‘Beautiful’ is in the eye of the bond vigilantes

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Today's Points:

A Big, Beautiful Deficit

Donald Trump has a way with words. Nobody can possibly take this away from him. After six weeks dominated by a Liberation Day that was anything but, the debate has moved to the president's promise of a Big, Beautiful Bill that is certainly big, but not very beautiful.

The bill has now arrived in Congress. It's a basis for negotiation and is bound to change in important ways before it can become law — but the bottom line is that the combination of tax cuts with feeble attempts at cost cuts will mean a deeper deficit.

The Biden administration avoided a widely anticipated recession over the last two years by priming the fiscal pump. The federal deficit has never been this deep outside a recession. Indeed, it hadn't been this serious even during the downturns of the 1970s and 1980s:

Until recently, the new administration had appeared ready to take a big hit to its political capital in the aid of reordering global trade. Now, it seems the bond vigilantes may need to levy a similar price to bring fiscal continence back to the US. The menacing rise in longer yields shows that they have doubts:

Bonds have moved in conjunction with expectations for the Federal Reserve. Tariffs posed a clear and present danger to US growth. After April 2, when the administration was insisting that trade levies were not merely a negotiating tool, fed funds futures began discounting a series of cuts. That is over. The implicit rate for next month's Fed meeting is at a new high, with the chance of a cut now negligible:

Meanwhile, the most imminent risk has shifted from stagflation (a real possibility if tariffs remained at punitive levels) to inflation. Viewing the economy in terms of landings has gone out of fashion of late, and the Bank of America survey of fund managers showed that belief in a "no landing" scenario — in which the economy booms, inflation is not tamed, and rates eventually have to rise still further — almost disappeared during the tariff tantrum. We can expect those odds to rise considerably from here:

All of this is consistent with the theory that Trump has given up on a certain kind of 2.0 radicalism, and will now follow his 1.0 model — which involves tax cuts, and a pronounced concern to please the stock market. Eight years ago, that led to a potent rally once it became clear that the tax cuts really were going to happen. It ended when 10-year yields rose to 3.25% — a level that at that point the stock market could not tolerate:

The excitement of the savage selloff in late 2018, culminating in what has come to be known as the Christmas Eve Massacre and a pivot toward easier money from the Fed, gives an idea of the risks ahead. It also suggests that investors would be well advised to stay on the equity train while watching the bond market very anxiously. Julian Brigden of Macro Intelligence Partners warned that the administration could shift back to "the devil-may-care policies of Trump 1.0":

This shifts the risk from stagflation to inflation and suggests we need to price out any chance of an imminent Fed rate cut. At the same time, we need to watch for signs that the rest of the world is no longer willing to fund our profligacy, as we ultimately search for a level of bond yields that brings stocks to heel.

Will it really play out this way? The DOGE cuts suggested a sincere attempt to reduce the deficit, but were centered on relatively small departments unpopular with core Trump supporters. The bill that is emerging aims for $900 billion in spending cuts from the House Energy and Commerce Committee, which covers Medicaid and Medicare. This would likely go down like a lead balloon with the Trump base, and has already aroused Republican opposition in Congress.

Even if that opposition is overcome, Ajay Rajadhyaksha of Barclays points out that the bill "seems to add around $2.5 trillion to the deficit over the next decade.'' Further, claims that the proposed tax cuts will cost "only" $1 trillion rests on the tenuous assumption that they wouldn't be continued:

It seems very unlikely that Congress will not attempt to extend these expiring tax cuts right before the 2028 presidential (and congressional) elections – no one wants to tell their constituents that they face a big tax hike right after the election.

What seems to be constant is that it's the bond market that decides. "Yippy" bond yields shook the administration out of its extreme tariffs, rescuing stocks in the process. It may yet fall to the vigilantes to save Washington from fiscal profligacy — only this time, that would involve squelching what is building into a remarkable rally in equities.  

Worth the Wait?

Trump's executive order aimed at compelling drug makers to reduce prices was no surprise — it was a matter of when, not if. Last year, US medication spending surged to $487 billion, intensifying long-lasting concerns over soaring health care costs. With Big Pharma struggling to shake its reputation for exploitative pricing, Trump's order seemed inevitable. 

Despite surging costs, and the tailwinds from Covid-19 vaccines and then obesity drugs, health care stocks' performance has been lackluster. The ratio of the S&P 500 health care stocks to the overall index highlights a gradual descent since late 2022. The artificial intelligence rally sucked up a lot of oxygen — but not even the breakthrough in GLP-1 blockbuster drugs for obesity has turned this around:

Trump's "Most Favored Nation" hasn't led to immediate price cuts, but the market's worried reaction hints at problems ahead. The order pushes drugmakers to lower their prices to the much cheaper levels available in other countries or face a new system forcing that outcome.

The president is touting price reductions between 30% and 80%. How painful would this be for Big Pharma? It's estimated that the proposal, seen as a way to help pay for tax cuts, could cost them as much as $1 trillion over a decade. UBS's Trung Huynh argues it could pose an average 10% net income headwind across US pharma groups if the policy were applied to the top 50 drugs. And it could be worse:

In a gray sky scenario, if it is total exposure across all drugs for each company, assuming a 50% net price cut at 60% contribution margin, this would result in a -15% average net income cut.

Trump's move adds pressure to an industry that was just starting to recover, buoyed by promising advances in weight-loss drugs. Preliminary results from Eli Lilly's experimental pill were encouraging, compared to injectables. Rival Novo Nordisk A/S announced it was partnering with US biotech company Septerna Inc. to develop oral obesity pills in a deal potentially worth up to $2.2 billion. But the performance of the Tema GLP-1 Obesity & Cardiometabolic ETF, which tracks the weight-loss drug makers, suggests the doubts over pricing have drowned any excitement in the market: 

Beyond political uncertainty, BofA analyst Allen Lutz note that health care and tech carry idiosyncratic risks. Historically, when one sector struggles, the other attracts investor inflows. This chart shows health care outperforming when the economic outlook worsens:

In that context, the abrupt shift to worrying about overheating rather than a recession is just what health care stocks didn't need. As for the longer term pressures on margins, Lutz shows that higher wages in the sector have outpaced rising prices. Labor is typically the largest cost item for hospitals, home health and hospices, so this is a key swing factor for profitability:

Still, health care isn't lacking in interest from investors, recording the second-largest cumulative inflows of any sector year-to-date after tech, according to the bank's data:

It looks like investors are counting on artificial intelligence to shake up health care — think faster drug discovery, fewer failed clinical trials, sharper diagnostics, and even better patient care. For the time being, that explains the greater enthusiasm for direct AI plays. And as the World Health Organization predicts a global shortage of 10 million health workers by 2030, AI-powered nurses might just step in to fill the gap. 

Richard Abbey

Survival Tips

A lot of songs have been written about dreams. Thanks for all your suggestions. For a new download, try: Dreams Never End by New Order, Sh-Boom (Life Could Be a Dream) by The Chords, California Dreamin' by The Mamas and the Papas, Midnight Oil's Dreamworld, White Rabbit by Jefferson Airplane (it's all about Alice's dream), The Dreams of Children by The Jam, Tame Impala's Apocalypse Dreams,  Dreams by Beck, Dream On by Aerosmith, The Dream of the Blue Turtles by Sting, Please Please Please Let Me Get What I Want by The Smiths, Nightmare by Halsey, Dream a Little Dream Of Me by Mama Cass, For Emily Whenever I May Find Her by Simon & Garfunkel, Dreams by the Allman Brothers, Dreams Go By by Harry Chapin, Fire and Brimstone by Link Wray, When I Live My Dream by David Bowie, Only a Dream by The Kinks, Dream Operator by the Talking Heads, Dream Baby Dream by Suicide, American Dream by LCD Soundsystem, Bruce Springsteen's Land of Hope and Dreams, How Can We Hang On to a Dream by Tim Hardin, Dreaming of You by Selena, In Dreams by Roy Orbison, and Dream Weaver by Gary Wright. We'll have one more assortment of dreams next week — any last nominations?

More Charts on the Terminal from Points of Return: CHRT AUTHERS

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