Welcome to the 37th annual Las Vegas
Perspective.
My name is Jonas Peterson. I'm the CEO of
the Las Vegas Global Economic Alliance,
and I am so excited. I am honored to be
your host this morning. Truth is, this is
my favorite event of the entire year
And thanks to your support, thanks to
your overwhelming support this turned
out to be a really hot ticket this year
I don't know if you guys saw this but we
sold out not a week ahead of time, not
two weeks, but over a month in advance,
right? is that worth thank you thank you
not only that but I'm glad you guys are
here we had to turn away around a
hundred that wanted to be with us this
morning so congratulations to you for
making the cut early thank you for
coming out but seriously this tells us
two things one we're probably going to
need to look at a bigger room next year
and two more importantly that we're on
the right track to deliver on the brand
promise for perspective that brand
promise is to be Southern Nevada's
premier source for community and
economic information analysis and
forecasting now for this morning we've
been working with our perspective
Council to raise the bar once again and
I am excited for what we have in store
for you. Let me tell you a little bit
about what we have planned. It starts
with the prospective data book that you
received when you came in this morning.
In that book, you will find a
comprehensive overview of the market as
it exists today. It's jam-packed with
information and statistics that you need
to know to understand our community, our
economy and where it's going. That's just
the beginning. This year, we put in new
content from dozens of community and
business leaders so that you can hear in
their own words about major projects and
priorities that they expect for the next
12 months. These are the big
organizations in our reach.
fFom higher education to our cities to
our TC to the Water Authority, and much
more. In addition, in the book, we've
retooled our polling to do a deeper dive
into the attitudes and opinions of the
Southern Nevada workforce. We want you to
be able to understand what the business
community is thinking on key topics,
sometimes controversial topics like
marijuana, stadium development, minimum
wage and much more. Also in the book,
you got forecast content where we pull
in subject matter. Experts,
dozens of subject matter experts, and ask
them to give their prediction on what's
going to happen in the economy over the
next 12 months. All that packed into the
book. And if we can advance, all right? So
you starts with the book during the
event today. We've got a powerhouse
lineup for you of speakers that are
going to do a deep dive into our economy
into advancing the business of health
care and a look at the future of gaming.
This is a powerhouse group of
speakers, and it doesn't stop there.
As you know with perspective, we want you
to be equipped with the latest
information and analysis throughout the
year. So is our gift to you, we're going
to be sending each of you that are here
this morning, quarterly newsletters with
more data analysis on topics like
education, infrastructure and
competitiveness throughout the year. And
we're also extending your access to the
LVG, a data portal.
You probably remember last year, we
showcased this new product. This is an
online tool that has real-time data
thousands of indicators and data points
all updated in real time along with
community mapping and much more. This is
our gift to you as well. Where if you're
here this morning, we want you to be able
to have this. So you will receive an
email with a one-year subscription to
the data portal and one last thing as
you leave this morning, we have the
latest project from our research center.
We're calling it the Southern Nevada
community map. This is not an ordinary
map, you'll grab it on your way out.
I want to tell you how it was created
We approached our friends that applied
analysis, and we asked them, "Can you help
us make a map that tells the future?" We
expected them to say no because that's
that's a ridiculous request. They said,
"Yes." They always do and the result is a
map that showcases the billions of
dollars of capital investment that we
expect to move forward along the Strip.
The billions more that's moving in our
economy through private businesses
around the region, new school
construction key assets, and so much more.
Take a close look at that map
when you receive it on the way out. I
think you will agree that it is awesome.
Now, we hope all this content it's
designed to add value to you so that
through the upcoming year you can make
better decisions at LVG, we believe that
information is the currency of economic
development and when we can equip
leaders like you with better information,
we as a team will make better decisions,
have a stronger community and have a
stronger economy. That's what perspective
is all about. All right. So again, thank
you for coming this morning. I want to
recognize a very special group. Make sure
I get this right so pull out the cards
for this. This is our Perspective Council.
The Perspective Council is responsible
for leading everything you see here, the
event, the speakers, the content. They're
not only sponsors but they're involved
in the process. There's an exceptional
group and I want to recognize them and
then give them each a big round of
applause. It starts with Cox
Communications, Derek Hill and your team.
could you guys stand up? Where you guys
at? I just...
So let me tell you just a little bit.
Derek is our vice chairman at LVGEA. Cox
is our pinnacle level investor and
they're all two on the prospective
Council. An amazing group. Thank you so
much. We appreciate you guys. Derek, you
are amazing. Thank you. 8 News Now
Lisa Howfield and the team does, stand
up for you. There you are
stand up and take a look at the crowd
that Lisa brings with. I believe this is
the largest group, you know, from 8 News
now that we have a perspective this
morning. So thank you so much. We
appreciate it.
Awesome at Nevada State Bank, Shannon
Petersen and the team, many times they're
there. Shannon's one of our new board
members at LVGA.
Thank you so much for this court. A
champion for our community at Wells
Fargo, Curt Clawson and the team. Stand on
up, guys.
Curt is on our executive committee at LVGA.
A rock star for this community always
saying as. Curt, you are amazing. Thank you,
and last but not least. The team at
Applied Analysis guys sent up Jeremy,
Brian,
Rachel, Melanie. The team, this is our
go-to group this is the brains behind
perspective. Perspective, I want you know,
they always say yes. They're always
striving to make this better, and they
blow us away when we ask for crazy
research requests. They find a way to
make it happen. We love you guys. Thank
you so much, all right? So that is our
perspective council. We also got a group
of in-kind investors that stepped up
this year. Let me read them off. We'll
give them a round of applause at the end
for helping us get the word out about
this event. We got KNPR, Lotus
Broadcasting, Elite Media and Vegas PBS.
Let's give a round of applause for this
group.
Thank you. There's a lot of elected
officials in the room. I caught a few of
you as you're coming in. So this
is probably an incomplete list, but I'm
going to give it a shot.
We've got mayor elect Deborah March from
Henderson here. Stand on up. Councilman
John Mars I believe is with us. This
morning councilman Dan Stewart,
councilman Stavros Anthony and
Commissioner Susan Prager.
Welcome elected officials. Stand on up if
I missed anybody all right now. It's the
fun part. We get to kick off the party.
We're going to invite up our first panel
before I do that, though, I want to remind
you to join the conversation on Twitter
#LVperspective. If you do that, I
think there's even on the the tent on
your table. You can ask questions
following our panel. You can be a part of
the discussion. In fact. I think we're
going to throw up a live Twitter wall in
just a little bit, so you will see that
firsthand. Here's our first panel. It's on
advancing the business of healthcare. Why?
Because there are amazing things
happening in this, in this industry, right?
Now, in fact, if you look at our economy,
it's the fastest jobs reducing segment.
There's major projects plan that you're
going to hear about and to tell you
about that. We've got a rock star group
of panelists. Let's start it off.
Betsy Fretwell from the city of Las
Vegas city manager, Betsy, could you come
join us?
From UNLV, we got the founding dean of
the medical school, Dr. Barbara Atkinson.
Welcome. Come join us.
[Applause]
From Toro University, the one and only,
Shelley Berkley, yeah.
And Doug Geinzer from Las Vegas HEALS. A man
who knows a lot about healthcare. Welcome.
Welcome. All right, all right. Good morning.
How are we doing? Excellent. So that's big.
If we could, I would like to kick it off
with you. Have them start us off, and
here's the question? Could you give us
the big picture? Why is
healthcare important to growing our
economy and also what is the city of Las
Vegas doing in particular to grow this
industry? Thank you, good morning, everyone.
It's a real pleasure to be here.
Healthcare is a critical industry for us.
One: we're underweighted in it and
everyone knows that when we do our
surveys at the city of Las Vegas that
there is always a concern about access
and quality. And so we know that we have
incredible quality, here in town, but we
do have an access issue, and many of the
panelists who are here with me today, are
working to improve that access by
creating new doctors and new medical
professionals that will help us.
It also helps bolster our economy. These
are good-paying jobs people, who are well
educated and they help us grow and
diversify. And that's been a critical
component for the city of Las Vegas. Most
recently, we put together a medical
district advisory board, about three or
four years ago, at the request of
Councilman Tarkanian and Mayor Carolyn
Goodman. We did that because we have one
of the single largest footprints of
medical care, and service delivery in the
middle of the city of Las Vegas. So, of
the distribution of healthcare
providers. In this community, we represent
64% of them right? In the medical
district in the heart of the city of Las
Vegas. And if you're trying to figure out
where that medical district is, it's
right by UMC. So, if you can picture that
right along Charleston, near Rancho, near
I-15. And also the council embarked upon
a plan to expand that district. And we've
added over 400 acres to that 200 acres,
so that we have plenty of room for
expansion. The council also adopted an
incredible master plan for that area in
partnership with all the institutional
providers in that 200 original acres, and
the expanded area that will bring us
over 600 acres of medical district
development. This is critically important
because if the city is investing wisely
in infrastructure, and all of the
providers in the area are partnering on
things that have a common good to them.
So not programmatic decisions not
whether or not Dr. Atkinson has 60 or 80
students per class, but really how are we
providing Street networks and a variety
of other infrastructure that helps drive
the cost down
to providing quality and affordable
healthcare to our community. It can
happen in the health district in the
medical district through our healthcare
providers. We really feel like this is an
important play for the city's economic
development plan, and that's what we have
been focusing on to make a huge
difference for our entire community. And
we believe that we can be the hub. This
doesn't replace what needs to be
happening throughout the community. This
accentuates what needs to be happening
throughout the community and creates a
hub in the middle of the city where
everybody can get to it for those things
that we can only have one up. For
instance, and those are the kinds of
things that we've been pursuing at the
city, we have great hopes for the medical
school and what it brings to that
district. We're thrilled that the Medical
Education building is going to be there,
and we have high hopes for additional
expansion in that area as the medical
school grows. Those are the things we're
focusing in on at the city of Las Vegas
Beautiful. Dr. Atkinson, your
up next. We know that the, our first class
at the School of Medicine is coming
online this summer. Could you give us a
taste of the kind of? What's next? What
are the major steps? What are you excited
about? Well, I'm excited about it all or
what I'm excited about the class. First, I
just have to tell you quickly, it's sixty
students. They're starting on July 17th,
they're starting with EMT training, but
of those 60 students. They are all from
Nevada or they have very strong ties to
Nevada we just interviewed Nevada
students. We had over 900 applicants and
300 of them were from Nevada, so we
didn't even have to go beyond that and
that's exciting in itself so they're
getting ready to start what we're really
working on this summer, too, is setting up
the clinical Enterprise. So, on July 1st,
the people who were the faculty at UNR
School of Medicine, which who are
practicing in Las Vegas are all moving
over to be UNLV faculty. So that's about
a hundred and twenty-five physicians, and
another 25 or so administrators and so.
They practice in the medical district
mostly. Although, they have a few other
sites, as well. They'll be practicing
under UNLV medicine starting then. And so,
we have to convert those practices into
a whole different level of care. A level
of care that really is one that you
would be proud to come to. So, that's a
major effort that's going on right now.
Recontracting everything. Everything
from getting telephones, EMRs, patient
records, ready to move over. It's a big
deal to move that many people besides
them. Moving over, they have 300 practice
plan employees that front desk, the
billing, people, everybody else. That goes
with the practice . They're coming over,
and 300 residents are moving over to
become, you know, UNLV residents. So we're
going from having about 80 faculty and
staff in the School of Medicine to over
800 on July 1st. So that's a pretty big
deal. That's about a quarter of what UNLV
is altogether. So, adding that many new
people is, is really exciting but the
practice is going to be very exciting,
but it'll take us a little while to get
it to where it needs to be beside that.
We're working on starting that medical
education building, and I have to say, the
city has been an incredible partner with
us on this and the county has as well,
but County gave us 9 acres of land in
the medical district. We've already moved
all our current faculty to the medical
district so we are clearly in the
medical district. Now, we are in the
second phase of design of the building
whereas you've probably read in the
papers, looking for our hundred million
dollar donor. We hope we'll be able to
say we have that. We hope we'll be able
to actually break ground on the building
I hope in the fall. We'll see. So that's
going on, and I think those are probably
the major efforts. We do have a research
effort going on, and that's one that's
really important for the community. It's
sort of trailing to a certain degree.
Everything else, because we did education
first, clinical second and research third.
But it's coming, we just celebrated a big
Mountain West conglomeration of people
who are all part of a research team that
works together to build research
infrastructure, and that's what's really
going to drive the economic piece of the
healthcare district. And I'll just say
that the projection of a Medical School
in a help, in a medical district with
everything. It brings is something like a
3.6 billion dollar a year. A
year economic benefit to the community,
and should have something like
twenty-two thousand new jobs within the
next 15 years. So that's what we're up to
awesome all right? Shelley I'm coming
your way actually, for the next one. So
Shelly, you have a unique perspective,
right? You've been involved in the
highest levels of government, and in
medical education, I want to ask for your
thoughts on one of those topics that's
critical, involves both those graduates in
Medical Education. I know our state
legislature in particular is taking a look
at this. What is it? Why do we need more
of it? Could you give us your thoughts on
that? Yeah, thank you very much. And thanks
for having me. Good morning, everybody.
GME is a very important issue and very
critical to the state of Nevada.
We are going to attract doctors and keep
them here when you graduate medical
schools. You still cannot practice
medicine. You have a minimum of three
more years of training which is your
residency graduates medical education
now. Years ago, its graduate medical
education dollars. How do we pay for GME,
comes out of Medicare funding, from the
feds. Years ago, it was capped, which means
if you're an East Coast state that has
lots of GME. You continued getting
funding for a growth state like Nevada,
where we've had a huge population
explosion. It's been devastating to us,
because the GME is cap. There's no
funding from the feds, so are very
limited funding, from the feds so
understanding that you need three more
years of training before you can
practice medicine. It is essential that
the state of Nevada create its own GME.
And so the governor, and I am very high
on Governor Sandoval, for a whole host of
reasons, but he understood that we needed
to create and spend some money on the
state level in order to create GME. So,
last legislative session he ensured in
his budget was a 10 million dollar
appropriation to create primary care
GME's. Why is that important? Because the
greatest shortage of doctors. Although, we
have shortages across the board, greatest
shortage of doctors is primary care
physicians. As consequently, we were able
to utilize that ten million dollars, five
million each year, of the biennium to
create Graduate Medical Education. Now, in
this legislative session, he again in his
budget was another ten million dollars.
I've been tracking it in the legislature
and the legislature; I believe when their
budget is put to bed the
ten million dollars will survive, and we
will be able to use it for GME it is
very important that it stays in primary
care because that is the greatest need
in the state of Nevada.
Let me quickly end with this, and it's
easy to understand why is GME here and
Nevada important because 70% of doctors
end up practicing where they do their
GME, their Graduate Medical Education. If
we don't have enough Graduate Medical
Education in the state of Nevada. These
young men and women these future doctors
end up going away, and unless they have a
tie with the state of Nevada. They're not
coming back, and it makes sense. They're
making contacts in the medical community.
They're getting married. They're
establishing ties in the community that
they're getting having their residency.
And a simple way to understand this: Toro
University graduates a hundred and
thirty-five future doctors every year.
We're very proud of that. We had 3700
applications for a hundred and
thirty-five slots this year. We can
afford to be very selective of who we
admit into our program. If we admit you,
we expect you to graduate, and we're
going to do everything we can to help
you. We have 30 residences will 90 but 30,
30, 30. Because it's 30, a year with valid
with the valley health system that means
that if we feel every residency with the
Toro students. A hundred and five of my
graduates of future doctors have to
leave the state of Nevada in order to
get their training. That is insane. And
Barbara and I have talked about this. A
lot of you could have a new medical school.
You could have 20 new medical schools.
We're all still competing for the same
small number of residences. Until this
stage gets more residences, we are not
not going to be able to keep doctors
here, and it's simple math. And it doesn't
take a genius to figure this out. So if
you ask, and maybe doing something to ask
later, "What can I do?" Call your legislator.
We know them. That's the beauty of Nevada
tell them to make sure that GME money,
primary care physicians is in the budget
this year. So we can start more
residences in the following few years so
important, so important audience. So there.
Thank you. All right, Doug. You're up next
want to hop into your world for a little
bit the audience when they leave today,
they're going to look at that community
map, and they're going to see hospitals,
clinics springing up all over the valley.
Could you tell us a little bit striving
this trend? Maybe share a few examples.
Sure. So it's a lot of things during the
Great Recession. We went into that under
bedded as a community. We just flat out
did not have a bed enough beds to serve
the community. The tear during that
recession our unemployment rates went up.
Therefore, our uninsured what not. So a
lot of folks just didn't have access to
care because of that we were the first
state or the first republican governor
that approved the expansion of Medicaid
through the Affordable Care Act that
brought in 300,000 new additionally
insured so these 300,000 needed a place
to access care and what that's it. Is it
also provided a patient that would
present themselves at the hospitals that
now had a payer source not quite at the
level that they need to to be profitable?
But they had a payer source attached to
them, so everybody started growing again.
At the same time, some other things
happen where they started. They corrected
the reimbursement rate for inpatient
behavioral health, so you saw some
readjustment around the community. So now,
you're watching all of these facilities
and all these systems grow. I think a lot
of the growth that's going on in the
medical district and with the UNLV
School of Medicine is going to continue
and we're building out now to embrace
and be prepared for a major
transformation into academic medicine. So
as that happens and more residents are
coming through, and 70% of those are
staying here.
They're going to be opening up practices.
Then we'll start developing specialty
and subspecialty programs and fellowship
programs to bring on the the access to
care that we desperately need. You're
seeing other systems such as yesterday,
there's a great presentation from the
folks from Union Village in Henderson
Hospital. That was a hospital that was
opened up just a year ago, and they're
already expanding they're already at
that capacity. Every single Hospital in
this town is growing at some rate
whether it's Centennial, Spring Valley,
Mountain View, Sunrise is building a new
tower. You're seeing the introduction of
stand-alone ERs. You're seeing the
introduction of community hospitals or
micro hospitals, and this is all
improving access to care because we all
want to access care whereas closest to
where we live. And you're going to see a
huge transformation that's for years to
come.
So I think it's an exciting time for
medicine in Las Vegas. I think the great
work that's being done by our governor
with the expansion of Graduate Medical
Education, what's happening with you and
I'll be medicine. What's going on at the
medical district? Health care is now top
of mind, and tip of tongue. It's happening.
It's growing and it's driving this
community and it's going to require
strengthening that healthcare pillar for
true economic diversification to happen
because, as we're trying to recruit
attract and expand companies to come
here. Those executives want to offer
their family, their executives, families
and all of their employees, and their
families good health care, and good
education. And so I think the healthcare
community has really come together to
help provide that part of the equation
beautiful, beautiful. All right, panel. I'm
going to open up the next question to
everybody. This is a little bit of a hot
button issue: reimbursement rates. Could
you guys could you tell us about what's
going on with reimbursement rates? How do
we stack up to other markets? Why is it
important? What can we do about it?
So I'll jump in there. Sorry to hog the
microphone a little bit, and a little bit
of a selfish plug. So Las Vegas Heals has
a reimbursement survey out on the street.
We partnered up with the LVGEA on this.
So,
let me explain why reimbursements is so
important economic development really is
job creation, okay, and workforce
development. It's what it comes down to.
In workforce development, you've got two
parts of that equation recruitment of a
workforce and retention of a workforce.
We have worked extremely hard over the
course of the last four years to expand
our physician pipeline. So, the expansion
of Graduate Medical Education to put
some perspective to that we're going
from programs existing in three
hospitals by the end of this year. We
should probably have programs and 12
hospitals, which is gigantic. And so we've
spent all this time developing this
pipeline of physicians with the new
Medical School with the expansion of
Toro and everything that's going on we
now need to focus our attention to the
retention part of the equation and
that's keeping them here. And the
residency programs get them here. What
keeps doctors here is their pay, and
their pay is directly tied to
reimbursement rates? So if we are not
reimbursing them adequately all of this
infrastructure that we've been building
over the last five years is for naught.
So, we have to get this part of the
equation right? Nevada, as a whole, is one
of the worst reimburse markets in the
entire country, so physicians have the
choice because they're in demand
everywhere. The physician shortage is not
just in Nevada. It is in every single
state and so doctors have choices where
they could live and when they could go
to a neighboring states, and they could
earn 40 percent more and see less
patients and do what they truly care
about. And is delivering exceptional
patient care spending time with the
patient's they could choose where
they're going to go. So in order for
Nevada to have a competitive advantage,
we must address reimbursement rates. If
we don't get that right, we're going to
have serious serious challenges. Well,
my husband is a nephrologist. They
when I first started dating him, I
thought that was sex with dead people.
It's not. It's, he's a gay doctor, thank
God. A kid and Ragnar and my stepdaughter
is a primary care physician. So we do
health care in our family. It's a very
simple thing and just get on it.
Reimbursement is important because
doctors like to eat and support their
families and if the reimbursement rates
are low they are going to go elsewhere
but it also has a lot to do with the
insurance companies who are negotiating
the rates with the doctors and because
there is very few choices of private
health insurers. The insurance companies
can pretty well determine what they are
going to pay for the services if the
doctor wants to be in their network. And
so, my husband is a managing doctor of
his group. There's 33 doctors. 700
employees in his group. It's a big
practice, but when he is dealing with the
insurance companies they are offering to
reimburse them 50 percent of Medicare,
which is pathetic. Anyway, Medicare is one
of his high pays, not one of his low pays.
And you know, they could look, you know,
we just going to deal with your
competitor, and we're giving them 50. 50
percent of Medicare. You want it or you
don't want it. Now Larry's groups going
to want to be part of that Network, too.
So those primary care physicians can
refer their patient to whoever,
whatever doctors in that network. So it
has a lot to do with lack of competition
with insurance companies offering this
type of insurance medical insurance to
our so, I guess, our fellow citizens.
That's huge.
Another thing that is going to be
devastating for this state if President
Trump's proposal to cut eight hundred
billion dollars out of men,
the cave goes through. I sincerely doubt
it will. It is going to be devastating
for the state of Nevada because that's
how poor people get their services and
it's important to know this. In
conclusion, just because you don't have
health insurance doesn't mean you don't
get sick. You wait until you get really
sick and you end up in the emergency
rooms of the hospital. What is the most
expensive type of treatment? Emergency
room treatment and there is a reason
that UMC is no longer having 70 million
dollar yearly deficits. They're not in
the red anymore, and that's because
Obamacare expanded Medicaid. Governor
Sandoval agreed that they should that
the state of Nevada should expand its
Medicaid program and as the
reimbursement from the feds gets lower
and lower the cost to the taxpayers of
the state of Nevada is going to rise and
rise and rise. It could be a big budget
buster, and for somebody like Barbara, who
needs those state dollar, of course. Itoro
doesn't take any state or federal money.
However, for yes for a medical school
that's dependent on state funding, the
fact that Medicaid is going to be cut is
really going to hurt, that they're going
to have to make up the shortfall and
things like UNLV Medical School. And so
many other programs that we as citizens
expect from our government aren't going
to are going to be cut because this is a
low tax state and our fellow citizens
don't want their taxes increased, alright.
Thank you, thank you. We've got so many
more questions that I want to ask, but
it's important that we open it up to you
guys. So this is a segment where, let's
see if we can't fit in some questions
from Twitter. And then we're going to
have a roving microphone as well
Twitter's not working okay.
Our feed is not working, all right. What's
the visit? This is good to know. So from
the audience, do we have a question for
this panel? Anybody will come get you
with a microphone while you're waiting. Can
I make it? Yeah, all right. Rebuttal. A
little carrot. I just don't want to
leave the audience with something that I
think is a misconception. I agree with
Shelley on almost everything and for
sure on the GME, we absolutely need it
and it is in the governor's budget. So
and it does look like it's going through.
What I disagree with is that primary
care is all we need. We need specialty
care in this city as well. You do one
first, and then the other, and you're
right. We need to both make money from
primary care. And you don't get the
pipeline that refers, Let me just tell
you why we need specialties now too,
because almost half of the students that
that went to Reno University of
Nevada-reno School of Medicine left the
state because the specialty training
they wanted isn't given in the state so
to actually fix the students leaving the
state. They have to have specialty
residents, and if you look at the medical
care that's missing. It's the highest
level of medical care that doesn't exist
at all things like liver transplants,
bone marrow transplants, pancreas
transplants, a heart failure program was
an external pump. Those are all programs
that need to be here in Las Vegas, and
you shouldn't have to leave even
insurance companies have to pay to send
people out of state for those kinds of
things. So we really need the other
residences, and just to tell you what
residences are missing in this state.
Some very basic things like in
nephrology fellowship, for one, is missing.
But things like dermatology,
ophthalmology, neurosurgery, cardiac
surgery, orthopedics just started. So we
now have that all of the radiology,
anesthesia, pathology, radiation, oncology,
I could probably name a lot more and
there's not a single pediatric
fellowship.
Only three medicine fellowship. So if you
want to, there's no oncology cancer
fellowships. So all of those need to be
built in this city and as fast as they
can be built and I will say that
depending on what charts you look at if
you look at a national average of
specialty versus primary care were more
scarce in specialties. If you look at
the Mountain West which includes things
like Idaho, Wyoming, in Montana
primary care is more comparing us to
them is really more in demand. But it
just goes to show that their region as a
whole needs more specialty care. So
couldn't leave it without that super
important. And in four years, when you
graduate your first class. Barbara, I
think, we should start those specialties
right. Now, let's get the primary care
physicians, what? Let's be real. We need
all of them, and we need them all now. So
please, talk to the governor. Talk to your
legislators. Let's get the GME funded,
Let's get the Medical School funded, and
let's just get this done. So people quit
getting on the airplane to go get their
care, that should not be OK for us in
this city anymore. And all of these
people are completely dedicated to
turning that ship around, but it takes
every citizen to care and act that is
the perfect summary. A transition to you.
Guys, we do have a question from the
audience.
Team. Yup. There we go all right. Fire away.
Rachel's all Mesquite Regional Business.
We're about an hour east of here, and we
feel the same way except people get in
their car and come here for medical care.
So is there going to be an effort to
reach out to rural Clark County
communities? Can we have some residences
in Mesquite, in Boulder City, and Laughlin,
and some of our other partners? I can
start out saying that I think the big
the biggest thing that could help rural
Clark County, and rural Nevada is
telemedicine, and I think that's really
the thing of the future, and that's
something that's really good for urban
areas too. For follow-up, you need to be
see a doctor in person the first time,
but often for follow-up especially with
chronic diseases, it could happen in your
home,
and save you the drive and save you, save
you, the parking and so on.
Let the echo what Barbara is saying, Kuro
is very aggressively moving into
telemedicine. I think it is very
important if there are not enough health
care providers, and there are not in the
state of Nevada. See a very good way. It's
not the ideal perfect way, but a very
good way to access healthcare and to
speak to a health care provider is
through telemedicine. So, we are also
moving in that direction very very
rapidly and very aggressively. Excellent.
I know we're running short on time so
we're going to cut cut this segment
short. And give this group a huge round
of applause? Can you join me? Thank you so
much, all right. I hope you can see how
critical healthcare is to our economy,
and to really to our community and
getting to that next level. I hope you
learn something there. We're going to
move on to our first keynote, and I want
to introduce this by saying a friend
once told me, "You'll know when you
arrived in Las Vegas when Jeremy agüero
considers you a friend," right? I believe
that that's kind of true and I'm proud
to say Jeremy, I consider you a friend.
You're one of the smartest people I know.
This is the presentation that I know you
guys really keep coming back for year
after year. That makes perspective. Great,
let's give a warm welcome to Jeremy
Agüero with a plot analysis.
[Music]
Good morning. I appreciate everybody
being here today as Jonas, my very good
friend, indicated my job is to come up
here and provide you somewhat of an
overview in terms of where we are as an
economy. And where we think that were
ultimately heading. Before I do that,
Jonas was so nice to say thank you to
our firm and the other sponsors that we
have and everyone being here. But he
would never be so presumptive is to say
to mention the LVGEA and all the
wonderful things that they do and their
entire staff does to put on this event.
Please give them a round in developing
my presentation today. The title of my
presentation is Coming Full Circle. It
occurs to me that our community is going
through some unique brand approach
traumatic stress. Excuse me, yeah. Me too.
Post-traumatic stress disorder in terms
of this ability to start to
conceptualize the fact that our economy
is no longer in recession that we're
starting to move forward, and the
questions that I get are relatively
similar. Hey look. What's going to happen
next? When are we going to fall off this
cliff? Are we growing too fast? This means
we're getting out over our skis. Are we
just setting ourselves up to happen
again? Should I invest? All of those type
of things seem to be this recurring set
of questions. And so, I'd like to take
some time to put some of those arrests.
And I understand why we got to this
point. Let's not forget about all of the
articles that came out for the better,
part of a five-year period right?
Crowds returned but we're no one's going
to gamble the housing market continues
to slide Las Vegas economy, absolutely in
freefall. My personal favorite, Las Vegas
economy, among the worst in the world
report, says now I can think of lots of
places on planet Earth many of them end.
With something like Tajikistan, you
know, whatever that I don't even ever
believe that we are the worst on planet
earth. And then the other one that was
out there was, of course, Las Vegas from
Time magazine, where Joel Stein called
Las Vegas the world's greatest ghost
town
in waiting. Right? This is why we continue
to have this type of concern, and I get
it I get that the economic downturn was
significant. I get that it created a lot
of stress for us in here. But the fact
that this room is filled with so many
familiar faces among people who found a
way to make it work. I think is something
we should be very proud of. And I think
being realistic about where we are is
important because this community will
not be judged, based on our ability to
survive a recession our community will
be judged on the ability to sustain our
prosperity. That is what you heard today,
and that is what we need to do as a
community. I'm going to start with
population growth because our community
is geared for exactly that we are
designed to grow. We have been among the
nation's fastest growing for decades and
decades and decades. And here we are
still again. what I'd like to do is just
show you the population growth during
sort of a boom period. And then you see
that it sort of flattens out a little
bit, and here we are again. And today, we
are a community of 2.2 million people
overall. 2.2 million people call this
place home.
Now it's the same 500 people that you
see everywhere you go. I get that, okay.
But there really are 2.2 million people
have physically live in this community.
Now, I went relatively fast to this and
if I was to go back through it. You'd see
that the demographics, and I'll go
backward because my guys were so nice to
create this. If you look on the right
side of my chart, that's the shares in
terms of races in terms of our
demographics if you will. And we look at
2000, and then we look at 2006. And then
we look at 2012, and then where we are
today, we are becoming increasingly
diverse. We are minority-majority. All of
those type of things this diversity is
what makes our community great. It is
part of who we are. It is the fabric of
our society, and there is nothing wrong
with it. As a matter of fact, we only
today are starting to embrace that and
carry it forward. These are the 35
largest metropolitan areas in the United
States. We are the third fastest growing
of all of them, not a bad place to be.
Where are newcomers coming from? There's
no surprise here. Who want to think about
it in terms of full
circle. Yes, people did not move to
Southern Nevada when the economy was
going down? Why did they not move because
they weren't moving anywhere because
their house was underwater. That's why
people weren't moving. And now they're
moving again, and guess where they're
coming from, excuse me, California.
Because it's the seventh largest economy
on planet Earth and people can't get out
of there fast enough. All of which is
fine right? But it's benefiting us but
more important than this idea of full
circle is how we've changed in that.
Let's just take a look at what those
newcomer trends look like throughout the
years in 2000. Look at what the income
level was. Look at the age of people
moving in. What we know is that today
people are moving into our community to
find jobs that are at a higher level and
they're bringing more income with them.
They're also bringing more home equity
with them, and surprisingly enough, there
actually appears to be some
Millennials that are moving out of their
parents house because they appear to be
moving here right? If you look at the far
right at 2016, the age at which people
are moving in is dropping for every
reason and the LVGEA has been absolutely
a leader on. This is the reality that we
cannot create as many professionals as
we need in this community.
Things like GME and others are
essentially a roadblock until we are
going to have to attract talent
particularly from around the western
United States. And they're coming here,
and they're coming here because we offer
a better way of life overall. If we
transition from this idea of population
to this concept of employment, right. The
number one motivation for people moving
into our community as it has been for
most of the past 37 years has been this
idea of finding a job, probably much
longer than that. But it is this idea of
finding a job and if we look at how we
are creating jobs, and where we've been
this idea of sort of coming all the way
back around. This is what job growth
looked in 2007. Most of the folks here
remember what 2007 was like. Jobs were
plentiful, the unemployment rate was
approaching 4%. Everybody that wanted a
job could find a job except perhaps for
my brother-in-law. And it was
fine, right. It was good right. We were
growing at 4.3%, we
were the
we were the fifth fastest growing
metropolitan area, excuse me, states in
the nation. And here we look at a 2011,
when the world is kind of coming apart,
and only North Dakota has positive
growth right. You know, yeah. There's a lot
of jokes there. We'll just leave it, leave
it there. And then you look at 2017, and
here we are again here we are again at
the now the third fastest growing state
in the entire United States. And that's
great, and that full circle is what is
important to us. But the nature of it,
what is underlying, it is the reason that
we can at least exhale a little bit, and
say we are learning to do it better as
we go forward. Let's just talk about that
for a moment. Now, here's the
pre-recession growth in employment for
the top 35 MSA.
I guess I should show this in advance of
showing how we're changing to make sure
that I'm showing sort of an apples to
apples comparison. So we were just
looking at states we're now looking at
MSA, is you can see there's only one
large MSA now to the right of us. In 2007
we're dead last in the among large MSA.
And in 2011, and here we are today at
about three a little over 3% employment
growth, which I'm sure my good friends at
the Nevada Department of Employment
training and rehabilitation, that are
here today will tell you that is pretty
darn good growth overall. And we like it
so we look at where we are in terms of
having created all of those jobs, right.
Here's our last peak. There it is, in May
of 2007 when we had about let's call it
nine hundred and forty thousand today
where, let's call it nine hundred and
eighty thousand. We have forty thousand
more jobs today in our community than we
did then on the far right hand side of
my chart, of course, is what sectors are
showing the greatest growth. And I think
this is part of the angst that we have.
The number one growth sector we had over
the past 12 months has been construction.
We added 8,500 jobs, and I am here to
tell you that as we're going through
this exercise. By the time we get to the
end of this year, our community is going
to be 10,000 construction workers short
of the number. We're going to need to
keep pace with all the projects we have.
And if there's some construction folks
in the room, they're probably going to
tell you that I'm light on that number,
and we're all
10,000 construction workers short of
hitting that number. Look at the other
areas that we're growing professional
and business services, leisure and
hospitality, education, in health care, all
expanding. Let's take a look at the
unemployment rate, right? Our unemployment
rate, of course, was always approaching
15% at the peak of the market. The green
area at the bottom shows the
differential between our unemployment
rate and the United States unemployment
rate, which I will argue would be almost
more important than anything else that's
on this chart. Why? Because that led to an
out migration of folks, and was part of
the reason that we lost 1 out of every 8
private sector jobs in its southern
nevada during the peak of the recession.
Today, we've gotten almost all of it back
we are doing well we are at near full
employment, if not at full employment and
that is extremely positive overall under
where we were where we're headed.
all those types of things now I
understand that this chart is is there's
a lot of colors and a lot of numbers all
type of things I'd like to talk about it
just for a moment that those sort of big
green blocks that's leisure and
hospitality right this shows us how many
employees we have and every sector of
the economy you can see the big green
block is still the big green block you
will also see that if we look at 2007
versus 2017 that the yellow area which
is education and health services which
of course you just heard a great deal
about is getting larger we still have
only 70 percent of the healthcare
economy we should for an area of our
size and that is hugely problematic
although you will notice that the yellow
area has gotten increasingly bigger I'm
really glad that Shelley clarified in
terms of what nephrology is because
there's been growth there and I was
really wondering what the hell was going
on right so I'm glad I now have all of
that straight but at the end of the day
is the one that we probably care about
the most is this one which is why we
created the chart in the first place and
that's the idea of construction so if
construction is now at the top of our
list are we getting out over our skis do
we have this huge problem in 2007 you
can see that 11.2%
of our employment was in construction at
the bottom of the market it was 4.8%
today we're 6.3 and on the right-hand
side of my chart I think is what is
critically important I just told you we
have 40,000 more employees than we did
at the prior peak of our economy we did
that with 40 thousand fewer construction
workers in our economy at its peak that
was a hundred and five thousand today
it's 61 thousand not a bad place for us
to be and I would argue significantly
more healthy than where we were going in
to the economic downturn now let's let's
take a look at what the u.s. averages
are for each one of those five point six
percent three point nine percent and
four point six percent okay we'll take
it that number starts that six point
three percent on that one on the right
starts to approach 8 percent we need to
start having a conversation about it in
our community that is the level of
growth that will start to be
unsustainable and something we'll need
to keep an eye on if we look at it in
terms of the demand for space right is
this creation of jobs and what we're
developing leading to this demand for
space this chart has all kinds of
information on it the vacancy rate and
how many employees are office using and
how many square feet they use and all
those types of things all of which is
important and I appreciate my guys
putting it on here but what is
critically important about this slide is
that the little green line is above the
little purple line which means that we
are demanding more office space than we
are bringing on concurrent with this
fact that we are growing more rapidly we
are also finding ways to utilize the
existing space that we have and we are
being pragmatic in terms of how much
we're bringing on this chart shows the
number of the amount of occupied space
for every office using employee at the
peak of the market sort of back sort of
looking far to the right and then we go
up into the recession and that number
gets to 130 square feet for every office
using employee why does it get to that
level because when you start laying
people off you've got a lot of office
space out there right and so if we look
today we're now at about 110 which means
we are utilizing our office space in a
way that's almost equally effective to a
period when the
vacancy rate was you know let's call it
sub 6% in our community what we have is
a disconnect between functional space
and well located space and non
functional space and stuff that's just
not that well located and that's what
we're seeing today and so what's working
out okay and in addition to that what we
are building in our community our
corporate headquarters build two suits
right some of the most phenomenal office
developments in the entire western
United States are happening right in our
backyard not the least of which is
something the UFC and aristocrat
facilities that are recently constructed
now the housing market seems to me to be
something that's worthy of some extended
discussion along the same lines
why because housing was given all of the
blame in terms of the economic downturn
and seems to be getting zero of the
credit in terms of coming back we've
seen subdivisions have started to pop up
and those types of things which is
creating some concern in terms of over
building within our market or price is
getting out of line are we building too
many houses should I buy a house is my
house going to drop in value as a result
I hear this question at least three
times a week and so let me try and
answer at the 500 people at one time on
the critical way of looking at it is
something we refer to as the ep ratio or
the number of employees versus the
number of permits that you're
constructing and forgive me for getting
overly technical but there are generally
about 1.3 5 employees in every household
it's just the way it averages out and so
if that number gets out of whack if you
start to permit more than that it
becomes problematic if you permit less
than that it becomes problematic from an
over/under supply standpoint today the
little purple line is what Las Vegas is
doing in terms of the EP ratio which
means that there are two point four
employees for every home that we are
constructing today with everything that
we're seeing we're not building enough
homes for all of the employees that we
are generating and the matter of fact if
we look at the Green Line which
represents the United States as a whole
the u.s. is building about 1.7 for 1.75
houses for excuse me employees generate
one additional housing unit we are under
building our residential today which
leaves us with some degree of comfort
overall in terms of housing
affordability is it getting out of whack
the answers really no you can see places
like the bigger numbers are actually
better here so don't we excuse me don't
read this in any way incorrectly UC San
Francisco Los Angeles and San Jose or at
the bottom in terms of housing
opportunity can people actually afford a
house no they cannot in those markets
can they in our market yes they can if
we look at the housing price index
we're not even back to where we were
overall now if we think about it in
terms of this coming full circle let's
make sure that we are clear here in
terms of how it all played out this is
2004
excuse me 2003 to 2004 arguably the peak
of the housing market the prior peak of
the housing market Nevada was number one
in the United States with annual
appreciation of 37.2% if anyone believes
that appreciation of 37.2%
is in any way sustainable we can have a
conversation after this meeting okay
it's just not right so now let's
fast-forward to the bottom of the market
we go from number one in the United
States we go all the way down to number
50 in the United States we drop by
twenty five point seven percent of
course that's dramatic everyone's
concerned so where are we today the most
recent numbers place us in the top five
yes I would prefer to be in the top 10
in the top five but that number is 8
percent right much more sustainable than
something that's measured with a you
know then thirty eight percent or twenty
eight percent or even 18 percent we'll
take it right we understand where it is
and it's certainly not as nearly as out
of whack as some have suggested now
arguably most important here is this
idea that people see building permits
are going up and they're rising by
double-digit rates and we're seeing all
these subdivision comes out and we're
hearing about all of these new
communities that are out here these are
new home market closings right
how many housing units we are building
and are being sold in the market on the
left-hand side of the chart is what it
looked like when we were going up right
over
40,000 housing units were being
constructed the past 12 months that
number is 8300 in our community today
again the idea that we are getting out
over our skis that it's becoming
increasingly problematic yes we have
things to be concerned about but I think
we should take a deep breath and not be
scared by our prosperity again
we will be defined by our ability to
sustain that prosperity over time on the
far right hand side of my chart is the
median price for newly constructed homes
you can see that we're almost back to
peak of course you also have 10 years
worth of inflation in there and the
reality is that home builders are just
simply building bigger homes today than
they did a decade ago so again we're not
even very concerned about that number
and for most of us sitting in the room
we're much more concerned about existing
homes than we are new construction
because that affects each one of us or
many of us I'm sure if you look at the
number on the right excuse me the
numbers on the left that reflects how
many closings are out there very
consistent with what we'd expect and on
the right hand side is what we call the
rollercoaster of doom ok and what the
rollercoaster of doom means is that if
you look on the far left-hand side of
that chart this is what median closing
prices were all the way back in oh three
and if you little red line represents a
three percent growth rate which is
pretty much exactly our housing prices
have appreciated over time for the past
50 years now we have a period with a
huge boom we have a spirit with a huge
bust you wipe all of that out over about
a 12 year period thirteen year period
and what happens we're exactly back to
the three percent growth rate that we
should have been at the outset it's just
markets doing what they do and if we
look at new homes as a percentage of
existing homes are we getting out over
our skis in terms of the amount of
construction versus existing inventory
it is 14 and a half percent nowhere near
what it was at the peak of the market
when it approached 60% of existing
inventory land land availability becomes
this big concern I've heard rumblings
about the fact that we have to go to the
federal government and get them to
release more land to drive down prices
because those prices are coming up this
the price of land that you see here we
have excluded residential excuse me
resort casino development that's in
there so you get the idea you see that
in 2007 the average price of land was
$800,000 nation we all remember the land
auctions and the like and now I'm going
to lay over the top of that median new
home price and median existing home
price we'll look at the expansion we'll
look at the peak we'll look at the
contraction we'll look at the trough and
where we are today that is with a very
normal cycle and that frankly on the
right hand side of my chart the distance
between the price of land and the price
of housing is where we would like it to
be on this chart now I'm not going to
say that I'm not somewhat concerned
about the fact that land prices are
escalating but nonetheless you get the
idea of where we are versus where we
were when things were overheated now if
we start to see a trend that looks like
what we saw in five six and seven it's
time to bring the fire trucks up to the
front
we cannot fear our prosperity as a
community there are today seventy one
thousand five hundred developable acres
in Southern Nevada we're developing
about five thousand of those every year
that's what these charts show and so we
have about fourteen years worth of
affected inventory left if we average
everything out not bad and where we want
to be if we look at this idea well we
hear all the time that incomes are not
keeping pace that housing prices are
going up but all of our incomes are
remaining they're remaining flat I read
yesterday that incomes haven't gone up
since 2000 or something along those
lines number one that's not right number
two let's just take a look at it
here's household income versus home
price this is what it was prior to 2004
this is when incomes outstripped housing
prices of course this is during the boom
period since when home prices
outstripped incomes when the world is
coming apart and here's where we are
today that Green Zone is what we would
refer to as the safe zone and you will
also notice that those numbers are going
down not going up which is something
that you know we we certainly want to
keep an eye on but we're not outside of
where we should be the number of homes
available
for sale is 1.64 in terms of available
inventory I bifurcated that into the two
component parts lower priced homes under
300,000 on the right hand side on higher
priced homes are on the excuse me above
higher priced homes are beneath there
and you can see that there are greater
inventory of higher priced homes
shockingly there are fewer buyers for
million-dollar homes and therefore the
inventory tends to stay a little higher
Oh
right now the homeowner equity right
here's where we were in two thousand
nine ten eleven twelve right and just to
be clear we want positive we don't want
negative the green can get as big as it
wants to get right here we are in
thirteen fourteen fifteen and sixteen
again we've made huge strides in terms
of reversing this trend this is the mix
of property sold green is good
everything else really bad we want green
to be big we want everything else to be
small you can see where we are if we
look at it instead of looking at some of
these markets and we start going to the
basics what are consumers doing overall
this is Clark County's taxable retail
sales overall right and we are four
billion dollars that's four billion
dollars among the higher than we have
ever been before
eating and drinking places Auto Sales
general merchandise are all up clothing
and accessories are dropping not because
people aren't buying them I assure you
they are my wife and daughter
single-handedly trying to keep the
economy afloat right
they're just doing it online okay we get
it autos are slowing a little bit nation
nationally thumb here that's to be
expected after seven record years that's
okay so we should be doing but if we're
going to look at it in terms of this
full circle concept where are we
relative this this is inflation adjusted
per capita taxable spending so we're we
getting out ahead of ourselves or not so
let's just draw the average over the
30-year period we remain below the
average today which means that spending
could escalate some and we would still
be in the healthy zone that area with
the peaks up there Oh 405 and oh six or
we get anywhere near that it's time to
have
conversation overall and we know that
taxable retail sales are changing we get
it the red area is non store retailers
you will refer to them as places like
Amazon and things like that right you
get this idea they're growing these
other ones they're not growing quite as
quickly okay that's just things are
changing and we know that we're sort of
trading this bricks and mortar retail
for more distribution space so let's
take a look at whether our economy is
adapting to this new reality on the
left-hand side is retail on the
right-hand side is industrial yes the
retail rate is elevated but dropping the
industrial area where retailers are now
actually doing their retailing
essentially fulfillment centers if you
will are down to six point nine percent
overall if we look at completions versus
absorption the green line and the purple
line aligned with one another like we
talked about with the office market yes
they are if we look at planned and under
construction no we're not building
retail because we shouldn't right and on
the other side we're building industrial
because that's where everybody is going
and yes it is at peak levels currently
under construction space is sourced 100%
to distribution centers exactly how it
should be overall and if we're asking
the question about whether we're getting
out over our skis whether we're building
too much let's look at whether the
future development as a share of planned
inventory for retail in the peak period
we were we essentially had under
construction 36 percent of our market
today at 7.3 for industrial we had 14
percent today we're at 11 again well
within the range of normalcy we look at
large store closings and this makes us
nervous and we tend to ignore that the
guys on the right are building on
occupying or occupying and maybe not
building 2 million square feet in the
last year alone this is simply a
transitional step relative to our
economy overall
now wrap all that up is of the big green
area that I showed you on my chart has
to do with tourism and tourism related
activity our growth and visitor
volume is significant and it continues
to be incredibly important to us in I'd
like talking about that is critical one
in six people one in six people that
puts a head in a bed on any given night
is not a resident of Southern Nevada
that's how big our visitor economy is
and that is bigger than almost anywhere
else in the entire United States where
are they coming from Western United
States we want to get that international
all the way up to thirty we're working
on it but we're setting records relative
to visitation overall and in particular
convention visitors who spend more
generate more stay longer all those
things than their traditional these
leisure counterparts McCarran
International Airport is today the
eighth busiest airport in the entire
United States it's the second largest
destination and origination I should say
that differently origination and
destination Airport in the United States
someone is going to have to explain to
me why we care about someone flying into
an airport staying on a plane and flying
somewhere else right makes no sense to
me whatsoever but we count it anyway
this is when we take all of that out
we'll take the people that stay someone
else because Atlanta can have all the
people who just want to go through
whatever right the LDC VA is absolutely
should be commended for being able to
expand our international reach with all
of these new flights including one to
Beijing China which would be critically
important overall and again thinking
about it in terms of coming full circle
on the left-hand side of my chart is the
occupancy rate on the right hand side is
the average daily room rate these are
the two factors that will become they
will become critical in determining
whether we make reinvestment here we are
approaching 90 percent not quite where
we were but approaching 90 percent and
on the right hand side ADR is 128
dollars per night almost back to the
peak but something we didn't have in
2007 and 2008 is the resort fee which is
also added on which means we are at peak
ADR today all of that having been said
let's wrap it all up and put a bow on it
because everyone wants to focus at least
the national media does on this concept
that gaming revenue is below where it
should be or has not grown ignoring
fact that Las Vegas trip total revenue
is up to eleven point two billion not
only the highest level that it's ever
been but blowing the previous piece out
of the water if we look at the amount of
development and I will tell you Jonas's
map is much more extensive than this and
you should really take a look at it
because I think it's super cool but if
we look at it in terms of development
that has recently happened on the strip
whereas occurring there seven point
eight billion dollars and I've talked a
lot about the amount of development
that's happening in our community
because I think it's great but if we're
going to ask the question is are we
building too much here's what those
numbers look like in 2007 when we had
forty five point eight billion dollars
worth of project on the books forty five
point eight billion how much do we have
today
fourteen point 1 billion dollars on the
books there are communities all over the
United States that would give their
eyeteeth to have 14 point 1 billion
dollars worth of projects on the books
but before we freaked out about the fact
that we're all building too much and
there's not going to be enough glass and
not enough concrete and we just can't
handle this much growth I think we
should put it all in a little bit of
perspective and what we are building is
based on bringing people here for
special events stadiums convention
centers all those things because we have
assets that we can leverage 150,000
hotel rooms the second busiest airport
in the United States restaurants dining
all those types of things but Las Vegas
is just as important for those events as
as we are to them as they are to us it's
a symbiotic relationship I hear it all
the time because of the work we do on
the stadium and other things on the
left-hand side it's the pac-12
tournament these are the attendance
numbers when it was in Los Angeles the
numbers on the right hand side are the
attendance numbers when it came to Las
Vegas what about the Mountain West
tournament Las Vegas mm oh three they
moved to Denver surprise surprise they
move it back this is why it works
Terrence is telling me that I have to
wrap it up so I'm going to go a little
bit quickly and you forgive me he's
great and I need to get it done the
other side of this is that when we think
about it overall the economic
implications of those special events are
massive
right Super Bowl Houston Texas 138,000
Super Bowl visitors and 350 million
dollars of impact that's why I was so
great to see the article in the
newspaper today that they're talking
about potentially getting us a Super
Bowl in two thousand 2023 or 2024
hopefully it happens but we cannot
forget about the fact that while Houston
was hosting the Super Bowl with a
hundred and thirty eight thousand people
we had three hundred thousand people
that showed up for Super Bowl weekend
right while we were here almost on our
phone convention centers are phenomenal
we have among the best in the entire
country we have been atop the list for
the past 22 years and the business tax
climate has benefited from this amount
we reach the tourists generate two
billion dollars in taxes for us every
single year I'm not going to spend a
whole lot of time here other than saying
those are all of the states that have an
individual income tax and we're not one
of them because 43 million people
decided to get in a car or get in a
plane and come here and spend money and
if you don't believe me this is what
your sales tax raise property tax rates
and personal income tax rate would be if
they didn't exist today we need to
preserve that sector of our economy at
all cost those are huge numbers these
are the companies we're bringing in
northern nevada is also getting them we
are innovating over all these are
companies we all know them they're
making great steps and great progress
but I do not want to minimize small
business development in our community we
have more businesses here than we have
ever had before we've created ninety two
hundred businesses since 2010 thank you
to the LV Gea because they have been
critical as well as each one of you in
making that happen
overall my friends at Nevada state bank
asked for this idea of power small
business folks thinking about all of
this we asked them are you optimistic
about the economy they are more
optimistic than they have been at any
point in the past five years do you plan
to expand over the next 12 months do you
think things are going to get
over the 12 next 12 months yes they do
in closing yes things are okay we're
doing better where we're finding our
footing but I'm always reminded of the
salient words those who cannot remember
the past are condemned to repeat it we
cannot ignore where we were when all of
development we couldn't handle so we
were spilling over into Arizona Las
Vegas Waze billion-dollar reliever
Airport right we don't have enough room
it can so we're going to build Ivanpah
right least affordable real estate
market in the United States these are
the type of articles that were coming
out when we were at our absolute peak we
cannot let this happen again Las Vegas
closing on another full house I love
that they have to come up with some type
of gambling analogy no matter what they
write anyway that's my own personal
problem condo mania in the West and as
we all remember the Manhattan ization of
Las Vegas right this is a map we
actually been doing this presentation
since 2007 this is my 10th year doing it
I'm very thankful for that
this is a map we used in the very first
one of all the plans proposed or under
construction condos that were in
Southern Nevada almost none of them were
actually built right this is where we
can't go because we've got to come full
circle so let's just fix let's talk just
for one minute and I promise I'll get
down from where we are downtown
Summerlin stall during the economic
downturn this is what it looks like
today we can be proud of that
the folks at Summerlin should be
incredibly proud of that yeah thank you
anyway they know the statistics only see
Manhattan West all during the economic
downturn this is what it looks like
today here's the Kyle Canyon master plan
1,700 acres was foreclosed on here's
what it looks like today the folks the
city of Las Vegas think Stavros was here
congratulations on what you guys have
been able to do a salon stalled during
economic downturn recently announced
they're getting that project going
forward and it'll be happening pretty
soon interstate 11 of course has that
met any number of delays and now is
actually going to happen City Center if
anyone's ever heard Jim Murr and talked
about how close it was to closing down
it didn't and not only have they
finished that project that they double
down with building the t-mobile Arena
which will probably be among the most
productive arenas in the entire United
States when everything's added up for
its first year of operation and the very
last one south strip right this property
was foreclosed on 62 acres there off the
freeway it's going to be the home of the
new Las Vegas Stadium thank you very
much
sigh landing was that powerful did you
enjoy that can we get another round of
applause awesome awesome for our next
segment you guys are in for a treat we
wanted to show you a look at the future
of gaming we have the best expert in the
entire country to talk to you about that
particular project
Jeff Freeman is the CEO of the American
Gaming Association he is a global leader
he is responsible for positioning
commercial and tribal gaming for success
and he's also a powerhouse speaker
please help me welcome to the stage
Jeff Freeman so I'm thinking of starting
every speech with that sex with a dead
person joke it's bound to get - laughs
congresswoman Buerkle had to leave so
it's even better I'd say this in her
absence I've been in Washington 20 years
I've met with a lot of members of
Congress I have never met someone who
was a greater champion for an industry
for a city for a state than
congresswoman Buerkle was she was a
tremendous champion for this area and
it's something for which all of you
should be quite proud we have today
great champions from Nevada we
appreciate the support from Nevada but
not for one second should we forget what
congresswoman Buerkle did it's also
great to follow geremy what great energy
we'll great - enthusiasm and passion for
this area and the message that I heard
there was fantastic about embrace the
prosperity embrace what this area this
region has accomplished figure out how
we sustain that figure out how we
capitalize on it you know that same
message actually applies to the gaming
industry and I'm excited to talk a
little bit about that today before I get
started I want to thank Jonas I want to
thank the LB Gea I really appreciate the
invitation here and what congratulate
you for everything you've done in this
area supporting the economy here in
Nevada
I represent a national industry I'm
based in Washington a national
organization but I believe everything
we're doing whether we're doing it in
Nevada
New Jersey where I'll be tonight in
Atlantic City or whether we're doing in
Missouri or any other state that is
gaming it all comes back to helping Las
Vegas it all comes back to helping
Nevada so let me talk a little bit about
who this industry is right now where
we're going and the great opportunities
we have ahead because this is an
exciting time in the gaming industry not
just because we've got great new
properties opening we've got new markets
emerging we've got a former casino owner
as president of the United States and
whatever you might think of President
Trump for this industry that only says
opportunity that only says we've got an
opportunity to do something great that
we haven't had before so let's talk
about why we have that opportunity
because I think it's important that we
embrace that and then let's talk about
how we capitalize on this industry today
this industry that just started right
here in Nevada is today a 240 billion
dollar industry across 40 states in the
US 1.7 million jobs supported nearly 40
billion dollars in tax revenue this
industry is a major economic force and
it's only growing in the latest year for
which we have data available commercial
gaming did 39 billion dollars in revenue
tribal gaming 30 billion dollars in
revenue nearly seventy billion dollars
in revenue between these these two
entities commercial and tribal this is a
massive economic force in communities
across the country and that economic
footprint now speaks to the increasing
mainstream nature of our industry you
know when you look at the critics of
gaming the critics of gaming only exist
in the communities in which we don't do
business and the communities in which
casinos operate were strong community
partners and we are incredible economic
generators and that's a big part of the
opportunity we have ahead the second
part of the opportunity we have ahead
and more to that mainstream nature of
this industry is the improving
perception of this industry as all of
you know this October the Vegas golden
eye
we'll kick off their inaugural season
the Raiders will arrive in one two three
years of stadium not too far after that
we had a presidential debate last year
here in Las Vegas and as I said we have
a president who's a former casino owner
and one of the most amazing aspects
about that and there are a lot of
amazing aspects about that one of the
most amazing aspects about that the act
of owning casinos never came up during
the campaign the act of managing and the
ability to manage it came up a couple
times but the act of owning casinos
never came up so just as Jeremy was
talking about the prosperity here in in
Las Vegas and in this area think about
the prosperity of 2016
think of all the things that happen in
that year and ask yourself would that
have happened 10 years ago would have
happened five years ago in your wildest
dreams did you think all of these things
would happen just last year this
industry has come incredibly far in
terms of being a mainstream player in
the American economy in terms of being
accepted coast-to-coast eighty-five
percent of the American public now
saying that they're perfectly
comfortable with casinos for themselves
their friends their family were
mainstream how do we take advantage of
it these are the external factors that
are helping us as an industry there are
also several I think internal and excuse
me internal factors inter industry
factors that are changing who we are
increasingly I want to talk about these
three increasingly or a unified industry
for those of you that have been in Las
Vegas for some time for those of you
that have been close to the gaming
industry you know that unity
collaboration these are not hallmarks of
the casino gaming industry but they are
critical to our future success I often
talk about my own team asked me not to
talk about it but we're much better at
having a circular firing squad in this
industry than we are about getting in a
straight line and focusing on a common
target increasingly we're identifying
who when what that common target is the
American Gaming Association of today my
organization was created it was modeled
after the Motion Picture Association if
you know anything about that
organization Jack Valenti created it
years ago it was the Six Day
studio heads in Los Angeles and they
created this organization in Washington
and they sent him one of two messages
either do what we tell you to do or
leave us the hell alone
that was the MPAA message AG a
simplified that it created the big you
know the big six from here on the Las
Vegas Strip it had one simple message
for Washington leave us the hell alone
and that was the exclusive club that the
HEA was today we're different today we
represent that unified industry that
gaming is becoming we represent ninety
percent of all the revenue and
commercial gaming ninety five percent of
all the supplier revenue that's critical
to this industry we represent with just
ten prominent tribes in our organization
a third of all tribal gaming revenue the
industry is increasingly on the same
page and getting in that straight line
to focus its sights on issues of common
cause I'm gonna go back there the second
aspect of that that we're doing as an
industry is we're beginning to gain
confidence or beginning to gain a sense
that we can go get stuff done in 2016
alone this industry saved off three
critical attacks from Washington one an
effort to suggest that our industry
didn't take its anti-money laundering
compliance efforts seriously a sense
that this industry was not committed to
strict regulation and a threat of
hundreds of millions of dollars in fines
from the federal government when the
head of the agency in Washington left
her role after getting to know this
industry and getting exposed to the
people in this industry her message was
your industry actually has a good story
to tell our industry the gaming industry
is that a model for others in financial
services as to how to do anti-money
laundering compliance right when the IRS
said we want to lower slop tax
thresholds from $1,200 to $600 and we
want to use all those loyalty marketing
cards that many of you probably play
with we want to use those to track what
people are doing in the casinos that was
the proposal from the IRS this industry
stood up it worked in a collaborative
fashion it prevented that from happening
also last year when the federal
government set out to eliminate those
resort fees that Jeremy mentioned
resort fees that not everyone likes but
are worth a half a billion dollars on
the Las Vegas Strip alone this industry
worked together to prevent that from
happening three critical successes there
were only made possible because of the
unity of the industry and three critical
successes that give the industry
confidence next we can do a lot more we
can make other great things happen
the other great thing that make
positions us for future success is we're
not putting our head in the sand we see
what's coming down the pike we see what
the new issues are that are emerging we
see the development of daily fantasy
sports and east boards of skill-based
games outside Nevada the the development
of what's called convenience gaming
retail gaming distributed gaming
whatever you want to call it
machines and bars and taverns around the
country we realize these challenges are
out there and we're confronting them
head-on
we're asking ourselves and for a 240
billion dollar industry today how do we
become a 300 billion dollar industry
tomorrow and how do we work with these
newfound challenges that are out there
it's that type of bold thinking and
leadership that I think sets this
industry with these other factors sets
this industry up for tremendous success
in the future I think we are paid to do
position to do great things in the years
ahead and to areas I want to highlight
for you and you might be picking
yourself well we have these things in
Nevada so why does that matter to me I'm
going to close by coming back why these
things that are going to happen
elsewhere in the United States matter
and matter in a very good way right here
in Nevada the first tremendous
opportunity in front of this industry is
to take what Nevada has today a legal
regulated sports betting market and
permit every state in the country to opt
into this if they so choose you know
there was a long time where Nevada felt
hey we've got a monopoly on sports
betting why would we want to share this
with anybody else we get all those
people coming here for the Super Bowl we
get people coming here for March Madness
maybe we won't have people coming here
if sports betting is permitted elsewhere
well here's the dirty truth there's no
monopoly here in Nevada last year 4.7
billion dollars was wagered on the Super
Bowl three percent of that was wagered
legally here in Nevada 160 billion
dollars was
spent on sports betting across the
United States 3% of that was done
illegally here in Nevada Americans are
finding a way to wager on sports there
is incredible demand to be involved in
these games daily fantasy sports which
got all the attention is the tip of the
iceberg when it comes to how people want
to be engaged in games today and the
question becomes how do we open up these
other markets around the country to
enjoy this same product to regulate this
product to prove that they can regulate
effectively sports the same way they
regulate every other form of gaming I
think we're on the cusp of doing that
you've got League leaders coming out and
saying it's time for regulation Adam
silver of the NBA leading the way and
others following you've got law
enforcement increasingly coming to the
table to say that our resources are best
spent not trying to track down illegal
sports bettors but to focus on other
more serious crimes you've got states
and municipalities the US Conference of
Mayors the National Conference of State
Legislators and many others saying it's
time to regulate in this area I think
and I have said publicly in the first
term of the Trump administration sports
betting will be legalized or at least
Washington will get out of the way to
empower other states they have sports
betting now a disclaimer when I said
that I didn't realize this first term
might be shorter than usual I think we
will get this done
I'm confident we will get this done it
is a multi-billion dollar growth
opportunity for the industry around the
country and it's a growth opportunity
right here in Nevada the other thing we
have to do as an industry absolutely
have to do and this is where in many
senses Nevada is a model we have to
improve reform the regulation that
guides this industry in the other 40
states in which we're doing business you
know when casino gaming expanded beyond
Nevada and New Jersey and it went into
these other states these other states
thought they were bringing in a great
evil a great sin and they wanted to do
everything they could to get the revenue
from it but paralyzed every other
activity there with it the speed to
market of new machines the ability to
innovate with new products in these
other markets it's quite difficult the
ability to reinvest in your product when
you have 50 60 % tax rates in these
other states it's quite
physical our future success as an
industry demands that we've modernized
these regulations in every other state
in which we're doing business now the
obvious question on all these
modernizing regulations and sports
betting why is that good for Nevada two
reasons one as we've seen the gaming
industry thrive and other communities
around this country
Nevada's success has only increased
upwards of 50 million visitors now to
Las Vegas there was a fear when tribal
gaming came on in California that we see
a decline in visitation to Las Vegas
don't think anyone's making that
argument today as gaming thrives and
other markets gaming goes mainstream
Nevada's success only increases it is in
Nevada's interest to see sports betting
legalized elsewhere we don't want to be
the anomaly we don't want to be this
thing that's okay here but illegal
everywhere else we want what we do here
to become and practice a mainstream
industry the second reason this is
critical as so long as we have all these
different policies and antiquated
approaches to gaming everywhere outside
Nevada the ability to innovate in Nevada
remains difficult the cost to do this
research and development the cost to to
build these new products and really give
tomorrow's customer what it is that
they're looking for is extraordinarily
difficult with the inefficiencies that
we have across the country the more we
can streamline that the more we can get
a level playing field around the country
Nevada which is the home to so much of
this innovation the homes that some of
the biggest suppliers in this industry
stands to benefit and that's why what is
good for gaming outside of Nevada is
good for Nevada and it's our focus at
the aga it's our focus every day to
strengthen this industry I'm confident
that the future for the gaming industry
has never been brighter and the future
right here in Nevada has never been
brighter the aga is committed every day
to working on behalf of the gaming
industry many of you in this room to
build an environment where the casino
gaming industry can thrive my ask of
each of you in this room is to be our
partner in doing that to help us
understand
there are the challenges where are the
roadblocks where are the issues that
need to be addressed because the
industry has never been more capable to
get in those roadblocks those challenges
out of the way right now it's about
capitalizing on the opportunity we have
building on the success we've enjoyed
and building the strongest industry that
we can have in the years ahead I'm
confident that we're well on our way
there thank you for the opportunity I
don't we want to take any questions I
really appreciate the opportunity yes
sir excellent we do have time for just a
couple questions from the audience we've
got a roving mic out there Jeff is a
graciously agreed to stay on for a
couple minutes from the audience that
was a powerhouse presentation first can
we give him another round of applause
if no-one has any questions I see a
couple faces I recognize including
Marcus over there a couple others so
I'll just call on you ask questions
anybody going going once going twice
alright thank thank you very much again
thank you Jeff I'm not closed with this
I hope you had fun this morning I know I
did and it is our sincere hope that the
perspectives you hope that you heard
today will be of assistance as you make
your critical decisions throughout the
upcoming year again thank you for coming
have a good day
you