Who’s in charge here?

Lately it seems like an open question. Artificial intelligence has taken over the economy, and some of its leading luminaries are just now saying maybe the industry should slow down. There’s renewed bipartisan interest in doing so.

Meanwhile, the Federal Reserve is acting against President Donald Trump’s wishes, raising interest rates and fight inflation, and the president is now saying that’s fine… kind of. We’ll talk about all that below, but first let’s zoom way, way out and explain a couple schools of thought around economic policymaking. — Tony Wagner, newsletter editor  

The U.S. government’s debt surpassed $40 trillion last month.

Meanwhile, the Federal Reserve continues to fight inflation, which is still higher than its 2% target rate . High inflation is actually good for the national debt, because an elevated inflation rate reduces the real value of the money the U.S. owes.

Sometimes, economies reach a point where their debt gets so out of control that monetary policymakers must prioritize the government’s borrowing needs over stabilizing inflation. It’s called “fiscal dominance.”

“It's a situation where fiscal policy runs the show, and monetary policy is subjugated to fiscal needs,” said Veronique de Rugy, the George Gibbs Chair in Political Economy at George Mason University.

In the U.S., monetary policymakers (that’s the Federal Reserve) control interest rates and money supply, while fiscal policymakers (that’s Congress and the president) control taxes and government spending.

But when monetary policymakers raise interest rates — as they do when trying to combat inflation — the interest the government pays on debt goes up too.

“When the borrowing costs of the government get really high they may start to struggle to bring in enough revenue to cover those borrowing costs,” said Rashad Ahmed, economist at the Andersen Institute for Finance & Economics. “If the central bank starts to set interest rates in a way where they're prioritizing a reduction in the debt burden of the government, you have what's called fiscal dominance.”

In the United States, this happened during World War II and its aftermath.

Too much bloat and too little transparency drive up the cost of healthcare in the U.S., Patel says, which might be why many Americans are traveling thousands of miles to receive treatment.

Millions of Americans travel abroad to save money on medicine each year. On this week’s episode of “This Is Uncomfortable,” host Reema Khrais talks with a woman who sought out a $300 root canal in Mexico City, and ended up returning for more dentistry later. We also got tips from Patel for anyone interested in exploring medical tourism.

About two-thirds of Americans think there’s at least a moderate chance artificial intelligence could kill us all, according to a new poll from Politico. That holds even when you break out voters by party, just the latest example of how big tech is scrambling party lines.

This new data comes as the AI industry argues over slowing down development, and as OpenAI disclosed six more instances of its most advanced agents going against the wishes of their human minders. “Model misalignment” is the term of art.