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Rethinking affordability: policy has to start with how households experience shocks

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Public debate often treats economic disruptions as short-lived problems—sharp swings in prices, employment, or growth that settle once the broader economy finds its footing again. Early November’s election results suggest voters may see things somewhat differently. Candidates who focused squarely on affordability did well because households may be responding, at least in part, to something far more persistent: years of declining economic well-being that do not roll back once the headlines move on. 

For decades, policy conversations have too often accepted a simple assumption: that it is only rational to tolerate short-run turmoil in exchange for long-run stability. In this model, policymakers adjust course—sometimes modestly, sometimes not at all—while workers, small-business owners, jobseekers, and caregivers are expected to weather the turbulence. In theory, these shocks are supposed to fade, and the greater good is served by merely bandaging the complaints of lower-income groups until the headline metrics herald an apparent return to normalcy. In practice, however, households experience these shocks—and their aftermath—very differently. And while some economic turbulence is truly inevitable, appreciating the disconnect between the picture painted by the aggregate indicators and the ripple effects households feel is a necessary step towards identifying policies that can improve affordability. 

Everyday Americans certainly feel the effects of economic shocks that are captured in the headline statistics, but there are many reasons why an improvement in those headline numbers doesn’t map to an improvement in a household’s financial situation. For example, most people don’t budget for the 80,000 goods and services tracked by the Consumer Price Index (CPI). They manage a much smaller set of expenses, e.g. rent, groceries, childcare, utilities, insurance premiums, and a few others. If the weekly grocery bill jumps by $40, that often becomes the new number they have to live with.

Even when market forces eventually push prices down, the clock is rarely fully wound back and wages often fail to keep pace with the new cost realities. A rent increase does not automatically reverse when inflation cools. Childcare prices do not necessarily fall just because CPI moderates. Shocks to essentials are rarely one-time disturbances that disappear when the crisis fades, even if the price increases only once—more often, they become lasting additions to the cost of living, raising the baseline from which working Americans make every subsequent financial decision.  

Recent price surges underscore how rare true reversals are. The CPI for food shows prices decelerating but not reversing from their 2022 spike, a frustration grocery shoppers have experienced firsthand. Milk prices, for example, fell briefly from $4.20 per gallon in January 2023 to $3.86 by May 2024, only to stabilize around $4.00 by August. By November 2025, consumers were paying 25% more for the same purchases than they had in 2019. Egg prices tell a similar story: despite easing from their most serious spikes in January 2023 and March 2025, they remained roughly double their pre-inflation level as of September 2025.  

Housing offers little reassurance. The Zillow Observed Rent Index (ZORI) shows rents jumping more than 15% in 2021. The increases slowed down between 2022 and 2025, but rents did not plunge back to their 2019 level; instead, they resumed climbing at roughly their pre-pandemic pace from a much higher baseline. The end of the inflation shock does not mean a return to affordability—it means the return to typical price movement. For many working households, that means a continuation of the faster-than-CPI-U accumulation that characterized the cost of necessities for the previous two decades. 

Even if a one-time shock dissipates, the damage households sustained in the interim can slow their progress for years. A temporary hit to purchasing power may force a household to take on additional debt or postpone savings for college or retirement—effects that do not show up clearly in present-day headline indicators. From that perspective, a one-time shock at the macro level can easily become a permanent shift in a household’s financial position.  

This distinction explains, in part, why voters responded so strongly to affordability-focused campaigns. They may not be rejecting long-run thinking entirely; rather, they are likely reacting not just to today’s “sticker shock,” but to the reality that the long run they have been living is defined by accumulated, irreversible shocks—none of which appear clearly in top-line indicators. 

For policymakers, the implication is straightforward: there is often no such thing as a one-time effect for households. A shock might disappear from the inflation tables or unemployment charts, but everyday Americans continue to feel its consequences long after the data normalizes. Further, even when a shock resolves at the national level, local communities may continue to struggle if critical employers have downsized or if reduced spending within the community has resulted in a more permanent slowdown. 

From a macroeconomic perspective, shocks do often look temporary. The unemployment rate eventually fell after the 2008 financial crisis. Gross Domestic Product (GDP) rebounded after the 2020 lockdowns. The CPI surge in 2022 slowed as supply chains recovered. From that vantage point, the economy appears to move past each disruption in turn, reinforcing the idea that these are temporary events. 

But this “recovery” story breaks down at the household level much more than policy leaders take into account. In 2021, households reported surviving the initial COVID slowdown by postponing their progress towards financial goals: either by drawing on savings set aside for something else, by taking on additional debt or putting off bills, or making plans to delay retirement. But by 2023, when the slowdown was replaced by inflation, consumers once again leaned on the savings to cover the rising costs of groceries—with nearly one in five relying on funds they had not intended to use for everyday purchases. 

Aggregate indicators do not show how much financial well-being households lost during those periods, how long it will take them to rebuild, or whether they ever will. This is a critical blind spot: the metrics policymakers rely on were never designed to measure the compounding, non-reversible nature of household-level shocks.  

Research from my colleagues at the Ludwig Institute for Shared Economic Prosperity (LISEP) and others shows just how large this gap has become. When inflation rose in 2021, much of the debate framed price increases as a temporary concern overshadowed by the risk of recession. But for many, the pressure had been building for years. Essential expenses had outpaced median wages over the past two decades. For a family of four, between 2001 and 2023: 

  • Rent: 40th percentile rents rose 125%. 
  • Healthcare: Annual health-insurance premiums borne by middle-income workers more than tripled. 
  • Childcare: The average price of center-based childcare doubled. 
  • Wages: Median wages for typical workers rose by only 92% in nominal terms, resulting in a 4% decline in purchasing power for families whose budgets are dominated by necessities. 

These aren’t short-term fluctuations. They are structural and cumulative increases in the cost of essentials, compounded by wage growth that lagged behind. That combination steadily eroded families’ room to maneuver. So, when inflation in groceries and consumer goods spiked in 2021—even for a relatively brief period—low- and middle-income Americans had precious little slack left to absorb it. 

This is why focusing on headline inflation misses the larger, persistent threat. Rising unavoidable expenses have been pushing up the household cost structure for decades. CPI understates the rise in many essentials, and labor-market metrics often overstate the prevalence of living-wage jobs. Add in higher barriers to homeownership and education, and the financial path forward becomes even steeper. Consumer behavior reflects this reality. New tariffs introduced in 2025 were described as temporary “trade adjustments,” yet analysis from the Budget Lab at Yale University estimates they will raise consumer prices by roughly 1.7% and cost the average household $2,300 this year alone. Even if those increases eventually unwind, the impact will fall on households that have already been squeezed for decades, and many households are no longer assuming prices will fall back—they’ve been burned too often. 

In a recent survey, 44% believe tariffs have already increased the price of goods and services, and a quarter reported switching to generic or private-label goods in response. These are not the behaviors of households expecting a quick return to pre-shock conditions. 

Against this backdrop, new shocks—whether from AI-driven disruptions, federal layoffs, or additional trade-policy changes—may well land on households that are already stretched thin. Even well-intentioned policies can have unintended consequences if they are not evaluated through the lens of a household balance sheet. Focusing only on short-term affordability or only on long-term reform which may never come misses the point; both matter, because families must make both short- and long-run decisions at the same time. 

After more than two decades of declining well-being for most middle- and low-income households, it is clear that structural reforms are needed to bring costs back in line with wages. Short-term fixes alone are unlikely to address the root causes of affordability and, if misguided, could even prove counterproductive. Effective leaders should recognize that working-class households need both immediate breathing room and policies that make long-term stability possible. 

Ultimately, policy must be judged not only by aggregate performance of the economy as a whole or political resonance but by its ability to strengthen household financial resilience of all income groups—helping families make progress in good times and avoid lasting setbacks in bad. Until our measurement tools capture these realities directly, policymakers will continue to rely on short-termism, intuition, and ideological prejudices rather than evidence. 

And while intuition and such prejudices may shape elections, and too often do, effective policy and the country’s well-being require something more precise: an economic framework that recognizes that very few shocks are ever truly “one-time” for the households who have to bear them. 

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.



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Powell says DOJ criminal probe is attack on Fed’s independence to set rates

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Federal Reserve Chairman Jerome Powell called out the Trump administration for attacking the central bank’s independence, saying a criminal probe is due to the Fed’s refusal to lower rates earlier this year as President Donald Trump demanded.

He said in a statement Sunday that the Justice Department of served the Fed with grand jury subpoenas, threatening a criminal indictment over his testimony before the Senate last June related to renovations on the headquarters, which has seen cost overruns.

Powell, who is typically cautious in his public remarks, was clear that the probe was political in nature and had nothing to do with the Fed renovations or his testimony, calling them “pretexts.”

“The threat of criminal charges is a consequence of the Federal Reserve setting interest rates based on our best assessment of what will serve the public, rather than following the preferences of the President,” he wrote.

“This is about whether the Fed will be able to continue to set interest rates based on evidence and economic conditions—or whether instead monetary policy will be directed by political pressure or intimidation.”

Powell added that he has served under Republican and Democratic presidents “without political fear or favor,” while focusing on the Fed’s dual mandate of price stability and maximum employment.

“Public service sometimes requires standing firm in the face of threats,” he said. “I will continue to do the job the Senate confirmed me to do, with integrity and a commitment to serving the American people.”

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Oil prices rise as Iran crackdown suggests Tehran fears a ‘dire security threat to the regime’

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Crude oil futures pointed to continued gains on Sunday as markets weighed potentially transformative events in Iran, which has been wracked by protests across the country.

U.S. oil prices rose 0.56% to $59.45 a barrel, and Brent crude climbed 0.52% to $63.67 a barrel, as reports said President Donald Trump is weighing military options in Iran to follow through on his threats to attack if the government kills protestors.

Iran, which pumps 3 million-4 million barrels per day, has seen protests spread nationwide amid an economic crisis. Human rights groups estimate hundreds have died from the government’s crackdown, as the regime’s piecemeal attempts to appease Iranians have failed.

The government cut off internet access in the country last week, slowing the flow of information on the latest developments. But various reports and expert assessments indicate the unrest is posing a major threat to Tehran’s authority.

In particular, the security apparatus that keeps the leadership in power is showing cracks, according to the Institute for the Study of War (ISW).

“There are further indications that the ongoing protests are challenging the ability and willingness of Iranian security forces to crack down on the protests,” the think tank said in a recent report. “The IRGC Intelligence Organization released a statement on January 10 that it is ‘dealing with possible acts of abandonment.’ This statement suggests that some Iranian security forces may have already defected or that the regime is very concerned about this possibility.”

It cited additional reporting that pointed to some officers anticipating the regime’s collapse, forces in one city refusing to fire on protesters, and the possibility the government will deploy the regular army.

These rank-and-file troops, known as the Artesh, are less ideological and more representative of the Iranian population than the Islamic Revolutionary Guard Corps, ISW said. That raises the risk Artesh troops, who aren’t trained to handle civil unrest, could defect and indicates internal security forces are stretched thin, it added.

A separate analysis from ISW noted that the government is treating the protests as a military issue instead of a law enforcement one. It also said Tehran “has taken the rare step of using the IRGC Ground Forces to suppress protests because it has likely determined that these protests represent a dire security threat to the regime.”

Energy markets are digesting the implications of political upheaval in Iran, a top OPEC member with the world’s third largest proven oil reserves. In fact, anti-government protests have already spread to Iran’s oil sector with workers at a large refining and petrochemical complex going on strike.

Market tracker Kpler said in post on X on Saturday that Iran’s regime faces a tipping point and is under unprecedented strain.

“Though a full collapse remains a low-probability event, the rising risk is already lifting the geopolitical premium in oil markets. Any disruption—through factional conflict, export curbs or external intervention—could prompt near-term price spikes, despite global surpluses,” it added.

“Over the medium term, regime change could unlock sanctions relief and reshape trade flows, with European, Indian and Japanese refiners poised to benefit, while Chinese independents and Middle Eastern producers face stiffer competition.”



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Anthropic debuts Claude for Healthcare, partners with HealthEx for patient electronic health records

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AI lab Anthropic is making a major push into healthcare with the launch of Claude for Healthcare and an expansion of its life sciences offerings.

The announcement, timed to coincide with the start of the JPMorgan Healthcare Conference in San Francisco this week, comes just days after OpenAI unveiled ChatGPT for Health. That’s no coincidence and reflects the growing competition among leading AI labs to build specialized products for lucrative industries like healthcare, finance, and coding.

The Claude for Healthcare announcements include a partnership with HealthEx, a startup that allows patients to see all of their electronic medical records in a single place and control access to that data. The partnership includes a way for users to connect their personal medical records to Anthropic’s Claude in order to use the chatbot to answer health-related questions.

“HealthEx lets people bring their health records into a conversation with Claude and ask important questions in everyday language—What does this lab result mean? What should I bring up with my doctor? How has this number changed over time?—and get answers grounded in their own health history,” Amol Avasare, product lead at Anthropic, said.

The announcements also include a similar set of connectors for Function Health, a company that helps patients schedule lab tests and interpret the results, as well as integrations with Apple Health and Android Health Connect that will be rolling out to beta testers next week. For now, the connectors to HealthEx and Function Health are available to Claude Pro and Max subscribers in the U.S.

Health-related queries are among the leading consumer use cases of AI chatbots. But so far, Anthropic has been less focused on serving the general consumer market than its rival OpenAI, which boasts more than 800 million weekly users. Anthropic is thought to have far fewer consumer users and has instead concentrated on specialized use cases, such as software coding, that more naturally appeal to enterprise customers. It has pulled ahead of OpenAI in enterprise marketshare according to several recent surveys. It has also recently been creating more tailored versions of Claude to serve other industry or professional verticals, such as Claude for Financial Services and Claude for Life Sciences.

Anthropic has said it is interested in serving consumers as well as large organizations, and today’s announcements were aimed at both consumers and enterprise customers, such as hospitals, insurers, and pharmaceutical companies.

New offerings for healthcare providers, insurers, and pharma

The company said it was adding connectors to industry-standard databases including the Centers for Medicare & Medicaid Services Coverage Database, the International Classification of Diseases (ICD-10), the National Provider Identifier Registry, and PubMed.

These connectors are designed to help healthcare providers with tasks like speeding up prior authorization requests, supporting claims appeals, coordinating care, and triaging patient messages.

For life sciences companies, Anthropic is expanding beyond its initial focus on preclinical research to support clinical trial operations and regulatory work. New connectors include Medidata for clinical trial data and ClinicalTrials.gov. It is also launching connectors to bioRxiv and medRxiv—which are repositories for medical and biological research papers, usually before their findings have been peer reviewed; Open Targets, a database of identified drug targets; and ChEMBL, a database of bioactive compounds that could be used to make drugs.

The company is working with major healthcare and pharmaceutical companies including AstraZeneca, Sanofi, Genmab, Banner Health, Flatiron Health, and Veeva, among others. In a video clip Anthropic provided to reporters, it showed how Claude can now help a pharmaceutical company design a protocol for a Phase II clinical trial of a hypothetical drug designed to treat Parkinson’s Disease. It reduced the time it takes to draft the protocol design from many days to just about an hour.

Letting Claude use medical records to answer patient queries

Among the centerpieces of the new consumer health offerings is the partnership with HealthEx, which can help patients consolidate medical records from more than 50,000 health systems.

Fortune talked with executives from both companies exclusively about the new offering.

“Personal health records today are scattered across providers, and it can be difficult to get a complete view,” Avasare told Fortune. “HealthEx built a way to use Claude to unify those records with user consent and strong controls. Users decide what to share and can revoke access at any time, and their health data is never used for model training.”

HealthEx cofounders Priyanka Agarwal, now the company’s CEO, and Anand Raghavan, its CTO.

Photo courtesy of HealthEx

Users enable the HealthEx connector inside Claude, verify their identity, and connect their patient portal logins. HealthEx then unifies records across providers. When users ask Claude health-related questions, Claude uses Model Context Protocol (MCP)—an open standard Anthropic developed for connecting AI to external data sources—to securely retrieve relevant portions of the record for each specific question.

To enhance data privacy, Claude requests only the categories of information most likely to be relevant to a question—such as medications, allergies, recent lab reports, or doctor notes—rather than pulling an entire medical record. If relevance isn’t obvious, Claude can prompt users to broaden the scope, asking if they want to look further back in their history, Avasare said.

Priyanka Agarwal, cofounder and CEO of HealthEx, said the partnership addresses a fundamental problem in American healthcare: making it easier for consumers to access and understand their own health data.

“We’re giving every American a safe, private way for them to use their health data with AI,” Agarwal told Fortune. “We know that AI based on personal context is going to be more effective at providing support.” She said that by connecting medical records to HealthEx and HealthEx to Claude, users will get “responses [that] are grounded in your health history, not generic advice.”

According to Anthropic, the healthcare and life sciences announcements are possible because of recent improvements to Claude’s underlying capabilities. When tested on simulations of real-world medical and scientific tasks, Claude Opus 4.5, Anthropic’s latest model, substantially outperforms earlier releases. The company also said Opus 4.5 with extended thinking shows improvements in producing correct answers on honesty evaluations, reflecting progress on reducing factual hallucinations.



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