XLV vs FHLC: Which Healthcare ETF Fits Your Portfolio?

The State Street Health Care Select Sector SPDR ETF (XLV) and Fidelity MSCI Health Care Index ETF (FHLC) both offer low-cost healthcare exposure with identical 0.08% expense ratios. XLV focuses on 60 mega-cap healthcare stocks and has delivered stronger 5-year returns ($1,332 vs $1,276 on $1,000 invested), higher dividend yield (1.60% vs 1.30%), and greater liquidity with $41.7B in AUM. FHLC provides broader diversification with 365 holdings including mid and small-cap stocks. Over 10 years, both underperformed the S&P 500 significantly, with XLV returning 157% (9.9% CAGR) and FHLC returning 159% (10.0% CAGR) versus the S&P 500's 301% (14.9% CAGR).