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Government & Policy | Healthcare IT News

Decision-making, then, is a continuous process with numerous people participating. At any given time, government is at various stages of policy-making in a never-ending quest to provide solutions to countless societal problems.

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Government Agencies and Elected Officials

Of course, international comparisons are not the only rankings that should inform the debate about reforming the health care system. Within the United States, there are dramatic variations among regions and racial or ethnic groups in the rates of death from preventable causes. While aiming to provide solutions to the problems of incomplete insurance coverage and inefficiency of care delivery, health care reformers have given insufficient attention to the design, funding, and evaluation of interventions that are tailored to local realities and address preventable causes of death. The big picture — the poor and declining performance of the United States, which goes far beyond the challenge of universal insurance — will inevitably get lost if we do not routinely track performance and compare the results both among countries and among states and counties within the United States.

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Although ED's share of total education funding in the U.S. is relatively small, ED works hard to get a big bang for its taxpayer-provided bucks by targeting its funds where they can do the most good. This targeting reflects the historical development of the Federal role in education as a kind of "emergency response system," a means of filling gaps in State and local support for education when critical national needs arise.

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Tax reform requires grappling with difficult issues. One is the amount of revenue the federal tax system should raise. The imbalance between revenue and spending will mean increasingly large and ultimately unsustainable federal deficits and debt. Tax policy needs to be part of a multipronged approach as policymakers assess how to alleviate the fiscal pressures.

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Tax expenditures can help further federal goals through the tax system. They narrow the base and increase the tax rates needed to raise a given amount of revenue. The myriad of tax expenditures—reductions in a federal taxpayer's tax liability that result from special credits, deductions, exemptions and exclusions from taxation, deferral of tax liability, and preferential tax rates—have various economic and social policy purposes, but their success in achieving these goals is too often not assessed. These provisions are also an important reason why the effective tax rates on individuals and corporations, which attempt to measure taxes paid as a proportion of economic income, can differ significantly from the statutory tax rates. See also for more information.

U.S. GAO - Key Issues: Tax Reform

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The Federal Reserve System fulfills its public mission as an independent entity within government. It is not "owned" by anyone and is not a private, profit-making institution.

The Role of Government in the U.S

GAO's previous work has shown that, once enacted, tax expenditures and their relative contributions toward achieving federal missions and goals are often less visible than spending programs, which are subject to more systematic review. One reason for this is that they often operate, in practice, like entitlement programs not subject to annual appropriations. Since 1994, GAO has recommended greater...