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The best dataset on American health care will be harder to access

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Prachi Sanghavi, a health-policy researcher at the University of Chicago, studies whether ambulances that provide medical care at the site of the emergency are better than basic ones that simply rush a patient to the hospital. (They are not.) She also studies whether the federal government’s rating system for nursing home quality is any good. (That’s a no, too). Her research helps Americans evaluate the country’s health-care practices. Unfortunately her work is now at risk.

Dr Sanghavi’s research uses data provided by the Centres for Medicare and Medicaid Services (CMS), the federal health-care agency that administers America’s public-health insurance. CMS announced plans in February to change its data-sharing practices. The proposal raises the fees for data and makes access less convenient. Nearly 400 researchers, including Dr Sanghavi, from over 75 institutions across America have signed a letter in protest. They claim that the new restrictions will jeopardise ground-breaking research.

America does not have a national health-records system, so the CMS numbers are the best data available. Over a third of Americans are covered by CMS, and over 1bn medical claims a year are processed through the agency. This makes it a trove for researchers studying anything from health-care privatisation to the causes of the opioid epidemic.

The agency says it is changing the rules over concerns for data security. On the face of it, that sounds reasonable. CMS had a data breach just last year. Sensitive personal information, such as social-security numbers and mailing addresses, was compromised for over 600,000 people. Last month Change Healthcare, a health-care payment company bought by UnitedHealth Group, a large private insurer, was also targeted.

Under the current model of data-sharing, researchers can receive physical copies of the CMS data. They are then responsible for keeping the data secure, explains Alice Burns, a researcher at KFF, a health-policy think-tank. Unlike the CMS data that were hacked, the data for researchers do not contain individual names and social-security numbers.

However, they do contain sensitive information such as health diagnoses and a person’s age, race and zip code. In some instances a determined hacker could be able to identify an individual, but it is highly unlikely, says David Maimon of Georgia State University, who studies cyber-security. The proposed policy requires researchers to switch instead to a virtual centre hosted by CMS.

This is about balancing risk and benefit, says Haywood Talcove of LexisNexis Risk Solutions, a firm that sells fraud-prevention services. In this case the calculus seems lopsided. Since CMS has been hacked before, hoarding the data there doesn’t make it secure.

The researchers say that the benefits of the current model far outweigh the security risks. The protesting scientists claim that less-established researchers and those at poorer academic institutions could lose access. “Why wouldn’t we invite the best public-health experts in the world to look at the same data that we have?” asks Paul Mango, a former chief of staff at CMS under the Trump administration.

All is not lost. The changes have yet to go into effect, and the agency is accepting feedback from researchers until May 15th. But for now, the researchers would like to keep the status quo. Since the vast majority of older adults are on Medicare, these numbers give “a beautiful longitudinal view of a person’s life”, says Dr Sanghavi. It’s hard to put a price on that.

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Economics

Reeves’ plans contending with the bond market

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LONDON, UNITED KINGDOM – MARCH 26, 2025: Britain’s Chancellor of the Exchequer Rachel Reeves leaves 11 Downing Street ahead of the announcement of the Spring Statement in the House of Commons in London, United Kingdom on March 26, 2025. (Photo credit should read Wiktor Szymanowicz/Future Publishing via Getty Images)

Wiktor Szymanowicz | Future Publishing | Getty Images

Britain’s government is planning to ramp up public spending — but market watchers warn the proposals risk sending jitters through the bond market further inflating the country’s $143 billion-a-year interest payments.

U.K. Finance Minister Rachel Reeves on Wednesday announced the government would inject billions of pounds into defense, healthcare, infrastructure, and other areas of the economy, in the coming years. A day later, however, official data showed the U.K. economy shrank by a greater-than-expected 0.3% in April.

Funding public spending in the absence of a growing economy, leaves the government with two options: raise money through taxation, or take on more debt.

One way it can borrow is to issue bonds, known as gilts in the U.K., into the public market. By purchasing gilts, investors are essentially lending money to the government, with the yield on the bond representing the return the investor can expect to receive.

Gilt yields and prices move in opposite directions — so rising prices move yields lower, and vice versa. This year, gilt yields have seen volatile moves, with investors sensitive to geopolitical and macroeconomic instability.

The U.K. government’s long-term borrowing costs spiked to multi-decade highs in January, and the yield on 20- and 30-year gilts continues to hover firmly above 5%.

Official estimates show the government is expected to spend more than £105 billion ($142.9 billion) paying interest on its national debt in the 2025 fiscal year — £9.4 billion higher than at the the time of the Autumn budget last year — and £111 billion in annual interest in 2026.

The government did not say on Wednesday how its newly unveiled spending hikes will be funded, and did not respond to CNBC’s request for comment about where the money will come from. However, in her Autumn Budget last year, Reeves outlined plans to hike both taxes and borrowing. Following the budget, the finance minister pledged not to raise taxes again during the current Labour government’s term in office, saying that the government “won’t have to do a budget like this ever again.”

Andrew Goodwin, chief U.K. economist at Oxford Economics, said Britain’s government may be forced to go even further with its spending plans, with NATO poised to hike its defense spending target for member states to 5% of GDP, and once a U-turn on winter fuel payments for the elderly and other possible welfare reforms are factored in.

Additionally, Goodwin said, the U.K.’s Office for Budget Responsibility is likely to make “unfavorable revisions” to its economic forecasts in July, which would lead to lower tax receipts and higher borrowing.

“If recent movements in financial market pricing hold, debt servicing costs will be around £2.5bn ($3.4 billion) higher than they were at the time of the Spring Statement,” Goodwin warned in a note on Wednesday.

‘Very fragile situation’

Mel Stride, who serves as the shadow Chancellor in the U.K.’s opposition government, told CNBC’s “Squawk Box Europe” on Thursday that the Spending Review raised questions about whether “a huge amount of borrowing” will be involved in funding the government’s fiscal strategies.

“[Government] borrowing is having consequences in terms of higher inflation in the U.K. … and therefore interest rates [are] higher for longer,” he said. “It’s adding to the debt mountain, the servicing costs upon which are running at 100 billion [pounds] a year, that’s twice what we spend on defense.”

“I’m afraid the overall economy is in a very weak position to withstand the kind of spending and borrowing that this government is announcing,” Stride added.

UK is in a 'very fragile situation,' Shadow Chancellor Mel Stride says

Stride argued that Reeves will “almost certainly” have to raise taxes again in her next budget announcement due in the autumn.

“We’ve ended up in a very fragile situation, particularly when you’ve got the tariffs around the world,” he said.

Rufaro Chiriseri, head of fixed income for the British Isles at RBC Wealth Management, told CNBC that rising borrowing costs were putting Reeves’ “already small fiscal headroom at risk.”

“This reduced headroom could create a snowball effect, as investors could potentially become nervous to hold UK debt, which could lead to a further selloff until fiscal stability is restored,” he said.

Iain Barnes, Chief Investment Officer at Netwealth, also told CNBC on Thursday that the U.K. was in “a state of fiscal fragility, so room for manoeuvre is limited.”

“The market knows that if growth disappoints, then this year’s Budget may have to deliver higher taxes and increased borrowing to fund spending plans,” Barnes said.

However, April LaRusse, head of investment specialists at Insight Investment, argued there were ways for debt servicing burdens to be kept under control.

The U.K.’s Debt Management Office, which issues gilts, has scope to reshape issuance patters — the maturity and type of gilts issued — to help the government get its borrowing costs under control, she said.

“With the average yield on the 1-10 year gilts at c4% and the yield on the 15 year + gilts at 5.2% yield, there is scope to make the debt financing costs more affordable,” she explained.

However, LaRusse noted that debt interest payments for the U.K. government were estimated to reach the equivalent of around 3.5% of GDP this fiscal year, and that overspending could worsen the burden.

“This increase is driven not only by higher interest rates, which gradually translate into higher coupon payments, but also by elevated levels of government spending, compounding the fiscal burden,” she said.

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Economics

Here are the three reasons why tariffs have yet to drive inflation higher

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Shoppers browse the frozen food cases at WinCo.

Joe Jaszewski | Idaho Statesman | Tribune News Service | Getty Images

Despite widespread fears to the contrary, President Donald Trump‘s tariffs have yet to show up in any of the traditional data points measuring inflation.

In fact, separate readings this week on consumer and producer prices were downright benign, as indexes from the Bureau of Labor Statistics reported that prices rose just 0.1% in May.

The inflation scare is over, then, right?

To the contrary, the months ahead are still expected to show price increases driven by Trump’s desire to ensure the U.S. gets a fair shake with its global trading partners. So far, though, the duties have not driven prices higher, save for a few areas that are particularly sensitive to higher import costs.

At least three factors have conspired so far to keep inflation in check: companies hoarding imported goods ahead of the April 2 tariff announcement, the time it takes for the charges to make their way into the real economy, and the lack of pricing power companies face as consumers tighten belts.

“We believe the limited impact from tariffs in May is a reflection of pre-tariff stockpiling, as well as a lagged pass-through of tariffs into import prices,” Aichi Amemiya, senior economist at Nomura, said in a note. “We maintain our view that the impact of tariffs will likely materialize in the coming months.”

Wholesale price measure rose just 0.1% in May, below forecast

This week’s data showed isolated evidence of tariff pressures.

Canned fruits and vegetables, which are often imported, saw prices rise 1.9% for the month. Roasted coffee was up 1.2% and tobacco increased 0.8%. Durable goods, or long-lasting items such as major appliances (up 4.3%) and computers and related items (1.1%), also saw increases.

“This gain in appliance prices mirrors what happened during the 2018-20 round of import taxes, when the cost of imported washing machines surged,” Joseph Brusuelas, chief economist at RSM, said in his daily market note.

One of the biggest tests, though, on whether the price increases will prove durable, as many economists fear, or as temporary, the prism through which they’re typically viewed, could largely depend on consumers, who drive nearly 70% of all economic activity.

The Federal Reserve’s periodic report on economic activity issued earlier this month indicated a likelihood of price increases ahead, while noting that some companies were hesitant to pass through higher costs.

“We have been of the position for a long time that tariffs would not be inflationary and they were more likely to cause economic weakness and ultimately deflation,” said Luke Tilley, chief economist at Wilmington Trust. “There’s a lot of consumer weakness.”

Indeed, that’s largely what happened during the damaging Smoot-Hawley tariffs in 1930, which many economists believe helped trigger the Great Depression.

Tilley said he sees signs that consumers already are cutting back on vacations and recreation, a possible indication that companies may not have as much pricing power as they did when inflation started to surge in 2021.

Fed officials, though, remain on the sidelines as they wait over the summer to see how tariffs do impact prices. Markets largely expect the Fed to wait until September to resume lowering interest rates, even though inflation is waning and the employment picture is showing signs of cracks.

“This time around, if inflation proves to be transitory, then the Federal Reserve may cut its policy rate later this year,” Brusuelas said. “But if consumers push their own inflation expectations higher because of short-term dislocations in the price of food at home or other goods, then it’s going to be some time before the Fed cuts rates.”

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Economics

Does America now have a woke right?

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THE HORSESHOE theory of politics—the idea that the far-left and far-right resemble each other—has performed admirably well in the Trump era. It gained fresh vindication in a recent squabble among intellectuals of the new right, as some accuse others of being part of the “woke right”, the mirror image of their hated opponents on the left.

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