Mark Thoma explains the methodology of election to the Fed policy-making apparatus. The leadership issue at the Fed makes me laugh in some ways, it reminds strongly of Congress. Or perhaps I should say the British cabinet system of Government. Every decision made must be a Consensus, where its Protagonists receive the support of another member bank and/or district bank by backroom discussion. Support garnered may be based upon any range of backroom negotiation, and often that Support has been guaranteed through disparate measures functionally opposed to one another. The policy is picked, the methodology is chosen, then Everyone awaits the fate of the policy which has never been consistently supported by Anyone. The problem, though, sits within the decision process. Any alteration of policy must initiate the original selection process, with new Promises made, and new Support elements aligned. Previous policy, therefore, develops a deadweight where it is maintained until a new coalition can be formed among the ranks. Ineffectiveness becomes integral in the process, where even obvious obnoxious effect can be maintained, for failure to derive a Consensus among policy-makers.
Opponents of any political measure will always assure that the Time is not right for going ahead on any measure dealing with the problems involved. Obama is faced with the political Wind filibuster, where the foundation block of his policy is being delayed. The Opposition knows that they need to buy Time, until American attention turns to other matters. Obama needs to approach the problem of health care in simple blocks. I would suggest he start with a medical services bill, where a automatic Payroll enrollment of 1% Tax on Income would pay for a set Dollar amount towards Doctors’ fees, Clinic services, and Emergency Room Care. The Dollar amount should be alterable by medical board recommendation and approval by Congress periodically; the Dollar amount should be assessed to pay about 60% of formal bills, a position where medical Providers would absorb the lost income because of the volume of Patients and overcharging in the first place–a situation quite similar to Medicare today. Getting this position attained will allow for more fundament health care reform, without the organized Opposition currently resistant.
You can get some idea of how much health care is costing the American taxpayer, both individually and in aggregate. The fact remains that We can do little for the Individual taxpayer, as there will be continual need to expand the taxable base and the degree of Charges to the majority of Taxpayers. We can vastly affect the aggregate, though, and limit the excess Charges of health care; making it cheaper to obtain and maintain. Opponents to health care reform must be led to understand that universal measures of health care is the only effective means to expand the taxable base from the huge Public expenditures of today. Supporters of health care reform must understand that We cannot provide any freebie medical provision–as it costs too much, but We can introduce an effective limited Cost schedule of health care. We have to get both Sides working off the same page, before We can even reach Agreement on the Need. lgl