This week’s feature story is about the lack of advancements in women’s health care and what family offices can do about it. Erin Chan Ding talks with industry professionals who are leading the charge in the space and with the impact investors who are outraged by how women’s health has been overlooked in both the private and public sectors.
We’re also reporting on how wealthy families may be heavily impacted by the results of the November elections as the Trump-era tax cuts face expiration. Andrew Cohen met with Jeff Fishman of JSF Financial, who shares what’s riding on the election from a pure tax planning and overall asset and estate planning perspective. All eyes are on November.
As always, we appreciate any comments, ideas and insights that would make this newsletter more useful. I look forward to growing this family office community with your help. Please email me at [email protected].
- Crain Currency is looking forward to covering Family Office Exchange’s upcoming Global Investment Forum this May 7-8 in Miami — and you should consider joining, too. The event will provide family offices the opportunity to connect with peers for an exchange of ideas about how to navigate an ever-evolving investment landscape.
HANDPICKED: Investing in women’s health: ‘Dollars made and lives saved’
By ERIN CHAN DING
One thing seemed sure for Eve McDavid in January 2020: She was one month away from giving birth to her second baby.
Back then, the threat of a virus that the world had started calling COVID-19 loomed. But something else completely unexpected slammed into McDavid’s life — a diagnosis of cervical cancer.
Shortly afterward, with a newborn to care for while worrying about a flaring pandemic, McDavid underwent aggressive treatment for cancer. During the ordeal, McDavid, who had been working for Google for a decade, became invested not only in her own treatment but also in research and a cure for all women with cervical cancer.
The more she researched, the more McDavid realized that with cervical cancer, “there are solutions in every single category” across the care continuum — so much so that the World Health Organization in 2018 called for the elimination of cervical cancer and in November 2020 published a global strategy to do so.
And yet McDavid also recognized that a primary obstacle is the vast underfunding of research and treatment — “which means that the existing state of tools and technology are for the most part quite dated, which then means that there's such little innovation,” she said.
In response to these funding and treatment gaps, McDavid co-founded Mission-Driven Tech — which aims to eradicate cervical cancer by administering brachytherapy, a cervical cancer treatment, using modern devices to lessen pain and create more effective outcomes.
Family offices, she said, can play a large role in improving women’s health care — and, in turn, society — by investing in technological advances that not only help with potential cures but also could prove financially savvy.
Investing in women’s health generates substantial returns
Investing in women’s health care and solutions could generate $1 trillion in economic returns by 2040 by enabling women to participate more fully and actively in the workforce, according to a recent McKinsey report. McDavid explained that for every $1 invested in cervical cancer prevention, research and treatment, $26 is returned to the global economy.
According to the McKinsey report, which says women spend 25% of their lives in “debilitating health,” the National Institutes of Health allocates just 11% of its budget to women’s health-specific research. And although women have a 50% higher mortality rate after a heart attack, the NIH allocates just 4.5% of its funding for coronary artery disease toward women-focused research.
“Women's health care is overlooked both in the private sector and in public markets," said Kristin Hull, CIO of Nia Impact Capital, a women-led investment firm focused on making a positive impact. "With the vast majority of investors identifying as male, women's health has not been an area of expertise or of interest historically.”
The White House Initiative on Women's Health Research, launched in November, along with an initiative to close the women’s health gap, could bring more attention to women’s health and pique investor interest, Hull said.
In February, first lady Jill Biden announced that the Advanced Research Projects Agency for Health (ARPA-H), an entity within the NIH, will invest $100 million toward a “Sprint for Women’s Health” to fund both early-stage research and late-stage solutions.
Ida Tin — who coined the term “femtech” in 2016 to encompass technology and innovation that focuses on women’s health — said it’s important for family offices to invest in women’s health because “it’s clear that a singular focus on profit won’t give us a healthy planet to live on. Investing into women’s health is getting us on a track where women can participate in society more fully.”
Tin — who’s also the co-founder and former CEO and chairwoman of Clue, a menstruation-tracking app — said this is true both domestically and globally. “Women struggling with basic health needs are not as impactful as healthy women are,” she said, “and we need them.”
How family offices can help
The McKinsey report says there’s “enormous potential around treatments for sex- or gender-specific conditions” for private equity, citing sales revenue for breast cancer treatments totaling $18 billion in 2022, compared with $11 billion for prostate cancer treatments that same year.
“Women’s health is an excellent area for family offices to make a significant difference and be quite catalytic, as all areas of women's health are underfunded and underresearched as compared to the male body,” Hull said. In particular, menopause and vaginal health are vastly underresearched, she said, adding, “Impact investors can seed change in these areas.”
In 2023, Amboy Street Ventures, a venture capital fund that invests in women’s health and sexual well-being, closed on $20 million in its inaugural fund, according to Venture Capital Journal. The report noted that Amboy's limited partners include a family office and several high-net-worth individuals.
Anu Parvatiyar, co-founder and CEO of Ananya Health, is building a tool that clinics can use to freeze abnormal cells before they become malignant cervical cancer. Public and private funding, including from individuals and families, is important to her startup, Parvatiyar said, but “private capital allows us to move so much faster.”
As a first step for family offices, Hull recommends that they identify managers on the public equity side that concentrate on women’s health, such as her own. On the private side, there are funds that focus on specific areas — such as Rhia Ventures, which invests in reproductive and maternal health.
When it comes to investing in the sector, McDavid stresses that it’s important for everyone in a family office to look at their own stories.
“What I would start with is: ‘What issues matter? What health issues have you been touched by? And what were your own pain points that you would have liked to see improved?” she said.
The most effective family office investors build relationships with founders, Parvatiyar said. “Do you trust the worldview? Especially if you don't know too much about their domain area — do you trust their decision-making?”
She also wants family offices to remember that investing in women’s health does not mean that impact comes at the expense of return.
“By investing in companies that you believe in,” Parvatiyar said, “because they are good companies making things that you think should exist in the world, you give them the potential to create that financial return as well.”
Wealthy families face major estate tax implications from election
By ANDREW COHEN
Families intending to pass wealth down to the next generation could be heavily impacted by the results of the November elections as the Trump-era tax cuts face expiration.
The Tax Cuts and Jobs Act (TCJA), enacted in 2017, is set to expire Dec. 31, 2025, and the legislation’s renewal largely depends on which party gains control of the White House and Senate this fall. Under the current TCJA, the top individual tax rate dropped to 37% from 39.6%.
If the tax cuts expire, "that means wealthy families who are now able to give to the next generation almost $28 million, they'll be cut in half,” Jeff Fishman of JSF Financial told Crain Currency. “So now couples will only be able to leave $14 million.
"You’ve got wealthy people who are like 'Wait a second: We're going to lose the ability to give $14 million tax-free to our kids and grandkids — what do we do? How do we plan for that?' So that's one major issue.”
Fishman founded Los Angeles-based JSF Financial in 1996 and advises about $2.5 billion in assets for high-net-worth clients in Hollywood. JSF recently launched a philanthropic entity to advise wealthy clients on strategy around planned giving. The amount that families are inclined to give back to charities figures to be affected by tax policies hinging on November’s election.
“New York and California have high state taxes," Fishman said. "It used to be you could deduct them against your federal taxes, but you no longer can if that current tax law rolls off the books. So there’s a lot riding on the election from pure tax planning and overall asset and estate planning. All eyes, at least in our world, are on what happens in November, and then we'll have a year arguably to really try to plan hard.”
2010 was the last year that the federal government eliminated an estate tax, also known as a “death tax.” Currently, the Internal Revenue Service exempts from the tax estates of less than $13.61 million, while those above that threshold face tax rates between 18% and 40%.
Several states, including New York and Connecticut, also levy their own estate taxes.
If the Democrats win November’s election, Fishman expects high-net-worth families to pass down their assets before the expiration of the Trump tax cuts at the end of 2025.
“I think you’re going to have wealthy families go ahead and give all $28 million worth of assets to the next generation now,” he said. “So it could be real estate, it could be marketable securities, or we’re gonna give you our house right now, a beach house. They'll do whatever they can to shift assets out of their estate because anything above that [estate exemption] is taxed at 40%."
LOOSE CHANGE
Forbes Banister adds family office staffing expert: In his new role, David Friedman will provide family office staff retention and recruiting services to the wealthiest families.
Tuscan winery innovates by integrating next gen: Leonardo de Keersmaeker shares the family’s history and how the multiple generations are working together to move the family business forward.
Art Basel unveils highlights of 2024 fair: The Swiss fair, which runs June 13-16, will feature 286 galleries from around the world that showcase painting, sculpture, photography and digital artworks.
Help us with a story: We’re working on a story about family office compensation and seeking professionals who can speak to this. If you have any comments on the topic, reach out to [email protected].