Demographics and Politics are inseparable. As a consequence, your practice will be impacted in a major way.
Watch the video here:
A Note from Scott McDonald on This Week’s Episode:
At this time, the World is getting a little crazy. In fact, the craziness is right at the nexus of politics and demographics (which is the subject of our episode today.)
In this episode, I discuss the specific aspects of demographics that are causing all the craziness. And it is worth considering in some detail how folks seem to want to look at politics as a “blood sport.” No, I don’t discuss much the morality of choosing one side or another. Assigning blame is unwise. But it is true that if you are going to choose an area to purchase or start a practice, some places are going to look much better than others. Hey, that is my job. Right?
If we were to look at specific states (both good and bad), North Carolina and Tennessee would come out on top. But WHY do they look good? Sure, growth is good but that isn’t a complete answer. In the end, folks are voting with their feet. And what “their feet are telling them” is what matters.
In this episode, I want to go over the top trends that are helping doctors decide where to practice. And these factors are changing frequently! Don’t be left behind.
Read the Demographics and Politics Transcript Here:
Scott McDonald: [00:00:14] This is Scott McDonald a Dr. demographics dot com and it’s getting to be that time of year or we’re talking about nexus of politics and demographics. Now this is a concept that I’m sure a lot of people know about. Unfortunately, a lot of those people forgot all the things, things I’m going to talk about when they were in junior high. So we’re going to go through a little lesson in civics and discuss why it is important for you to understand this, because it’s going to have an impact on the demographics of your practice. Now, demographics and politics are not separate. Remember the reason that we started the US Census Bureau where we count noses and determine where people live and where they’re moving? The major trends in the country is because of politics. The founders of the country tried to come up with a method that they could determine where people are moving and where the dominant populations can be found. With that in mind, they can make projections on voting rolls, but also where electoral power can be found. Now, the reason I’m bringing it up is because this is the first real election since the US Census Bureau came out with the new numbers and a lot of people are very sensitive about what’s happening. In fact, they’re mad. Now, part of this is because of what the political outcomes of elections have been. We talk about Roe versus Wade and everybody’s up in arms and they’re thinking about a lot, a lot about this.
Scott McDonald: [00:01:58] And I understand why it’s an emotional issue. And it’s well, the legislation was passed 50 years ago, and it has only recently changed because of that. Some people are crying foul. You can’t change the law. But in fact, we know you can. And why these changes are occurring and the changes that are going to be occurring are important to having a practice. So some people are going to say, why are some parts of the country growing and some are shrinking? Why are some places in the country gaining in political power and others are losing political power? That’s what our lecture is about today politics and demographics. And this is extremely important. So please pay attention. Here we go. All I ask is that you remember that demographics and politics are not separate. And in fact, how they operate I’m just going to go over this briefly is important for everyday doctors to know, especially if they’re going to make projections and plans to buy a practice or start up a practice or move to a particular part of the country. Please. Like I said, this is important. Now it seems that many people don’t know or have forgotten that the reasons that we have a national census is really to determine. What is likely going to happen. It seems that many people don’t know or have forgotten that the reason we have a national census is to determine the distribution of congressional seats in the House of Representatives.
Scott McDonald: [00:03:55] Not just because the population is growing doesn’t mean that we create a number of new seats to represent the population. A lot of people kind of forget that. They sort of think, well, this state is growing, therefore, they should get more representatives in the House of Representatives. And that’s not how it is. The population is going to shift all the time. And the shift that we have right now are historic. We’ve been looking at this kind of formulation for more than 100 years. The total number of congressional persons, and we don’t call them congressmen anymore, but rather Congress persons. It remains at a constant 435. The population may grow, but the number of House seats doesn’t change. The parties vary by proportion. So every ten years we start looking at where do the people go and why are they moving there? See the why are they moving? There is the demographic imperative. The big controversy is that at this point in this year, congressional Republicans are expected to dominate in the next election this November as majorities will shift. Now, it’s no surprise to you that the president of the United States is particularly unpopular. We also know that we’re looking at an economic downturn. We know that inflation is growing significantly. And some people are saying that’s good. Some people are saying it’s bad. But it’s important to understand why the great compromise and this is what they used to call it historically was about balancing the big states, those that are very large and have big populations with the interests of the small states.
Scott McDonald: [00:05:59] So California and New York are large population centers. Now, some people believe that because a lot of people live there, that they should dominate the politics of the United States. The compromise was big states and small states each had to be represented and that the there is a benefit to the United States in having both large, small and medium sized states that would represent the interests of the people. Now, some are demanding a change right now, but especially you’re going to hear it this fall. But this shift in which party dominates the House in the Senate is expected to be especially chaotic this year. You can’t do that to us. And again, I go back to Roe versus Wade, but there are several other issues. For example, the use of natural resources like oil and gas. It takes natural resources to grow our food. We can’t ignore the fact that the United States is, believe it or not, an agricultural nation, and it’s got parts of it that is feeding the rest of the world. Manufacturing is also going on, but we’re losing a significant number of manufacturing centers in the United States. Food, however, is kind of a permanent need. So are we going to see chaos? Oh, you bet we are. We do a national reshuffling every ten years. Some states will gain and some will lose power.
Scott McDonald: [00:07:47] We know that happens. As an example, the obvious ones are Texas and Florida. They are gaining and they’re picking up House seats. Not a shift in the Senate, which happens as different parties come into power. But when we look at the power of the purse, and that’s what they call the power of the House of Representatives, there’s a population increases the power or influence of a particular state or states will tend to shift and grow. New York and California are going to lose congressional seats this year. How much? Well, it may be one seat, maybe two. And the people in New York are concerned about it. So where is the population in New York State gone? Well, they’ve gone to Florida. A significant number of people have gone from the northeast to the southeast. But it’s also true that the Midwestern states have really like Oklahoma and Texas. They’re changing the representation numbers as well. And it could be that Texas is going to be the biggest winner and a lot of people are going to be very upset. These demographic changes are not just in party affiliation, but rather in political power. Now let’s get a little bit more into this. There are a few things that you must keep in mind. And we’re going to talk about national trends. And this is going to have an effect upon where we go. The states that are slated to lose House seats due to population loss.
Scott McDonald: [00:09:37] In other words, people who are moving, they’re going to scream bloody murder. And among those who are going to be most upset are going to be New York and California, even though this formula of representation has been in place for more than 100 years. There’s no surprise here. There’s no political shenanigans. It’s baked into the demographic cake. So Texas, Florida and North Carolina. Don’t forget, North Carolina are going to be the big winners in this election cycle. California and New York and especially Illinois are going to be the big losers. Now, some people don’t recognize that Illinois is losing or bleeding population significantly. And that’s one reason that a lot of people are upset with the politics in Chicagoland. They sort of assume we have always had power. We’re always going to have power. And therefore, power should just come to us. But that is not the case. If history is any guide. And please pay attention to this. High taxes and high cost of living will be determining factors in where people are going. High taxes and high cost of living. Now, in California, for example, it is almost impossible to build large numbers of houses. The state has mandated it almost by the state legislature, and they don’t want it. They believe that, in fact. This is a big favor to the country if they don’t build new buildings, new houses, especially. So the thing that’s weird about the politics is the blue states, the Democrat dominated states, are the ones that are likely to lose.
Scott McDonald: [00:11:39] The red states are gaining, and it’s a manifestation of where people want to live. Now, it’s no surprise that when taxes are lower and the cost of of living is lower, people will want to go there. Now in the News recently, Idaho. Is actually had a decline in the price of housing. Now that’s good and that’s bad, but it’s just a fact that the places that people are living and it’s not costing them more. Include places like Idaho. So greater Boise is likely to increase in population size because it’s not as expensive to live there. There’s more single family dwellings and those single family dwellings aren’t as expensive. The cost of borrowing money for a mortgage is lower in some states. You understand that? Now, if history is any guide, the high taxes and the high cost of living are going to make it difficult for some states, particularly blue states, to have an even parity with those states that it’s less expensive in which to live. Oklahoma is one of those states. It’s not as expensive to live. Alabama and Georgia are going through a similar thing. So we can expect that’s where the population shifts will go and political power is going to go with it. Blue states will continue to lose influence and population. And let’s talk about real quickly why. People are voting with their feet. Now, I’ve mentioned this several times. If you look at the U-Haul and Ryder truck rental databases, it is much less expensive.
Scott McDonald: [00:13:32] To leave some states than to move to some states. In California, for example, it is much more expensive to get a one way trip on a rider or U-Haul truck. That’s just the demand that people have about moving with their feet. Now the reasons are baked into the demographic cake and it’s going to continue for some time. These changes should not be strange to you, and I’m going to list what those factors are. And I will only refer to the United States and its parts. In general terms. I don’t want to bore you with numbers. In fact, in these podcasts we already go over a lot of numbers and I don’t want to bore you to death, but this is important stuff. Now what are going to make the changes in the population shifts happen? Why is Illinois in New York and in California losing population? Why are people leaving their. Now there are ten primary reasons that I’m going to bring up why power is going to shift to some places. Now, I’m not saying, by the way, that those are the places to start up or purchase practices. Please understand there are lots of good reasons why Illinois is going to be a great place for you to go, particularly if you’re a specialist. But there are lots of reasons why some parts of Illinois are not good. Now, let’s talk a bit about birthrate.
Scott McDonald: [00:15:08] What causes some places in the United States to really have the babies and which ones really keep people from wanting it? And one of the first ones that I have to tell you about is religiosity. When people believe in God and they go to church and they identify as religious people, they tend to have higher birth rates. I didn’t make that up. It’s just a fact. And as religiosity. Church attendance, if you will, increases, so does the birth rate. But that is not the only factor. There are a few others. Housing availability is a big one. And you remember I told you about Idaho? The asking price of houses is actually going down. Well, that just makes it so that people are thinking, Hey, Idaho is a good place to go when the houses in Idaho don’t cost as much and the interest rates are lower, people are going to move to Idaho, particularly. Western Idaho. That’s where the housing availability plays now. Portland, Oregon, by the way, is surprisingly. And let’s just talk about Oregon overall has also had a housing boom, and this is primarily on the eastern side of the state. The same thing is true in Washington state. But other states that you know about, like Texas and Florida, are having housing booms themselves. So expect the birth rates to go up. They also have large areas in which they can build. California has taken off the plate a lot of places because they will not allow water for building and building supply.
Scott McDonald: [00:17:00] Prices are going up and therefore. Availability of housing is going down and the area to build in California is going down. They’re not allowing as many places to go. The tax rates are obviously going to be important. And we know that right now, today we are having a major tax increase. And we’re also looking at, incidentally, the price of borrowing money is going up in some places. Now, when the tax rates increase and this is something I don’t know why they’ve done it, but a lot of people in Washington, D.C. are saying it’s a great idea to increase the tax rates right now. They’re thinking somehow this is going to be a benefit to. To to the credit markets or inflation? I don’t know. But it’s the thing. Now, there are other factors we want to keep in mind, and crime rates are one of those. I mentioned Illinois, which is having kind of a crime resurgence, and it’s caused by politics. The same thing is true in lower state New York. We know that when tax crimes increase, there are two ways of measuring crime crimes against people and crimes against property. When that goes up, a lot of people say, I’m not going to live here. I’m not going to put at risk what I’ve got. So I’m getting out of here. This is especially true when there are large numbers of children. You see how all this plays together.
Scott McDonald: [00:18:41] So let’s keep going on. You may be surprised to know I’m not a real fan of illegal illegal immigration, but we all know if you look at the news from the southern border, there are a lot of people trying to get across the border to the United States. And it looks like the federal government is not interested in sending them back or restricting their movement. Now, I’m not going to make a big political point of that. I’m simply stating a fact, and you already know it. But immigration rates are funny because there are some populations like Asians and Hispanics in particular, who are increasing at a far greater proportion than other states or in other races. As the immigration rate increases, there’s more disposable labor. In other words, people will work for low wages, and that increases the amount of people, babies being born and also jobs that are being created. I’m not saying it’s a cure all, but I’m saying the immigration rate is likely to increase for the foreseeable future. And this is having an effect upon how many people there are in an area now. Austin, Texas and Houston, Texas are really going to be the beneficiaries of this kind of thing. Is it going to hurt their local economy? Probably. And crime will increase, but it also means that there’s a lot more available workers who are going to take jobs at a low wage. And therefore, the other truth is that startup businesses are really going on.
Scott McDonald: [00:20:25] Now, doctors, if you want to know where to put a practice, you can’t ignore immigration and you can’t ignore start up businesses. The places that are increasing in population will tend to have mom and pop stores, small shops that hire people, and sometimes only two or three. And they may be family members, but because of that, these startup businesses are an indication of success and projected success into the future. Now some people are very nervous about start up businesses. They don’t like it. But it is one indication of growth and development in the United States that is going to play for a long period of time. Now, I already mentioned something about this, but home construction and home ownership and that’s what we mean by single family dwelling units or CFD use are increasing in some states. And I’ll use Utah as an example because I live in Utah and it’s before us all the time. They have decided in Utah developers have to purchase land and build on them relatively small single family dwellings. They have put a lot of money into public transportation. I don’t know if you know this or not, but they’ve got a huge growth in freeway traffic as well as light rail. I’m not going to talk about the wisdom or lack of wisdom of this. I’m simply saying this home construction and increase ownership of single family dwelling units means that states like Utah are likely to increase in population.
Scott McDonald: [00:22:12] Therefore, in the next census, people are saying, well, we’re probably going to see more House seats go to Utah and Arizona and Idaho because that’s where the people can afford to live. This is a controversial one here. Family formation. What it means is when people get married, they tend to have children. Now let’s go back and look at a couple of facts. When an immigrant family moves to the United States, the first thing they want to do is have a baby. Why? Because back home, they can’t have babies many times. And when they come to the United States, they were investing in the country. Yes. With their money and their labor, but also with their families, with their children. So this immigration rate is related to start up businesses, home construction and family formation, even though they look like they’re not related. They certainly are. Now family formation. People getting married is. Well, since Norbit, in other words. Yes, there are gay couples getting married, male and female, but the vast majority are going to be. Cisgender meaning there are men and women marrying and they are the ones who are likely to have children. That increases their representation in the House and it’s going to make a big difference. So places with family formation are likely to grow. Now, I’ve talked about the empty quarter. That’s part of the United States in the Midwest, primarily the Appalachians to the Rockies. And that area is where family formation is happening fastest.
Scott McDonald: [00:24:05] That’s what we’re likely to see in the near future. But there’s another statistic that may not look related, and it is related, and that’s labor participation. Now, young people, people who are in 18 to 25 year old categories are having a lower and lower labor participation rate. In short, if you want to hire someone, young adults are not interested in working. I don’t try to explain why, but it is a fact that they’re not taking jobs very much and they’re demanding very high wages. So people are kind of going, why hire them? I can get a person in their thirties and forties who are willing to work for the wages I’m paying and they’re more mature. They’re going to stick around. They’re going to show up for work. And this is what people mean by the labor participation rate. I’m expecting that it is going to increase as the economy tanks. So more people are going to look for work than have before. And that’s what the Census Bureau is telling us. And it’s important. Now this is going to freak out everybody because I’m adding it to the list. For a long time, we kind of ignored pets. You know, Scherzer, veterinarians. Yeah. They’re all excited about dogs and cats and birds and exotic animals. Sure. But we have found that there is a relationship between places where people are buying and raising pets, lots of pets, companions. That is showing an indication even beyond birth rate that families are sticking around.
Scott McDonald: [00:25:49] And pet ownership is a very positive thing. And you can find out, even if you’re not a veterinarian, what the likelihood of someone setting up a home, having a backyard and getting a dog and a cat, it means that that is a more permanent location for that family. Now, I mentioned the crime rate already, and we know that some people are in places where there’s a lot more crime than in others. And I mentioned Chicagoland and other metropolitan areas. You have to know that crime is happening everywhere, but it’s not happening at nearly the same rate as everywhere. Do I think that Denver, Colorado, is having an increase in crime? It certainly is. But you see, it’s not Denver that you get concerned with. It’s all the other metro areas within Colorado that are showing a decline in crime rate, and therefore, that’s a positive indicator of where people are likely to move. That’s what you want to keep in mind. Now. I’ve already gone through this in the last couple of episodes, and that is Hispanics. Now, this may sound tremendously bigoted. It is not intended to be, but many Hispanics are coming from Venezuela and Cuba, Mexico and all these places have a very high rate of crime. The cartels have come in. They’re proliferating in crime, specifically fentanyl and other illicit drugs that are literally killing people. Now, what has happened is Hispanics, you can name the country, are pretty much saying, we’ve seen this movie before and we don’t like the ending we’re moving.
Scott McDonald: [00:27:47] So some people are saying, why are so many Hispanics coming to the southern border of the United States? Well, simply put, it’s not to get free benefits. It’s to find jobs and safety. Security is a very important thing with the Hispanics that have been talked to. Yes, a far greater number of Hispanics are male immigrants. They’ve come to the United States. But you know that eventually they’re going to send for their spouses and their children and their parents. So it happens in stages that the Hispanics are doing this and we expect it to likely increase. But we also know that with instability in Asia. That the expectation for Asian immigrants is likely to dramatically increase. Do I think that Hong Kong is the future? No. But Taiwan is certainly a place that a lot of people are going to come from. And these are well-educated, motivated people, and they’ve got family members in the United States already. That’s an indicator that they’re going to make that move. Now, another last fact I want you to keep in mind of why immigration is occurring, where people are going and how they’re making these changes. And it’s the savings rate. I know you probably have heard of it before, but I want you to understand the savings rate is not caused because of how much you’re able to save. It is rather the percentage of people in an area who are putting money aside.
Scott McDonald: [00:29:28] That’s where the Asian population is kicking the butt of everybody else. Their savings are dramatically increasing. They’re going to have property. They’re going to have well land. If you look at how much farmland of the United States is being purchased by Asians, it is big. Now, you can’t move a farm. They may own the property, but it’s more likely the people who work and own the property are going to move to it, that this is going to be a significant issue. I’m not doom and gloom oriented. I kind of believe that Americans and I mean people of all races and ethnicities are going to stick around is kind of our pattern. My family originally came from Great Britain and Scotland. They came here and settled here and over the last hundred years have been quite successful in savings, starting businesses, having babies and getting their educations. We don’t expect that to change. I want to put a little positive spin on this. If you are wise, you will look for those places that these ten indicators are showing are important. Do I think that North Carolina is a good place? Yeah. Immigration. Startup businesses. Pet ownership. Low crime rates. Yeah. North Carolina. South Carolina. Virginia has made some major changes, so I think you can find a really good place to practice. And if we can help you get the numbers, competition ratios, educational attainment, scores, we are here at Doctor Demographics to provide a relatively inexpensive but accurate service on how to do it.
Scott McDonald: [00:31:21] But. You cannot wait. The time that you’ve got to do your research is right now. Don’t wait until things change after November, which is what a lot of people are assuming. You’ve got to get these statistics and get some informed knowledge on where you’re going to go based on these factors and others that you need to know. This is Scott McDonald. You can come to doctor demographics dot com or dial 800 8490499 to get the facts. Now we’re going to have some webinars that are going to be very inexpensive in September, but they’re going to be on orthodontic practice and practices, emergency care, oral maxillofacial surgery and others to say how the demographics in an area are going to affect the type of practice that you want to have. So please. Keep an eye on this and details are going to follow. Attendance will be limited. I can’t have just masses of people and be able to help them as much as I want to. Mike Green is one of the smartest guys you’re ever going to meet, and I look forward to having you talk to him, too. But do not delay for some comfortable time in the future. For just a few dollars, you can find out the facts on where to go and reduce your risk. This is Scott McDonald and thank you so much for watching. Goodbye.