Thoughts on the Market

In the second part of our economic roundtable, Michael Gapen, Jens Eisenschmidt and Chetan Ahya join Seth Carpenter to discuss how central banks are balancing sticky inflation, resilient growth and regional policy trade-offs.
Read more insights from Morgan Stanley.

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Seth Carpenter: Welcome to Thoughts on the Market. I'm Seth Carpenter, Morgan Stanley's Global Chief Economist and Head of Macro Research.
And once again today, I am joined by Morgan Stanley's chief regional economists: Michael Gapen, the Chief U.S. Economist, Jens Eisenschmidt, our Chief Europe Economist, and on the other side of the world, Chetna Ahya, our Chief Asia Economist.
Yesterday, we talked about what's supporting growth around the world, especially AI spending in the U.S. and some government spending in Europe, and Asia's role in making all of this happen. Today, we're going to try to dig deeper and go into policy.
It's Tuesday, July 21st at 10 am in New York
Jens Eisenschmidt: And 4pm in Frankfurt.
Chetan Ahya: And 10pm in Hong Kong.
Seth Carpenter: Since the last time we did this in mid-April, I will say the debate around central banks has probably become more complicated. Global growth has held up, probably better than many people expected. And inflation, which picked up a lot, started to recede. But it has not gone away. And some of the forces helping to shape the economy, the AI spending, government spending, that possible upswing in manufacturing, that could keep demand strong, and it might keep pushing inflation higher.
So, the question today is, if growth remains resilient, how much room really do central banks have to navigate?
Mike, let me start with you because your call for the Fed here in the U.S. is out of consensus, or at least at odds with where the market is pricing things. We talked about the demand going from AI. You pointed out that imports are actually limiting how much domestic demand there is.
So, what is the underlying story for inflation in the U.S.? And what does it mean for the Fed?
Michael Gapen: So, our view is that inflation will come down in the U.S. So, we think disinflation will be driven by some payback in energy prices. Some payback from tariffs, which have pushed up goods prices over the last year. And some further diminishment in housing-related inflation, namely shelter.
So, we think on a broad-based perspective, inflation has already peaked and will start moving lower. And we think we've seen evidence of this in recent inflation prints.
A risk to that, though, is from the demand side of the economy and AI-related inflation in two parts. One, higher software prices, chipflation. So, the pass-through of some of the AI pricing components. Fortunately, here, they're about less than 1 percent of the consumer basket. So, we don't think that there's a great risk, a strong risk, a high risk of AI-related inflation in the consumer bundle.
I think the real risk is that maybe we underestimate broad-based demand, animal spirits. And so, you might just see a broad-based increase in inflation from stronger demand. That'll be a little bit harder to see in real times. But our expectation is that inflation moves lower to about 3 percent, by the end of this year and closer to 2.5 percent next year.
Seth Carpenter: All right. Thanks, Mike. And in fact, the most recent inflation report that we just got confirms your perspective that inflation should be coming down. And so, I guess the question then remains: What would it take for the Fed to hike this year if inflation has come down like we've seen?
Michael Gapen: Well, I think that the answer there is that inflation wouldn't come down in line with our expectations. So, if the view is that energy prices, tariffs, and shelter inflation should provide plenty of offset and bring inflation down, I think the answer is you don't get payback.
Explicitly, core goods prices stay elevated. Maybe we get ongoing disruptions in the Middle East that push energy prices higher and create second-round effects. So, I think inflation just lingering at elevated levels could mean the Fed gets brought in to raise rates in September or later this year.
We think if they're patient enough, they'll see enough disinflation to keep them on the sidelines. But the risk is disinflation forecast is too optimistic, inflation stays firm, the Fed needs to raise rates.
Seth Carpenter: All right, Jens, what about for you and the ECB? They've already raised interest rates once this year. I think you've got a forecast for them raising interest rates again in September. What could make you wrong about that forecast? What's going to make you convinced that you're right about that forecast? And is there a similar tension that the ECB is wrestling with that Mike talked about for the Fed?
Jens Eisenschmidt: Yeah. I mean, starting with the last part of your question, I think no doubt, very similar tension. Just that, of course, it's less obvious. It's essentially a nuanced European version instead of the loud American version that we always stereotypically think the world looks like.
So, essentially, we have here clearly not an AI boom. That, I mean, there's no question. And we have discussed that yesterday. Still, there is certainly the notion that the world demand is not really weak, and some of this will also arrive in Europe. And so, you have that tension between maybe there's more resilience than we had thought, and so inflation will not come down through to slack as much. And so, we might actually add something here in terms of monetary restrictiveness.
Now, the other thing that is often forgotten, even though it's blatantly obvious, the starting point is just different. The ECB is running neutral monetary policy by all accounts. I mean, you could say 2 percent is neutral, and now they are 2.25. But, you know, there are ranges of uncertainty around any estimate. And the latest that they published runs – goes from 1.75 to 2;2.5.
So basically, even if they were to increase rates to 2.5 in September, you could go with the microphone around the governing council, and you would probably find a lot of people saying, "Well, this is still a neutral policy." That's probably not the case for the U.S. So, I guess this matters here for that debate too.
Seth Carpenter: All right. Yesterday we talked about lots of different things, but for Europe, we brought up fiscal policy. How do you think about fiscal policy and how it affects monetary policy? And so, I'm thinking about two channels.
One, how much does the ECB care that if they keep pushing up interest rates, they're going to increase the debt service burden for countries that are already facing high debt costs?
And second, is fiscal policy going to be the extra impetus for inflation that forces even more rate hikes from the ECB?
Jens Eisenschmidt: I guess it depends on who you ask. Certainly, more concerned members in the governing council that would point to exactly that fiscal stimulus as a reason why interest rates have to be increased further from here.
The other answer I would give is – probably for now at least, the view on fiscal policy is really model-based. You look at what type of increase in interest rate gets you essentially more fiscal restraint because there's an increase in interest rate bill and so less spending somewhere else. And that gets you basically less stimulus or less growth, I mean, very roughly speaking.
I don't think it's a major concern for now. We haven't reached yet interest rates where this would start to play a role. I guess, again, Europe being fragmented as it is, with all the political risk that's around the corner. Think about the elections in France and Italy and Spain next year. That will very likely find itself expressed in spreads. And so, the higher the interest rates are, the larger the spreads could become.
Seth Carpenter: So, for each of you, there's clearly a role for inflation. One of the risks we'll talk about maybe is inflation expectations and how maybe there's a big shift in what's going on with inflation.
But Chetan, that brings me to you and Asia, because one economy where there unquestionably has been a fundamental shift in inflation and inflation expectation over the past several years is Japan.
The Bank of Japan is on this normalization path where they're raising interest rates. Interest rates had been negative and then zero, and now they're gradually raising things up. Inflation has come back to Japan. Markets are looking at what the Bank of Japan is likely to do. Can you tell us a little bit about what our view is for the Bank of Japan this year and next? And what might make them hike interest rates faster than we think?
And is there any risk that in fact they hike interest rates slower than we think?
Chetan Ahya: Yeah, Seth. So, we are expecting BoJ to hike twice from here. The first rate hike is coming up in December of this year, and then another one coming up in June of next year. And then we think that, you know, the underlying inflation trend in Japan is not really that strong.
So, while market pricing is for about three more rate hikes instead of two that we are building in our base case. And some of the macro investors are even talking about four more rate hikes. We think the underlying inflation trend warrants a caution and BoJ to go slowly than what the market is pricing in and what the macro investors are saying in.
And the key part of our framework on thinking about Japan's inflation is that bulk of the explanation to inflation rise in Japan lies in currency moves. And secondarily, you can look at also the other drivers are more from supply side, which is higher energy prices or food prices. Whereas it's not driven so much by demand.
To elaborate further on why it is not driven by demand, when you look at Japan's consumption trend, and if you index it to hundred at pre-COVID levels in September [20]19 then it's currently about 101; i.e., that it's just about 1 percent up over the last seven years.
So that's a very tepid trend of consumption demand. And therefore, we don't think that BoJ needs to rush into hike in a more aggressive pace going forward.
Seth Carpenter: So, there is this fundamental shift, but boy, it's not on a tear, and so the BoJ can take its time. You know, Chetan, it's hard to wrap up a conversation about the global economy without talking about China.
I get the sense that there's not a lot going on with monetary policy, but we did just see a soft Q2 GDP print. So, against that backdrop, what should we be expecting in terms of policy? Is there any monetary policy coming? Or is there going to be some fiscal expansion? Or is China just sort of stuck in this lower gear?
Chetan Ahya: Yeah, Seth. So, we were also surprised by the soft GDP print. But when you look into the data, actually, it was interestingly doing well on exports.
And I mentioned earlier about how the global CapEx trend is helping Asia. It's definitely helping China too. But at the same time, China's domestic demand turned out to be quite weak. And particularly in the areas where we think that the policy response can be providing some help, i.e., infrastructure spend, was also very weak.
And therefore, we are expecting that in the back half of the year, you will see the government taking up some fiscal expansion. Not new stimulus announcement, but whatever they had budgeted. They have enough room within that to utilize that budget and actually increase that fiscal spending towards infrastructure.
We have about 2 trillion RMB worth of funds available for the government to go ahead and spend in the second half. And then lift that growth trend, which has dipped to 4.3 percent in second quarter to back to 4.6 percent in the back half of the year.
Seth Carpenter: You know what? Maybe that's a great place for us to leave it. We've gone around the world again today, but this time focusing much more on policy.
In the U.S., the Fed is facing this interesting situation. We think inflation is coming down. The last CPI print went in our favor. And so as a result, our forecast is that the Fed doesn't change policy at all this year. But it's going to come down to the data, and in particular, whether or not Mike and his team are right in terms of where inflation is going.
In Europe, the ECB has already raised interest rates once this year. Jens and team are looking for another interest rate hike. The ECB really does seem more sensitive to inflation coming from the energy shock, but there are lots of other crosscurrents that they're paying attention to as well.
And then the other major developed market central bank, the Bank of Japan, is on this normalization path. They are in the process of raising interest rates, but Chetan pointed out to us that the growth rate is such that they don't have to be in any sort of hurry, and they can take their time.
So, with that, Mike, Jens, Chetan, thank you so much for helping us connect all of these dots. And to the listeners, thank you for listening.
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AI investment is reshaping the global outlook. In part one of this economic roundtable, our panel explores where the momentum is strongest — and where investment still needs to catch up.
Read more insights from Morgan Stanley.

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Seth Carpenter: Welcome to Thoughts on the Market. I'm Seth Carpenter, Morgan Stanley's Global Chief Economist and Head of Macro Research.
Michael Gapen: And I'm Michael Gapen, Chief U.S. Economist.
Chetan Ahya: And I'm Chetan Ahya, Chief Asia Economist.
Jens Eisenschmidt: And I'm Jens Eisenschmidt, Chief Europe Economist.
Seth Carpenter: And today is going to be our third quarter economic roundtable taking a wide-angle view on the global economy and all the key forces shaping our outlook and the economy.
Seth Carpenter: It's Monday, July 20th at 10am in New York
Jens Eisenschmidt: And 4pm in Frankfurt.
Chetan Ahya: And 10pm in Hong Kong.
Seth Carpenter: Since our last roundtable in April, the global economy has continued to face all sorts of shocks, a mix of resilience and friction. Inflation pressures have not disappeared. Energy and geopolitical risks have come up, they've receded, they've come back, they've receded all over the place
But there is one underlying source of momentum that we have to talk about. And that is the AI-driven CapEx cycle.
Michael, let me turn to you because the U.S. is a real focal point of all of this. Tell me a little bit about where Morgan Stanley Research is thinking about hyperscaler CapEx. How big it is? And then for you, when you think about the U.S. economy, just how big of a driver is it for what we're looking for in the U.S.?
Michael Gapen: Yeah, we continue to revise higher our estimates for hyperscaler and AI-related CapEx in the U.S. economy. We were thinking a little over a trillion for 2027. Now we're more like 1.2 - 1.3 trillion, maybe as high as 1.4 trillion in 2028. So, the level of hyperscaler spending continues to keep rising.
The growth rate and its effect on the economy is likely to slow. But as you noted, it's still a major driver of momentum in the U.S. You would look at that headline number and think, "Wow, that's, you know, 3.5 percent or so of GDP. Must be a massive source of momentum for GDP growth." But roughly about 60 percent of that hyperscaler CapEx spending goes to items like computers and peripherals, equipment spending categories that have a very, very high import content.
We still get a significant number that AI CapEx is probably contributing around 40 basis points to growth this year. Be a similar-sized amount perhaps next year.
So, for an economy that's growing somewhere a little bit above 2 percent right now, maybe closer to 2.5 percent next year, that's a non-trivial amount. We just have to remember it's fueling growth around the world, just not here in the U.S.
Seth Carpenter: Yeah, that's a really great point because I have seen some estimates where people say, "Well, if it wasn't for AI CapEx, the U.S. economy wouldn't have grown at all." And that's clearly wrong, as you point out.
But U.S. imports are necessarily exports from somewhere else. And, Chetan, if I can pull you into the story then, U.S. firms are buying a lot of AI-related equipment from Asia. What does that mean in your part of the world? And in particular, I'm thinking about Korea, Taiwan, and maybe some other economies in Asia.
What's the critical story there?
Chetan Ahya: So, for Asia, this has definitely been a big boon. If you look at Asia's exports, they have been booming, and particularly for the ones which are exporting semiconductors to the U.S. They are seeing semiconductor exports growing by 90 percent. And when we go back in time and compare Asia's semiconductor exports, it's very tightly linked to the U.S. IT CapEx. And it's not surprising when Mike Gapen mentions about the imports going up. It's on the other side, helping Asia's exports quite meaningfully.
So, so far, we've seen this benefiting Korea, number one, Taiwan, and also Japan. All these three are big beneficiaries of U.S. AI CapEx. And of course, also not just U.S., but the other countries which are doing any little amount of CapEx on AI front, that's also helping these three economies in the region.
Seth Carpenter: You've been doing a lot of work, Chetan, recently about how much the story can actually broaden out, that the AI CapEx cycle has really contributed to Asian growth, but it doesn't tell the whole story that there's a broader industrial cycle.
Can you give us a little bit of a flavor of that story?
Chetan Ahya: That's right, Seth. So, we are actually highlighting that there is a CapEx and industrial super cycle that is underway in Asia, and there are four components to this story. AI and semiconductors CapEx, which we just briefly discussed.
Number two is energy. Number three is defense. And number four is industrial supply chain onshoring related CapEx. I know that everybody still thinks that AI is the most important part of this story, but when I give you the numbers and the breakup of that... So, for Asia, AI and semiconductor companies CapEx is about $380 billion in 2026, but energy CapEx is going to be $900 billion.
So, this is a far broader story than just AI for Asia.
Seth Carpenter: Mike, let me come back to you and to the U.S. then. So, isn't the growth story also broader than that as well domestically?
So, what's going on in terms of consumer spending in the U.S., and is there a broader CapEx story in the U.S. as well?
Michael Gapen: I would say, is it broader than that? I think maybe you could argue also it's narrower than that. Here's what I mean by that. As I noted AI CapEx contributing about 40 basis points to growth, it's certainly underpinning equity valuations in the U.S. and underpinning strong wealth creation.
So about [$]180 trillion in household net worth in the U.S. About [$]55 trillion of that has been created in just the last five years alone, underpinned in part by AI-related spending and optimism about future profitability. That's really supported spending by upper income households. So, I think it's both investment-led and consumer-led, but they're inextricably linked.
So, the positive for the U.S. is that it's providing a lot of resilience. The negative component of that is it feels like momentum in the U.S. is narrowly driven.
Jens Eisenschmidt: Let me maybe jump in here from Europe to provide some perspective from the other side. So, I think it's a fair summary to say that AI investment is not yet, or maybe will never get there, dominating the business cycle.
What we do have instead is an unusually consumption-driven expansion. That has to do not so much with an extraordinary strength of consumption, but more of an absence of other factors. Now, prospectively looking forward, we think the fiscal expansion might help lifting us a little bit. And then it is really the debate how much AI investment can arrive in Europe.
For now, I would say it's probably a factor of 20 that separates European investment plans from the plans we know that exist for the U.S.
Seth Carpenter: Let me stick with you then in Europe because you brought up fiscal as one of the factors going on here and where it's going… You and your team recently wrote a blue paper talking about what the outlook is for fiscal policy in Europe, and in particular, we had this era of cheap debt. Interest rates in Europe were low, at times negative. It was super easy to borrow. Not as much happened then.
There's been a shift towards more fiscal expansion at the same time that interest rates have gone up, causing the cost of debt to go up. Feels like there's a lot of push and pull going on. Can you unpack for us a little bit what was in that paper you wrote, what's going on with fiscal policy in Europe, especially in Germany? And what it might mean over time for Euro-area countries?
Jens Eisenschmidt: Yeah, so I think fiscal policy in Europe really is looking at a regime shift. So, there is this very famous, probably in the U.S. even more so than here, notion that the Europeans have built a very comfortable welfare state. And that's true if you just look at the accounting from a GDP perspective. It's close to 50 percent that, you know, budgets are actually extended on welfare spending.
And now you have three structural headwinds for any type of fiscal spend. So, one is aging related costs, you mentioned it already. Defense spending has to increase significantly, and the interest rate costs will also rise significantly. All of that means there will be very hard choices to be made.
The one thing that actually could help here is growth. Growth is the one thing that's, for now at least, missing, at least in comparison to the U.S. It's probably half what we expect, what the U.S. colleagues think is in stake for the U.S., and a quarter or even less than that of what is there in Asia.
So, growth is really the key, the solution, the answer to everything in Europe. More growth than just 1 percent, which is potential, would help solving that fiscal challenge. For now, it looks really, really like an uphill battle. Returning to Germany, it's the one country that has a very good fiscal starting position.
They are pushing a lot but they're to some extent pushing a string. So, even with the German huge fiscal package, given that private sector investments so far are absent, doesn't get us a ton of growth.
Seth Carpenter: Chetan, maybe I'll come back to you before we close part one of this roundtable. The AI CapEx cycle started with AI, broadened out further. How long do you expect this cycle to last? How durable can it be? And how might it compare to previous CapEx cycles?
Chetan Ahya: Yeah, Seth. So, we think this will be a multi-year CapEx cycle. And when we are thinking about the duration of the cycle, there are two things that I would keep in mind.
Number one is that most of the drivers that we just discussed – the CapEx on AI, energy, defense, and industrial supply chain onshoring related investments – these are all structural drivers. So, we think these are going to continue for some more time. At this point of time, we have the visibility for this cycle to be lasting for three-four more years.
And then the second point of framework that I would keep in mind is that the corporate balance sheets are in a pretty good shape. So, when you are thinking about the leverage in the private sector, you can look at both households and the corporate sector balance sheet. But since the cycle is CapEx driven, we are looking at the corporate balance sheets, and they are in a pretty good shape.
Across the region, corporate debt to GDP is below where it was in 2019.
Seth Carpenter: Mike, let me, let me wrap up quickly with you. We talked about AI, AI CapEx. For now, that's a very strong demand story.
When are we going to see a supply side of things coming from AI? Are you already seeing a big contribution to GDP and growth from productivity coming from AI?
Michael Gapen: We are, but not outside of the high-tech sectors, and we're seeing limited, what I'll call labor market restructuring of tasks and occupations beyond high AI-exposed occupations.
So right now, everything is still very isolated I think maybe as we get into 2029 and beyond, so as Chetan says, we probably have a three to four-year super cycle here around a build-out phase. Then we might see some of that broader-based diffusion to other non-tech sectors in the economy.
Seth Carpenter: All right, Jens, for you, let's wrap up here. So, what is the state of play for the build-out in the CapEx cycle for AI in Europe?
Jens Eisenschmidt: Yeah, it's very early stages. As I said before, we really; we connected to all the industry experts or analysts covering the sector and the total plans are a factor of 20 below what we see in the U.S. by just the seven hyperscalers. So, I would say very fragmented, very small, in general. Not only AI.
I think the one thing I would be looking at for any type of sign of revival, sign of growth is investment. The second would be investment. And you can guess what the third would be… Investments in the core countries. That's really what we need to see, and we haven't seen much in Germany or France on this front.
Seth Carpenter:
That's a great place for us to stop today. We talked about the real side of the economy, AI, CapEx, trade. Tomorrow we're going to come back, and we'll talk about how that growth outlook affects inflation. And once you start talking about growth and inflation, you got to talk about policy, and that's where we'll be tomorrow.
Mike, Jens, and Chetan, thank you for joining today. And for the listeners, thank you for listening. Be sure to tune in tomorrow for Part 2 of our conversation. And I have to say, if you enjoy this show, please leave us a review wherever you listen, and share Thoughts on the Market with a friend or a colleague today.

Our analysts Andrew Sheets and Mark Schmidt unpack why U.S. healthcare feels so expensive and the potential impacts of rising hospital costs.
Read more insights from Morgan Stanley.

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Andrew Sheets: Welcome to Thoughts on the Market. I'm Andrew Sheets, Global Head of Fixed Income Research at Morgan Stanley.
Mark Schmidt: And I'm Mark Schmidt, Head of Municipal Strategy at Morgan Stanley.
Andrew Sheets: And today on the program, a discussion into one of the biggest mysteries in one of the biggest sectors of the economy. We're talking about healthcare costs.
It's Friday, July 17th at 2pm in London.
Mark Schmidt: At 9am in New York.
Andrew Sheets: So, we're talking today about healthcare, which represents roughly a fifth of the U.S. economy, the bulk of job creation over the last several years, and in my view, honestly, one of the biggest inflation paradoxes that we see in the market.
On the one hand, the high cost of healthcare is taken as a given, and it's something that many Americans still struggle with financially. But if you look at the official inflation data in the U.S., healthcare costs have been lower than normal, and that's been true now for a number of years.
So, what's going on? How do we tie this together? And Mark, you just wrote a report that tries to do exactly that. So, what did you hope to accomplish with this report?
Mark Schmidt: You're absolutely right. It's hard to underline enough just how large healthcare is to the U.S. economy overall. Americans spend nearly $6 trillion on healthcare. That's more than the GDP of the entire country of Germany. And if we think about prices, Americans pay more.
A knee replacement, for example, costs $25,000 in the United States. That same procedure costs just $6,000 in France. Common heart treatments that would cost $3,000 in Germany or $10,000 in Australia cost $34,000 in the U.S.
It also matters for everyone's local community. Healthcare jobs have been growing twice as fast as the rate of job growth in the economy overall. And those are good jobs. They pay above average wages. For many Americans these days, the most secure path to the middle class is a career in healthcare.
Now, this may seem a little bit arcane, but it probably hits close to your portfolio as well. Earlier in the year, when we took a look at how equity separately managed accounts invest, they typically have a core overweight to healthcare. And even though American prices may seem like an American issue, many of the largest and most profitable healthcare companies in the world are actually headquartered in Europe.
So, whether you're sitting in New York or sitting in London, the price of American healthcare probably matters to you.
But as you noted, Andrew, it does feel like a paradox because although Americans cite healthcare costs as one of their top concerns, and although healthcare spending is growing at 6 percent a year or more, the official inflation data says that healthcare prices are in check. And at one point earlier in the year, healthcare inflation, according to official data, even dipped below 3 percent.
It just didn't make a lot of sense, and that's why we got together with our colleagues across equities, fixed income research, public policy, and economics to dig into what was actually going on.
Andrew Sheets: So, Mark, let's dig right into that. I mean, it seems like a perfect encapsulation of the so-called Main Street versus Wall Street perception of the economy.
So, what's going on? How does one kind of square those two numbers?
Mark Schmidt: The easiest way to understand it is that you can't walk through a grocery store and figure out the price of a knee replacement. And that's true both for you and me. It's also true for the government. They have to survey hospitals and health insurance companies.
The trouble is that the prices that health insurance companies pay hospitals, well, those are trade secrets. So, at any given point in time, even for the best government economists, it's not entirely clear what the price trends are. And that's why when you look at the official data, healthcare inflation typically has relatively lumpy jumps in the series.
You could see several months of 0.1 or 0.2 percent official growth in healthcare inflation. Or as earlier this week, you could see certain categories jump to 0.4 or even 0.8.
Andrew Sheets: Another element, Mark, that you talked about in the report is that people are also consuming more healthcare. So, talk a little bit about that. How that factors into this dynamic, and again, is that just going to be the new normal as the population ages and we tend to spend more on healthcare as we get older?
Mark Schmidt: That's right. The good news is that we're living longer lives. The bad news is that means that we have more chronic healthcare conditions to deal with. The good news is that more procedures can be done in outpatient settings, and those, generally speaking, are cheaper. The bad news is that inpatient care, inpatient prices go up as the complexity of procedures that actually happen in a hospital setting increase significantly.
When you balance it all out, it's a situation where, thankfully, the United States and most Americans have the means and the wealth to pay more for healthcare. The flip side of that is that they are paying more for healthcare, and that's why we think that the recent softness in healthcare inflation is actually too good to be true.
Andrew Sheets: Something that jumped out at me from this report, Mark, was just how important hospitals are in this equation. And the experience of the patient and the experience of the hospital can be different economically. And that difference can also matter for how this shows up in official inflation and government statistics.
So, you know, it would be helpful maybe just to walk the listener through. If I go into the hospital and I need knee surgery. You know, how does that look like from my perspective in terms of paying for it, assuming I have health insurance through my employer? How could that look like to the hospital? And how could that look like coming out the other end into the official government statistics?
Mark Schmidt: Well, of course, Andrew, the first thing that you do when you break your leg is you call six hospitals and shop around for the cheapest price, right?
Andrew Sheets: [Laughs] Of course.
Mark Schmidt: So that's actually the problem because when you get care, you're not in a place to ask about the price. And frankly, even if you asked your doctor or nurse what the price is, they probably wouldn't know. Not only is it not their job to know the price, but all of those negotiations happen after the fact – with the prices that the insurance companies negotiate with the hospitals.
After COVID, hospitals had a lot more costs to spread out among the people who were coming in the door, and so they raised prices across the board, not just for procedures that were related to respiratory illness. Naturally, insurance companies noticed that, and they started to push back.
So long after you get a cast for your broken leg – and by the way, I wish you a speedy recovery – insurance companies end up going back and forth negotiating with your doctors for exactly how much they should pay you. And although these prices were loosely set well before you walked in the door, the exact way it gets billed and coded? Well, let's just say there's a lot of back and forth.
For a well-run hospital, the cost of talking to and ultimately getting reimbursement from your insurance company, that alone could be 2 to 4 percent of revenue. And in especially complex cases, that whole negotiation can eat up 5 to 7 percent of the total bill.
You're also right to flag that hospitals really are still the central point of the U.S. healthcare system. Americans spend $2 trillion in a hospital setting. And hospitals overwhelmingly coordinate care for both primary, specialty, and pharmacy services.
Andrew Sheets: Mark, another issue I wanted to ask you about was the Affordable Care Act, Medicare, Medicaid, and how those programs fit into the story?
Mark Schmidt: The One Big Beautiful Bill Act included a variety of measures to slow the overall growth rate of healthcare. Now, for all the reasons we just discussed, that's probably warranted. The Affordable Care Act is another wrinkle. Enhanced subsidies, which were already set to expire – did in fact expire at the end of last year. And as a result, more Americans are now uninsured.
It remains to be seen how that impacts overall costs. In the United States, when you have a health emergency, a hospital is legally obligated to treat you because of a 1990s law called EMTALA. Even if you can't pay, the system eventually does.
Historically, uncompensated care costs have been passed on to individuals and companies with insurance. For now, however, it remains to be seen whether these changes in law and in the overall number of people with insurance will cause healthcare prices to rise or fall.
Andrew Sheets: And Mark, just for the broad-based implications of this, right? It's fair to say that in any health insurance system, there are some people who consume a lot more healthcare. They're unhealthy or they're unlucky. And there are some who consume a lot less.
And, you know, this is something where that overall coverage question matters. Because if you have things that reduce the number of otherwise healthy people who are in those healthcare pools, it can raise the cost for everybody else. Those people who were in some ways subsidizing the higher consumers of healthcare are no longer there.
Is that a fair way to frame it, do you think? And are there potential changes given some of these legislative actions that could lead to changes of what the pool looks like – and what overall costs could look like?
Mark Schmidt: That's a great point. And healthcare is probably the only part of our economy where you would say, "Thank goodness I did not get my money's worth." As we think about it…
Andrew Sheets: [Laughs] Very true. Very true.
Mark Schmidt: As we think about it, most young and healthy people are going to be paying more for their health insurance than they receive in healthcare. Again, that's a good thing. Because American healthcare prices are so much higher than anywhere else in the world, paying in more than you get back? Well, that hits the wallet harder in America than it does in other countries.
And that's why for many people – choice – choosing how much health insurance to have and how much to pay for it, really is central to keeping the American economy dynamic. The flip side, however, is that as Americans get older, more people have Medicare.
Now, Medicare is pretty good if you have it. But the catch is that Medicare prices, according to most independent estimates, do not fully reimburse for the cost of care. So, as more seniors take up more beds in a hospital, that means that commercial prices, the prices for people who have private insurance through their employer, are likely to rise even faster.
Andrew Sheets: So, Mark, I think a good place to close it out and kind of bring this all together is a really important conclusion of this report – is that hospitals have been absorbing a number of these rising costs of healthcare through lower margins for the hospital. And that has resulted in lower ultimate inflation because the inflation is measured out the other side, out ultimately what the hospital earns.
And if you could just maybe talk a little bit more about that. To what extent have those margins been compressed? And what that might mean for things going forward?
Mark Schmidt: That's right. We dug into the finances for hundreds of not-for-profit hospitals in the United States. They are facing higher costs and shrinking margins. Historically, hospitals have partially passed on expense increases of this magnitude.
Now, in their conversations with insurance companies, the biggest benchmark setting of prices happens once every two to three years. So, we're not going to see hospital prices show up in the inflation data overnight. But when we look at hospitals across the country, their budget information and their guidance is consistent with firming prices.
Andrew Sheets: Great. Thank you so much, Mark.
I've really enjoyed the conversation.
Mark Schmidt: Thanks for having me, Andrew.
Andrew Sheets: And thank you for listening. If you enjoy Thoughts on the Market, please share it with a friend or colleague today. And rate and review us on wherever you listen. It helps more people find the show.

Credit markets are stepping in to fund the surging demand for AI. Our experts Lindsay Tyler and Anish Shah explore the opportunities and risks behind this record financing wave.
Read more insights from Morgan Stanley.

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Lindsay Tyler: Welcome to Thoughts on the Market. I'm Lindsay Tyler, TMT Credit Research Analyst at Morgan Stanley.
Anish Shah: And I'm Anish Shah, Global Head of Debt Capital Markets at Morgan Stanley.
Lindsay Tyler: Today, how issuers and investors are approaching the rapidly evolving world of AI financing.
It's Thursday, July 16th at 10am in New York.
As AI demand accelerates, credit markets are being asked to finance infrastructure on a scale that used to be associated with utilities, telecom, or energy. That raises a central question for issuers and investors: How much debt can the AI ecosystem absorb? And at what price?
Anish, can you walk our listeners through the key products in your purview?
Anish Shah: Certainly, in my nearly twenty years at Morgan Stanley, this is probably the most incredible time period I've ever seen in the credit markets. I've had the privilege of working across a number of different roles in capital markets and lending. And a couple of years ago, we integrated the debt underwriting business across both investment-grade and leverage finance franchises in recognition of how interconnected the whole credit ecosystem has become.
In addition to our core activities helping clients raise capital for their strategic priorities, two of the big focus areas that we've had have been finding ways to harness the power of the private credit universe and also delivering best-in-class capabilities in funding this incredible growth in AI spend.
Lindsay Tyler: AI financing has certainly been a theme we've also been focused on in research. Our equity research colleagues project that a handful of key players could add more than 30 gigawatts of capacity over a two-year timeframe, driving around [$]2 trillion of aggregate cash CapEx in that period. And to put that into context, a single gigawatt of data center capacity can require roughly $12 billion for the shell, and then often more than double that for chips and racks.
So, from your vantage point, what inning are we in? And what gives you confidence that credit markets can continue funding this opportunity at scale?
Anish Shah: I mean, Lindsay, the numbers certainly are staggering, as you note. And if you just observe the CapEx estimates for the hyperscalers and broadly for AI infrastructure, we're certainly in the early innings.
Lindsay Tyler: Mm-hmm.
Anish Shah: The largest tech companies have historically, as you know, raised very little debt. In fact, many of these companies have not even needed a credit facility. As CapEx projections were materially increased in the second half of last year, we saw the beginning of scaled capital raises. Hyperscaler issuance has quickly gone from less than one percent of the investment-grade market to more than 10 percent of the market.
You know, as I look ahead, based on what we're seeing on the ground, we think that AI-related funding, whether it's for data center development or financing compute capacity, could top 15 percent of the total issuance across all credit products.
This has been an unprecedented test for the capital markets, both in terms of the depth of capacity and the breadth of product. The teams have been on the forefront of deep investor dialogue and product innovation.
This spans corporate investment grade, first of their kind financings in high-yield and leveraged loan markets, and new takes on asset-backed financing. And each of these areas has seen material issuance both in public and private markets.
Lindsay Tyler: Great backdrop. Let's dig first into investment-grade corporate debt, an area you know well from your time previously leading the investment-grade team.
Can you help frame the scale and the significance of this financing bucket and how AI-related debt is scaling within it?
Anish Shah: Well, you know, as you know, the investment-grade bond market, specifically in dollars, is the deepest, most liquid pool of capital in the world. Volumes have grown materially over the last few years and are likely to eclipse $2 trillion in issuance this year.
Hyperscalers are among the very best credits in the world, and they have the ability to come in and out of markets with relatively quick twitch, little to no pre-marketing, and in fairly large size. You know, $20 billion-plus deals used to be rare in the investment-grade market, now happen multiple times a quarter.
This is why we've seen the predominance of AI-driven capital raising take place in the investment-grade market. For the most part, investors have digested that supply very well. While we've seen some modest widening credit spreads for hyperscalers and some of the other tech issuers, I'd say it's de minimis relative to their expected ROI.
Lindsay, I've talked a lot about supply dynamics and issuance. What other factors are you and investors considering when assessing fair value for investment-grade rated technology bonds?
Lindsay Tyler: Sure. It's prudent to really weigh a mix of technicals, fundamentals, and relative value. You know, as you discussed on the technical side, and related to my discussions with debt and equity investors, I've been focused on scale of buildouts, market capacity, digestibility across currencies, positioning along the curve, implications of equity issuance, and whether AI financing could crowd out other areas of TMT credit.
But moving more to the fundamental side of things, you mentioned ROI, and for the players that are scaling compute capacity, there are a handful of key monetization and return questions that keep coming up. How quickly can these companies bring new capacity online? Once it's live, how does it translate into durable revenue and cash flow?
Is that capacity supporting internal products, proprietary models, broader cloud offerings, or compute leased to third parties? And then how fungible is the capacity across those use cases if demand or returns shift?
Further on the fundamental side, we've done some differentiated work around growing long-term commitments. We've seen that high-quality hyperscalers and a few of the semis companies are anchoring the AI ecosystem through leases, guarantees, other obligations. These commitments really extend beyond vanilla bond issuance.
So, I encourage investors to look beyond the funded debt and really understand the accounting and the ratings implications here of some of those commitments.
And this ties nicely into the next topic that I wanted to raise, which is project finance debt. I've noticed that, you know, a lot of the commitments that we're seeing from IG players support another layer of financing. Lease commitments can underpin project finance debt, an area of sizable issuance and innovation.
The public high-yield market has emerged as a new funding source in this way for data center construction, with more than 30 billion priced across 15 deals, since fall 2025. Can you walk us through, Anish, the innovation behind these structures, and how are these high yield deals different than other ways to, kind of, raise project finance debt?
Anish Shah: Yeah, it's incredibly interesting. I mean, the bulk of the issuance, as I noted has come in the investment grade market, but I would say the bulk of the innovation has come in the sub-investment grade market.
You know, historically, for very capital-intensive sectors like energy and power or real estate, the project loan market was the most efficient source of initial funding. The developer would tap banks to underwrite a highly structured construction loan. Once the project is up and running, you could then refinance that loan with the predictable cash flows into a more institutional financing, like the investment grade bond market or the term loan B or securitization markets.
That product may still be very viable in many sectors, but we felt early on that bank-provided construction loans would not meet the capacity needs of the AI investment cycle. The market really needed an institutional credit product that bypassed the need for construction loans.
The key innovation came in the form of first-of-its-kind high-yield bonds that funded the development of a new data center complex. Given the relatively short construction period and the "offtake" supported by some of the highest quality credits in the world, we felt like this financing structure would be incredibly well-received in the high-yield market.
The win here is that the developer accesses fixed rate long-term capital and maintains flexibility to call the bonds and refinance at a lower cost. Judging by how these financings have gone, there's a strong level of investor enthusiasm.
I think that they've only scratched the surface, and I would expect that we see much more of this. And potentially even expand it to other products in the leverage finance markets given the tremendous level of investor demand.
Lindsay Tyler: Yeah. It's certainly been exciting to follow many of those deals. Beyond the public space, we're also seeing a wave of innovation in private credit and asset-backed finance. Anish, how do companies decide whether capital is best raised in the public or the private markets?
Anish Shah: Well, I'm glad you raised the whole avenue of private markets because it may be the most significant change in the credit markets over the last few years, broadening the scope of private credit from directly lending into leverage buyouts to now financing large investment-grade projects.
There are great examples in the world of GPU and TPU financing, where we structure loans secured by the asset and the cash flows, or in data center development.
Lindsay, from your perspective, what are investors focused on when these private structures intersect with public credits?
Lindsay Tyler: Sure. Many of these asset-backed private financings have prompted investors to look more closely at any of the public companies involved, whether as issuers, tenants, customers, or support providers. This ties back to the point I raised earlier. Where does the risk reside, and who ultimately is on the hook?
These financings have also sparked broader discussions around circularity, vendor financing, and technology obsolescence risk, even when amortizing structures are in place. I do think those are fair concerns to weigh, and they really speak to how quickly the AI financing trend is evolving and how much credit work there is to do.
So, Anish, with that balance in mind, relatively strong demand, rapid innovation, but also some real credit questions, let's end with a quick lightning round.
Anish Shah: Lindsay, let's do it.
Lindsay Tyler: First, what is the biggest risk that could test investor appetite for AI-related debt?
Anish Shah: I would say investors are acutely focused on construction delays. Don't underestimate the level of diligence being done by the breadth of capacity you're seeing in the markets. Investors are doing their homework, and we're spending a lot of time trying to mitigate any of their concerns with structural protections.
Lindsay Tyler: Got it. Second, beyond data center shells and chips, what is the next potential AI financing opportunity?
Anish Shah: It most certainly is energy and power. We're going to see a ton of capital being raised in utilities. It's going to be a little different than what the hyperscalers are doing, just given the nature of their balance sheets. You're going to see more junior capital. We've seen a wave of junior subordinated debt issuance out of the utilities.
We're also seeing a lot of activity from our project finance and tax equity team, just given all things energy infrastructure.
Lindsay Tyler: Great. And third, if we're sitting here a year from now, what do you think could be the biggest AI financing story we're talking about?
Anish Shah: Well, we certainly underestimated the level of financing activity that we saw in the past year. I think when we look back a year from now, we will probably see that the AI labs were much more ready to finance on their own on a standalone basis. That's going to alleviate some of the pressures in the market, but I think it's going to create a whole new set of considerations and structural innovation.
Lindsay Tyler: Well, it's certainly been remarkable to watch this financing theme take shape in real time, and the next chapter sounds like it could be even more interesting to follow. Anish, thanks for joining us and sharing your insights.
Anish Shah: Great to join, Lindsay. Thanks.
Lindsay Tyler: And thank you for listening. If you enjoy Thoughts on the Market, please leave us a review wherever you listen and share the podcast with a friend or colleague today.
*****
Anish Shah is a member of Morgan Stanley’s Global Capital Markets Division and is not a member of Morgan Stanley’s Research Department. Unless otherwise indicated, his views are his own and may differ from the views of the Morgan Stanley Research Department and from the views of others within Morgan Stanley.

AI has become a strategic policy priority as governments race to secure their technological future. Our Head of U.S. Public Policy Research Ariana Salvatore explores what’s driving the shift and the implications for markets.
Read more insights from Morgan Stanley.

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Welcome to Thoughts on the Market. I’m Ariana Salvatore, Head of U.S. Public Policy Research at Morgan Stanley.
Today: Why sovereign AI is becoming a policy priority around the world.
It’s Wednesday, July 15th, at 10am in New York.
The AI controls debate used to be focused on chips. Cutting edge semiconductors are essential to train large AI models, after all. But over the past year, the debate has moved well beyond that narrow focus. The policy conversation has broadened beyond things like which advanced semis can be sold to China.
The bigger question now is who controls the full AI stack — chips, cloud infrastructure, frontier models, data centers, cybersecurity standards, and the energy systems that support all of it.
That’s what we mean when we talk about sovereign AI. At the simplest level, it's a country’s ability to develop and deploy artificial intelligence using its own infrastructure, data, workforce, and technology ecosystem. But sovereign AI is also about reducing strategic dependence on foreign platforms and foreign-controlled supply chains.
That echoes a trend toward multipolarity that we’ve been writing about since back in 2018. Countries around the world are prioritizing national security over economic efficiencies. We see that theme applying to AI as well.
So, what does this all mean for markets?
First, sovereign AI turns AI infrastructure into a matter of national industrial policy. Data centers, power availability, and grid reliability are just a few examples of components that are becoming strategic assets. That means governments are likely to play a larger role in deciding several aspects of the AI buildout. Where it’s built? Who finances it? And which countries get access to the most advanced parts of the stack?
Second, sovereign AI reinforces the shift toward derisking and a more fragmented international order. The U.S. is trying to promote the export of an American AI technology stack to allies and partners. At the same time, it’s preserving national security guardrails around the most sensitive capabilities. Meanwhile, we see China trying to indigenize as much of the technology as possible, from chips to cloud to model deployment. Other countries are navigating between the two.
Third, and importantly, sovereign AI is also an energy story. Who gets to build and benefit from AI increasingly depends on access to low-cost, reliable power. That makes energy availability a competitive advantage — and it also makes energy affordability a political constraint.
That dovetails with one of our thematic predictions heading into this year: the politics of energy. We see rising power costs as a more visible political issue. That’s led to backlash against data center development. There’s more local opposition to new projects, and greater pressure on policymakers and utilities to make sure that existing ratepayers are not subsidizing AI-driven grid investment.
We think that could push AI infrastructure in a few directions. One is toward a conditional build-out. Here, offsets like large-load tariffs and other cost-allocation mechanisms are designed to protect households and small businesses.
Another direction is policy support for the lowest-cost sources of energy, even where that might create tension with emissions objectives. And the third direction is more off-grid or behind-the-meter power solutions. That would include things like fuel cells, storage, and other time to power strategies — so data center developers can secure electricity without intensifying local affordability concerns.
The pursuit of sovereign AI comes with many questions around inflationary impacts: compute & power are both constrained, regulation remains uncertain, and there could be more limitations on things like tech transfers if the government sees a national security edge. So, to the extent that countries want to reduce their dependencies, it may cost more to get there. There are, however, companies that can benefit in this environment.
But there’s also a policy risk. We are left with a more reactive policy environment. Selective access in some areas, tighter controls in others, and ongoing uncertainty around how Washington will treat advanced chips, cloud infrastructure, and frontier model deployment. Now that uncertainty matters because it affects corporate planning, cross-border investment, and the shape of global AI alliances.
So what does this all mean for investors?
More and more, governments view AI capability as a source of economic power and geopolitical leverage. That means the AI race is moving from a question of who builds the best model to who controls the infrastructure, standards, supply chains, and energy systems that allow those models to scale.
In our view, that means sovereign AI is one of the most important themes to watch in the next phase of the AI buildout.
And we’ll be coming back to this topic soon. In the coming weeks, Stephen Byrd and I will talk about sovereign AI in more depth, particularly around what it means for power demand, data center investment, energy affordability, and the broader infrastructure required to support the next stage of AI adoption.
Thanks for listening. If you enjoy the show, please leave us a review wherever you listen and share Thoughts on the Market with a friend or colleague today.