Can artificial intelligence be so transformative as to solve one of the U.S. economy’s biggest problems: its skyrocketing fiscal deficit? According to three economists at the Brookings Institution, the answer is yes — AI could prove a positive “critical shock” for the country’s fiscal health.
A working paper released last month by the Center on Regulation and Markets at Brookings projects that under the most optimistic scenario, AI could reduce the annual U.S. budget deficit by as much as 1.5% of gross domestic product by 2044, or about $900 billion in nominal terms, lowering annual budget deficits by roughly one fifth at the end of the 20-year span.
“The use of AI presents the rare — possibly unique — opportunity to expand access to health care information and services while simultaneously reducing the burden on the conventional health care system,” the paper’s authors, Ben Harris, Neil Mehotra and Eric So, wrote.
While the authors name various channels through which AI can increase productivity, they highlight AI’s potential to dramatically improve health care services and public health.
Not only could AI make American health care more efficient, it might also “democratize” access to the system by giving people more options for preventative medical care — “changing the ‘who’ and ‘where’ of health care,” the economists wrote.
AI could ease deficit pressure
The economic impacts of a more efficient health care system, and giving individuals more paths to manage their own health, could ease pressure on the government’s yawning fiscal deficit, which topped $1.8 trillion in the fiscal year ended Sept. 30. The national debt stands at $36 trillion.
But adopting AI in health care services isn’t a sure thing. Plenty of impediments stand in the way of widely implementing AI, largely tied to regulation and incentives.
Economists’ outlook on AI and health care is “a mix of enthusiasm and despair,” said Ajay Agrawal, a professor at the University of Toronto’s Rotman School of Management ,where he researches the economics of artificial intelligence.
“Enthusiasm because there’s probably no sector that stands to benefit more from AI than health care. … But there’s friction due to regulation, due to incentives — because of the way things are structured and how people are paid for things — and friction due to the associated risks and liabilities,” Agrawal said.
“So yes, there’s lots of implementation challenges, and at the same time, the prize for succeeding at this is very big,” Agrawal said.
Health care and the deficit
The federal government spent an estimated $1.8 trillion on health insurance in 2023, or around 7% of GDP, according to the Congressional Budget Office. From 2024 to 2033, the CBO forecasts federal subsidies for health care will total $25 trillion, or 8.3% of GDP.
The problem is that so much health care spending in the U.S. isn’t tied to treatment or patient outcomes. Instead, about a quarter of all spending, public and private, is estimated to go toward administrative functions.
“Nearly every industry in the U.S. has experienced substantial improvements in productivity over the last 50 years, with 1 major exception: health care,” according to a report by McKinsey analysts.
This is one area where AI could improve operations, according to the Brookings Institution economists. Basic tasks such as appointment scheduling can be automated, while tasks such as patient flow management and preliminary data analysis can also be done by AI programs.
While the three economists acknowledge that the impact of AI on federal spending is still “highly uncertain,” the coauthors believe it could ultimately be more transformative for the economy than past technological leaps, such as the use of personal computers in the 1990s. The current AI shock “feels different. This isn’t your typical technological shock,” Harris told CNBC.
AI is affecting “how people receive health care,” how the drug industry discovers new products and how researchers make medicine more precise, Harris said.
Disease and death rates
In particular, Harris underscored AI’s impact not just on productivity, but also its potential to transform the cost of care and the rates of illness, disease and death.
“Such changes could have profound impacts on Social Security and public health program outlays,” he and his coauthors wrote.
To be sure, there is also the potential that AI advancements could counterintuitively increase federal spending if the average lifespan increases as a result of the technology. Not only could improved technology lead people to seek more medical care, longer lifespans might also result in a larger retired population.
But the Brookings paper takes a more optimistic tack, predicting one of AI’s largest benefits will result from accelerating the efficacy of preventative care and disease detection. This will create a healthier population that will need less medical intervention, the authors wrote — and might also increase labor force participation rates if a healthier workforce stays employed for more years.
“AI’s ability to improve diagnostic accuracy can not only improve patient outcomes but also reduce wasteful spending on inappropriate treatments,” the economists said. “From a more optimistic perspective, existing AI systems may lower expenditures on all health spending, including Medicare, with cost reductions occurring through several channels—with personalized medicine being a prominent example.”
Evaluating whether AI can ultimately translate into a positive or negative shock on fiscal policy will depend on what stage of the age distribution it affects, Agrawal said. Whether AI is “having its bigger impact on retired people, or around working people,” will answer how the numbers play out, Agrawal said.
AI proliferating already
So far, diagnostics has shown the most advances and greatest potential in applying AI in health care. Agrawal cited AI’s influence throughout almost all the steps of diagnostic care, from receiving input data, medical imagery such as X-rays and MRIs, as well as doctor notes, charts.
“In almost every area of diagnosis, AI has, in some cases, already demonstrated what they call ‘superhuman performance’ — better than than most docs,” Agrawal said.
AI has also shown “significant promise” in better optimizing treatment plans for patients through data analysis. Machine intelligence can develop more effective and less costly plans for individual patients, according to the authors of the paper.
Agrawal believes it’s too early to say whether public or private health systems will take better advantage of AI. In the U.S., private insurers have generally been more keen on AI technology associated with preventative treatment, he said. There’s been less interest in using AI in diagnostic applications, possibly that might lead to a rise in cases and more treatment, he said.
“There aren’t clear economic incentives for the private sector to [implement] that,” said Agrawal. “In the public sector, even though there are incentives, there are a lot of frictions associated with privacy on the data side.”
He believes public-private partnerships will be key in driving the rollout of AI across health care.
The public health care sector “will need very strong incentives in order to drive change, because otherwise, everybody is in their routine. There’s a lot of resistance to change,” Agrawal said.
“So to get over that resistance, you need a very strong motivator, and the private sector generally provides a much stronger motivator, either because the users are trying to reduce cost, or the creators of the technology are trying to generate profit,” he continued.
Large tech companies have already pushed forward in developing large language models specifically for health care services. Google’s AI system, Articulate Medical Intelligence Explore (AMIE), mimics diagnostic dialogue. Its Med-Gemini platform uses AI to aid in diagnosis, treatment planning and clinical decision support. Amazon and Microsoft have their own projects underway to expand the application of AI programs in health services.
Outlook under Trump
President-elect Donald Trump’s second term could alter the rollout of AI in health care, and ultimately, its economic impact. Trump has vowed to reduce government spending and formed an outside panel called the Department of Government Efficiency designed to “dismantle Government Bureaucracy, slash excess regulations, cut wasteful expenditures, and restructure Federal Agencies.” Public health funding is one area that could reduced funding, frustrating the ability to roll out AI applications.
“Now, it is possible that if you do see a retreat in the federal government’s role in providing health care to people, that more efficient AI could help compensate for the cost of that retreat,” said Harris. “If AI means that each dollar goes farther, then I think we’ve timed everything in a sort of lucky way.”
There’s also the chance that rolling back regulations under a second Trump administration could expedite the implementation of AI across health care.
“Many people are fearful of reducing regulation because they don’t want technologies that are immature to be brought into the health care system and harm people,” Agrawal said. “And that’s a very legitimate concern. But very often what they fail to also put into their equation is the harm we’re causing people by not bringing” in new technologies, he added.
“Some areas need a lot more technical development, but there are some domains in diagnosis that are already ready to go, and it’s just regulation that’s preventing them from being used,” Agrawal said.
Guests and attendeess mingle and walk through the atrium during the IMF/World Bank Group Spring Meetings at the IMF headquarters in Washington, DC, on April 24, 2025.
Jim Watson | Afp | Getty Images
After years dominated by the pandemic, supply chains, energy and inflation, there was a new topic topping the agenda at the World Bank and International Monetary Fund’s Spring Meetings this year: tariffs.
The IMF set the tone by kicking off the week with the release of its latest economic forecasts, which cut growth outlooks for the U.S., U.K. and many Asian countries. While economists, central bankers and politicians have been engaged in panels and behind-the-scenes talks, many are attempting to work out whether trade tensions between China and the U.S. are — or perhaps are not — cooling.
These were some of the main messages from ECB members this week.
Christine Lagarde, European Central Bank president
On inflation and monetary policy:
“We’re heading towards our [inflation] target in the course of 2025, so that disinflationary process is so much on track that we are nearing completion. But we have the shocks, you know, and the shocks will be a dampen on GDP. It’s a negative shock to demand.”
“The net impact on inflation will depend on what countermeasures are eventually taken by Europe. Then we have to take into account the [German] fiscal push by the defense investments, by the infrastructure fund.”
“We have seen successive movements, you know, announcement [of U.S. tariffs], and then a pause, and then some exemptions. So we have to be very attentive… Either we cut, either we pause, but we will be data dependent to the extreme.”
On market moves:
“When we had done our projections, we anticipated that… the dollar would appreciate, the euro would depreciate. It’s not what we saw. And there have been some counter-intuitive movements in various categories.”
“The German market has obviously been shocked in a positive way by the program soon to be put in place by the German government, with a commitment to defense, with a commitment to a big fund for infrastructure development.”
Klaas Knot, The Netherlands Bank president
On tariff uncertainty:
“If I look back over the last 14 years, in the initial days of the pandemic I think that was comparable uncertainty to what we have now.”
“In the short run, it’s crystal clear that the uncertainty that is created by the unpredictability of the tariff actions by the U.S. government works as a strong negative factor for growth. Basically, uncertainty is like a tax without revenue.”
On the inflation impact:
“In the short run, we will have lower growth. We will probably also have lower inflation. As we also see, the euro is appreciating as energy prices have also come down. So together with the sort of negative factor uncertainty in the short run, it’s crystal clear that it will accelerate the disinflation.”
“But in the medium term, the inflation outlook is not all that clear. I think there are still these negative factors. But in the medium term, you might get retaliation. You might get the disruption of global value chains, which might also be inflationary in other parts of the world than the U.S. only. And then, of course, we have the fiscal policy coming in in Europe. So this is actually a time in which you need projections.”
On a June rate cut and market pricing for two more ECB rate cuts in 2025:
“I’m fully open minded. I think it’s way too early to already take a position on June, whether it would be another cut. It will fully depend on these projections.”
“I would need to see a more structured analysis of the impact on the inflation profile ahead of us, and only then can I say whether the market is pricing fair or whether I don’t.”
Robert Holzmann, Austrian National Bank governor
On the need to wait for more data and news on tariffs:
“We have not seen this uncertainty now for years… unless the uncertainty subsides, by the right decisions, we will have to hold back a number of our decisions, and hence, we don’t know yet in what direction monetary policy should be best moved.”
“Before looking at data in detail, the question is, what kind of political decisions will be taken? Is it that we will have some tariff increases? Is it that we will have strong tariff increases? Is it that we will have retribution by high counter tariffs?”
On the ECB’s April rate cut:
“I think there’s a broad consensus [on rates]. But of course, at the margin, people differ.”
“My assessment is that at this time, it wasn’t clear yet to what extent [tariff] countermeasures were being taken. Because with countermeasures in Europe, prices may have increased. Without countermeasures, quite likely the price pressure is downward. And for the time being, we don’t know yet the direction.”
On the direction of interest rates:
“I think if the recent noises about an arrangement [on trade] were to be true, in this case, quite likely it is more towards the downside than the upside with regard to prices. But this can be changed with different decisions and the result of which, we may even imagine in [the] other direction. For the time being, no, it will be down.”
“There may be further cuts this year, but the number is still outstanding.”
Mārtiņš Kazāks, Bank of Latvia governor
On opportunity from tariffs:
“With all this uncertainty and vulnerability, this is also the time of opportunities for Europe.”
“It’s a time for Europe to grasp all the aspects of being an economic superpower and becoming a really fully-fledged political and geopolitical superpower, and this requires doing all the decisions that in the past, were not carried out fully.”
“This requires political will, political guts to make those decisions, and to strengthen the European economy and assert its place in a global world.”
On market reaction to tariffs:
“So far it seems to be relatively orderly … but if one looks at the spillovers to Europe, the financial markets are working more or less fine, we haven’t seen spreads exploding or anything like that.”
“But in terms, however, of the macro scenarios, this uncertainty is extremely elevated in the sense that, given the possible outcomes, the multiple scenarios and their probabilities are very similar with the baseline [tariff] scenario.”
US President Donald Trump speaks during a bilateral meeting with Prime Minister of Norway Jonas Gahr Store in the Oval Office of the White House in Washington, DC, on April 24, 2025.
Saul Loeb | Afp | Getty Images
President Donald Trump denied that an aggressive bond market sell-off influenced his decision earlier this month to hold off on aggressive “reciprocal” tariffs against U.S. trading partners.
“I wasn’t worried,” Trump said in a Time magazine interview during which he was asked about financial market tumult after his April 2 “liberation day” announcement.
In the decree, Trump slapped 10% across-the-board duties against all U.S. imports and released list of tariffs against dozens of other nations. The extra levies were based on trade deficits the U.S. had against the respective countries and raised fears about inflation, a potential recession and disruption of long-held trade agreements.
Markets recoiled following the release. Treasury yields initially headed lower but quickly snapped higher. The 10-year yield rose half a percentage point in just a few days, one of its quickest moves ever, as investors also ditched stocks and the U.S. dollar.
Ultimately, Trump issued a 90-day stay on the reciprocal tariffs to allow time for negotiation. But he said it wasn’t because of the market tumult.
“No, it wasn’t for that reason,” Trump told Time in the interview from Tuesday that was published Friday. “I’m doing that until we come up with the numbers that I want to come up with. I’ve met with a lot of countries. I’ve talked on the telephone. I don’t even want them to come in.”
Yields have since moved lower, with the 10-year most recently around 4.28%, about a quarter percentage point higher than its recent low. Trump had said when he made the decision to hold off that the bond market had gotten the “yips.”
“The bond market was getting the yips, but I wasn’t. Because I know what we have,” he said. “I know what we have, but I also know we won’t have it for long if we allowed four more years of the gross incompetence. This thing was just running — it was running as a free spirit. This was — this was the most incompetent president in history.”
Though negotiations over tariffs are ongoing, Trump added that he would consider it a “total victory” even if the U.S. has levies as high as 50% still in place a year from now.
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The Bank of England is focused on the potential impact of U.S. tariffs on U.K. economic growth if there is a slowdown in global trade, the central bank’s governor Andrew Bailey said Thursday.
“We’re certainly quite focused on the growth shock,” Bailey told CNBC’s Sara Eisen in an interview at the IMF-World Bank Spring Meetings.
Going into its May 8 monetary policy meeting, the central bank will consider “arguments on both sides” around the impact of tariffs on growth and domestic supply constraints on inflation, Bailey said.
“There is clearly a growth issue we start with, with weak growth … but a big question mark is how much of that is caused by the weak demand, how much of it is caused by a weak supply side,” he continued.
“Because the weak supply side, of course, unfortunately, has the sort of the upside effect on inflation. So we’ve got to balance those two. But I think the trade issue is now the new part of that story.”
Inflation could be pulled in either direction by wider forces, with a redirection of trade exports into other markets being disinflationary, but a retaliation on U.S. tariffs by the U.K. government — which he stressed did not appear likely — pushing up inflation.
Bailey added that he did not see the U.K. as being close to a recession at present, but that it was clear economic uncertainty was weighing on business and consumer confidence.
IMF downgrade
The IMF earlier this week downgraded its 2025 growth forecast for the U.K. to 1.1% from 1.6%, citing the impact of U.S. President Donald Trump’s trade tariffs, higher borrowing costs and increased energy prices.
However, economic forecasting remains mired in uncertainty as countries engage in negotiations with U.S. officials over Trump’s swingeing universal tariff policy, currently on pause. The U.S. has imposed 25% tariffs on steel, aluminum and autos and a 10% levy on other British exports.
U.K. policymakers have expressed hopes of reaching a trade deal with the White House, with U.S. Vice President J. D. Vance saying there is a “good chance” of an agreement.
Bailey told CNBC on Thursday that he would be “very encouraged if the U.K. does make a deal,” but that its economy was very open and services-oriented, so it would still be impacted by a wider slowdown in growth or trade.
He also noted that inflation would increase from the current 2.6% in the coming readings due to effects from markets such as energy prices and water bills, but that the bump up would be “nothing like what we saw a few years ago.”
The Bank of England held interest rates at 4.5% at its March meeting, before Trump shocked the world with the scale of his tariff announcement.
Markets now see the BOE slashing rates to 4% by its August meeting.