Business Week’s cover story this week is great food for thought. The article argues that global economic factors have made the economy much less controllable by United States government forces. Several of the “big idea” solutions in the article deserve some special consideration, and response.

…[W]e need to take hold of the main unused lever of economic policy: health care. Politicians and economists have mainly thought of health care as a cost that is dragging down competitiveness. Health-care spending is the main source of long-term federal, state, and local budget deficits, the prime gobbler of national savings, and one of the biggest tax distortions, in the form of the tax exemption for company-provided health insurance.

All these things are true. But health care is also a huge source of private sector jobs, one of the most technologically advanced sectors of the economy, and frankly, the provider of a service people can’t get enough of. It can even be thought of as an investment, to the degree that better health allows Americans to work longer and to better enjoy their lives. We have to view health care as a force for growth, rather than an impediment.

While I believe in the essential role of health care, I’m not so sure we should view it as an engine for economic growth. The point of health care is not to serve the economy and the labor markets. The point of health care is to prevent illness and serve the sick — people in need of medicine and treatment. If we view health care as a cash cow, we will be inviting disease mongering — creating illnesses as a way to increase revenue and jobs, rather than as a way to serve those in need most effectively. We are already seeing the deleterious effects of this in the constant barrage of prescription drugs being advertised directly to consumers and the massive increases in uses of psychiatric medications on new populations such as very young children.

…Finally, a Big Big Idea–probably too big to even consider right now–would be the creation of global institutions for governing the world economy. History tells us that market economies are prone to financial crises, to which the only solution is a strong central bank. During the Asian financial crisis of the 1990s, for example, the Fed played that role.

But with the explosive growth of China and India, that sort of role for the Fed is no longer feasible, and no new institution has arisen to take its place. As former Treasury Secretary Robert E. Rubin, now a top official at Citigroup, recently said: “There’s no policy mechanism for bringing together the countries that really matter in the global economy.” The best solution would be some sort of global central bank with real powers–but that’s not going to happen until there’s a big enough financial crisis to truly scare people.

A global central bank. Hmmm. And how would we choose the people to put in charge of this global central bank? Would there be elections? If not, which government would have the most influence in choosing these leaders. If these global banks are going to have more influence over the world than country’s governments, how are we going to keep that massive level of power from being corrupted?

Finally:

Yet economists are hard-pressed to find evidence that tax cuts have a big effect on growth. Last summer, the Treasury Dept. released a study that looked at the long-term impact of extending President Bush’s tax cuts, which are due to expire at the end of 2010. The study concluded that extending the tax cuts indefinitely would boost GDP by only 0.7% over the long run. That’s less than a rounding error.

So all those tax cuts that depleted our social security trust fund, increased our national debt, and further concentrated wealth in the top 1%? There is almost no measurable positive effect on the economy. So can we stop giving away the money and the power to the richest of the rich?