and i live here, right up the street.


  12. Paul says:

    A great Captain can motivate the crew to keep working until water starts lapping their bottom lip. But by then it’s too late to save anyone, except for the Captain who’s already left the sinking ship.

  13. R Davis says:

    “if the property bubble bursts it risks taking down the banks .. especially smaller banks”

    How can a bank keep lending based on appreciating property prices ..
    When the appreciating property values are based on IN HOUSE BUYING & SELLING ?

    The property investment companies have their finger permanently glued to the Insolvency & Bankruptcy Button.
    One real hint of an interest rate hike & BINGO & you only get to repay 10 cents in every dollar.
    In declaring Bankruptcy successfully you need to press at exactly the right second or you are caught out & have to pay up.
    If the banks do not find a way to increase interest rates without it affecting them .. they are gone.
    Unless the governments of the nations BAIL THEM OUT.
    Mark Carney governor of the Bank of England .. is keen on BAIL-IN to solve this problem.
    10% of all savings in any & all banks will not cover the bill .. sorry Mark.

    As an observer .. I personally would welcome the property bubble bust .. it will be interesting to see who is left standing & in what condition they are found & I bet you would also Wolf Richter.

  14. Ed says:

    Well of course. Lot of that commercial real estate is in the medical industry. Health care related REITs are supposed to do well.

  15. c smith says:

    “…paid for by government entities…” No such “entity” exists. Government pays for nothing. Either taxpayers pay, or the costs are paid with inflated dollars, in which case savers and investors pay.

  16. mean chicken says:

    The FED has demonstrated they have no moral compass, just like corporations who place themselves 1st, above the citizens.

  17. Shawn says:

    Bubbles are the new norm, it’s the only thing that grows the US economy these days.

  18. The Housing Bubble says:

    California 2017 February Pending Home Sales Dial Back, Marking Weakest February In Three Years – Central Valley Down 11.4 Percent’

    ‘Santa Cruz and San Francisco counties experienced the largest year-to-year reductions in pending sales of 40.6 percent and 23 percent, respectively.’

  19. Very Curious says:

    I’m very green and new to economic trends, investments and money management. But all jokes and humor aside, what would be the best way to manage a million in cash if I had it. Not that I do at this point but I am seriously curious as to how one would invest a million right now under these precarious and unpredictable times. Serious advice only. Stocks (probably not), real estate (prob not), gold? Or just put it all in some safe box some where in cash? What would be the advice during historic times as this?

    • The Housing Bubble says:

      If you’re prepared to lose every penny of it, buy a house. If you’re not prepared to lose it, hold onto it tight. You’ll need every last penny of it.

  20. Willy2 says:

    – However, it’s more complicated than this. The Healthcare (HC) insurers are actually more powerful than other parties in other HC related sectors. The HC insurers determine the profit margins of those other HC players. And one of those affected by decisions made by HC insurers is Commercial Real Estate.

  21. Willy2 says:

    – In other words: Healthcare (HC) companies have benefitted from Obamacare. In that regard HC has been subsidized by the US taxpayer.
    – Mediacare part D (approved in 2006) also increased the profitability of the HC sector in 2 ways (at the expense of the US taxpayer):
    1) it increased the benefits for people of 65 and older.
    2) It made it much more difficult or even impossible to import drugs from abroad. Thereby allowing the pharmaceutical companies to (dramatically) drug prices.

    • Willy2 says:

      Correction: Thereby allowing the pharmaceutical companies to (dramatically) increase drug prices.

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