Monday, July 31, 2017

Medical Tourism--Montreal Choice Versus University of Vermont Medical Center

The University of Vermont Medical Center (UVMC) $600+ base cost for a routine dermatology appointment last year—it took six months to get that appointment—seemed way beyond reason after a routine one in Montreal in 2008 cost $75 Cdn in cash. So called the same Montreal physician's office two weeks ago and got my choice of morning or afternoon just six days later when planning a getaway visit to the True North. Made sure I brought some Canada cash and after the appointment the very pleasant receptionist gave me the bad news—the cost of the appointment over the last decade had gone up--$5--to $80 Cdn! That's medical inflation fo you! That is $60 US even after paying the ATM $3 fee. Quality of care?  Well, noticed this doctor, a McGill University Associate Professor of Medicine and researcher, displayed a plaque commemorating his presidency of the Canadian Dermatologists Association. Fortunately my State of Vermont supplemental insurance coverage allows 80% of the $60 US so I will get a check for $48.

Seems like everyone gets a benefit from this simple example of medical tourism. No claim at all against Medicare, very likely a smaller claim against the State insurance. Even my lower copay will cover a couple of trips to one of my favorite coffee shops—where I am writing this story.  Of course if a Canadian the government health care pays all--no copay, no-deductable (and no blizzard of mail from Medicare, Blue Cross Blue Shield, the physician, etc., etc.)! 

And UVMC? Well, wonder why except for the big stuff, a trip to them makes little sense if it can be avoided.   Besides, it is fun to travel!

Thursday, July 27, 2017

End of US Auto Age Reflected in Miles Traveled by Adults by Car

Doing research for the Parkway challenge ran into a fascinating and simpler explanation for the recent seven year plateau of car travel here in Vermont and across the nation.  When viewed from travel per person over age 16, the plateau extends to two decades long of no change--1997-2017. And that plateau likely slowly, inevitably, dips downward going forward for a number of reasons. 

This article last month by Jill Mislinski nails it by giving us a different reference point for discussion than the tired though once reliable century old data on US annual vehicle miles of travel changes.
By looking at age adjusted (miles of vehicle for those 16 and over) you catch a number factors working against any increase in US/VT car travel which include but are not limited to: (1) first and foremost the growing proportion of seniors whose yearly car travel is about 40% less than non-seniors; (2) for Vermont it is not only senior growth but also declining non-senior population  though somewhat lower in Chitteden County than elsewhere in the State; (3) over time the struggle to install safe walkable/bikable facilities in our cities will bear fruit and reduce car travel demand as a cross section of our population get to enjoy like many modern nations do today, safe walking and bicycling and walking urban areas; (4) ditto for public transit, particularly light and heavy rail; (5) perverse private and public incentives promoting sprawl will decline meaning greater densities; (6) global warming strategies as well as income inequality will force far higher taxation and pricing on gasoline and other nonrenewable energy--and over half Vermont petroleum gets consumed on the highway.  

Viewing car travel through miles per year by the over 16 population is a much better signpost than simply total vehicle miles. 

Tuesday, July 4, 2017

Healthy Housing Rental Vacancy Rate Prevails in Burlington

July 4, 2017

Healthy Housing Rental Vacancy Rate Prevails in Burlington

...the rental vacancy rate continues upward and may already be in “glut” territory of 6 to 7 percent

A July snapshot count of online available Burlington housing rentals totaled 344, more than double a similar July 2016 survey finding of 129 vacant available rentals. This 344 July number alone represents a rental vacancy rate of 3.5% using the base of 2010 rentals, well within a “healthy” rental housing market range of 3-5%.

The latest snapshot survey reveals apartment prices fairly stable over the past year while all bedroom sizes except studio (they increased from 14 to 24) available vacancies more than doubled (Table 1) in the past 12 months. While median rents increased somewhat over the past year, the number of units available today below the 2016 median rents increased substantially. The 344 survey units represent only part of the available rentals which may easily exceed 500 or 600 with an actual rental vacancy rate of 6% to 7%. Larger apartment complexes, particularly those which are now opening—like the former orphanage Liberty House of 65 units on North Avenue—are tabulated with as little as one or two vacancies. The overall project of Cambrian Rise development of 733 mostly apartments, including Liberty House, on lands once owned by the Vermont Catholic Archdiocese is equal to about 7% of the entire Burlington 2010 rental inventory of 9,800.

The January private comprehensive survey by Allen Brooks found Chittenden County's rental vacancy rate of 4.4%, well within the range of “healthy,” 3-5%. The July snapshot survey indicates the current Burlington vacancy rate may be above of the “healthy” maximum which places financial strains on landlord, especially those with a few rentals. The Allen and Brooks January survey predicted a stabilization of rental prices and increasing vacancies in 2017, and the new snapshot survey supports those comments. With a healthy vacancy rate those seeking to rent obtain a reasonable choice and landlords do have to consider the market when pricing apartments. A “glut” occurs when a surplus supply of apartments force landlords to reduce rents below what it costs to operate and maintain, thereby leading to a decline in the condition and quality of the rental inventory.

With Burlington built or well into development about 2,500 apartments since 2013, a glut of vacant apartments--6% or more if the July data is any indicator--becomes a surprising problem after over two decades when vacancy rates seldom rose over 2.5% and rarely reached the healthy 3-5% vacancy level—and never a rental glut. (Note the 2,500 number does not include 274 housing units proposed in Burlington Town Center [BTC] re-development.)

The snapshot survey data is tabulated directly from Craigslist and other online services. From the 2010 Census, Burlington rental inventory totaled 9,800, 12% of the State rental housing. One major project renting this summer is the Cambrian Rise “Liberty House” with 65 studio and one-bedroom apartments in the former Catholic orphanage building on North Avenue. Clearly the June and July period is a very busy rental season and a firmer picture can be provided in a similar survey done in October when student rentals are fully reflected and apartment turnovers are relatively low.

Table 1

Comparison of July 2016 and July 2017 Burlington Snapshot Surveys
of Online Listings of Rental Apartments and Homes

Bedrooms    Number for Rent    Price Range   Median (Middle) Price
                        2016 2017               2017          2016 2017 % Change

0 (studio)         14    24              $725-$1,285          $968   $962    -0.6

1                      38   102              $700-$2,200         $1,050  $1,150  9.5

2                     43    135              $895-$3,350         $1,350  $1,450  6.9

3                     26     53               $600-$3,333         $1,825  $1,975  8.2

4 or more         8     30               $1,900-$3,900       $2,400  $2,633  9.7

Total 129 344
The April to July snapshot survey comparison, Table 2, confirms a pattern of stable median rents when increasing numbers of rentals considered. Four snapshot rental surveys—July and October 2016, and April and July 2017—show a continuing increase in online listings.

Table 2

    Comparison of April 2017 and July 2017 Burlington Snapshot Surveys
    of Online Listings of Rental Apartments: Numbers and Median Rents
    By Bedroom Size

Bedrooms      For Rent Number       Median (Middle) Price
                        April    July                      April     July
0 (studio)            13    24                        $1,100  $962

1                         81  102                        $1,140   $1,150

2                        86   135                        $1,495   $1,450

3                       42     53                          $2,175   $1,975 

4 or more         28     30                           $2,650   $2,633

Total 250 344

The snapshot surveys began in conjunction with the Coalition for a Livable City efforts to reduce and re-imagine the BTC re-development, questioning both the need for a large slug of downtown housing and the myth that BTC $1,000 one-bedroom apartments responded either to market need or were, as promoted, “affordable” much less providing “livable rents” or “shelter security.”

Several factors can account for increases Burlington and Chittenden County rental vacancies. The impact of a net increase of 300 students being housed this fall at the new UVM dormitory and 300 Champlain College students to be housed at Eagles Landing housing on St. Paul Street in fall 2018 both reduce student rental market demand. Also, there are questions about possible declines in student resident numbers at all area colleges because of either the demographic decline in college age populations and/or free tuition for college educations sudden starts this fall throughout the public universities in New York State and in the City of Boston.

While there is population growth in Chittenden County, the composition of that growth radically differs the past when under-65 age population naturally increased in the County and the State. Since 2010, ten of fourteen Vermont counties actually lost population. But as important, State official population projections, averaged, predict a doubling of senior population while residents under 65 decline—even in Chittenden County. Since 2010 the County growth of about 800 residents yearly mirrors the State average official population projections for 2010-2030. But the official predictions show the current growth composed of about 1,000 seniors and a decline of 200 under-age 65 residents. If this is currently taking place, then the demand surely mounts for not only small apartments—studios and one-bedroom housing units—but also a surge in demand for senior housing along the continuum which house independent residents, assisted living facilities, and finally nursing homes.

Finally, there is a complete lack of housing planning and policy development in Vermont as well as needed housing assistance. Vermont has no state housing plan while regularly producing an update to comprehensive transportation and energy plans. Further while about 13% of all Vermont renters are low income households benefiting from “livable rents” paying a maximum of 30% of income for rent--mostly from federal housing programs like Section 8—those programs stopped expanding early in the last decade as the federal government a abandoned efforts to provide housing assistance to all those of low and moderate income. In addition, today in an age where most Vermonters in their working lives will experience several job changes with the ups and downs of income, “shelter security” may well be as important as regular housing assistance--”shelter security” being assured a reduction in housing costs with dips in income from illness, unemployment, etc. “Shelter security” is also provided by Section 8 type units with rental amount decreased (and increased) as tenant incomes change.

The response to the federal government abandoning housing assistance has resulted in well intentioned but fragmented responses at the state and local levels. Hospitals, the corrections system and mental health field has resorted using non-housing streams of government funding to pay for housing as a far cheaper and far more beneficial to client needs than holding these individuals in institutional conditions. These often creative effort do in fact provide a context for formal, focused state and local housing assistance programs. For sure, there are today plenty of apartments ready to house the homeless and those in need of shelter.

Burlington housing market rental websites:


Bissonette Properties:


Tony Redington

Twitter: @TonyRVT60