Real World Economics: Today’s Fed: Moral hazard on steroids

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Edward Lotterman

Managing the money supply of a modern economy is a dirty job, but somebody has to do it.

For some 110 years, we have had an operating central bank, the Federal Reserve system, to do that. It could reduce harm to businesses and households from bank failures. Well thought-out, it could increase or decrease the money supply as needed to maintain credit availability without inflation.

So how has it done?

The answer is “pretty well,” at least for the first 85 years. The Fed made mistakes, especially in the 1930s and 1970s, but so did virtually all central banks around the world. Yes, central bank mistakes contributed to the Great Depression, but the causes of that went deeper.

Ditto for the high inflations hitting most economies in the 1970s. The Fed under chairs Arthur Burns and G. William Miller let the money supply grow far too fast. But there also were commodity-price shocks. Prevailing economic doctrines proved flawed. However, by the 1990s, growth was strong, unemployment low and prices stable. Yes, many farm lenders had failed, as did a class of banks called “savings and loans.” But these problems had been handled. On the whole, the economy during this period was in fine fettle. But harsher challenges would present in the new millennium.

Most recently — and current Chair Jerome Powell would probably acknowledge this — the Fed misjudged how long the sharp inflation following COVID would last, and this became a political liability for President Donald Trump’s first term, and more dramatically for his successor, Joe Biden.

To understand the Fed’s role in all of this, one must understand that the key function of any central bank is to manage the money supply — not “set” interest rates. Nearly all the general public doesn’t get this. News reports stating that the Fed raised or lowered interest rates don’t tell us what’s really happening — that the central bank is actually increasing or decreasing the amount of money in circulation. Hardly anyone in politics or the media adequately explains the correlation, including virtually all reporters covering finance as well as general news. This also points to failures in the teaching of economics.

An often-used analogy is that if a driver decides to move the speedometer from 50 to 70, they have to step harder on the gas. It is the flow of fuel to the motor that is important. The speedometer only indicates the result. In the same way the flow of the money supply determines interest rates.

Next, one must understand key indicators showing how much money is in the economy. The “money supply” consists of currency, physical bills or coins, plus bank deposits. Subdivisions to various degrees, depend on which deposits count, from simple checking, to long-term CDs. The Fed has great influence over the money supply, but does not “control” it.

The “monetary base” consists of currency plus bank reserves. These are deposits not loaned out. The Fed can control this closely. Historically here and in many other countries yet today, the “reserve ratio,” or minimum percentage of deposits that must be kept in reserve, is a key variable. In the U.S. there no longer is a reserve requirement but prudent banks still keep reserves.

The money supply and monetary base look at assets, money held by banks or the general public. But the point of view of the central bank also is key. It can create or destroy money by changing the level of reserves in a nation’s banking system as a whole. This leads to an important point that takes up an entire econ class session to explain. So just understand that in a system of “fractional reserve banking,” an increase in total banking reserves by a central bank causes a much greater increase in the money supply.

A central bank has a number of ways to increase reserves.

First, it can change the required reserve ratio. Decreasing it lets banks lend more. Increasing it does the opposite. This was important when the Fed was established and still true in much of the world, but is moot for the U.S. because we no longer have required minimums.

Second, the Fed can make direct loans to banks at its “discount window.” The framers of the Federal Reserve saw this as its central function. (This was described in the Feb. 15 column.) Again, understand that when the Fed makes such loans, it creates the money out of thin air. It does not come from the U.S. Treasury or anywhere else. And when such loans are repaid, money goes poof and disappears.

Third, it can inject new money into the economy by going into open bond markets where bonds issued by the U.S. Treasury, corporations, or anyone else are traded. To increase the money supply, it buys bonds by paying for them with newly created money. To decrease money in the system it sells bonds and the money received disappears.

Historically, the Fed only bought and sold U.S. Treasury bonds. This was extended to include “repurchase agreements” or “repos” and “reverse repos.” These are derivative securities based on Treasury bonds.

Such central bank buying and selling of bonds to increase and decrease bank reserves, and thus the money supply, is called “open-market operations.” That is why Fed officials who decide how much to buy or sell make up the “Federal Open-Market Committee.” It includes the seven members of the Board of Governors that includes a Chair, currently Powell, plus the 12 presidents of Fed district banks. However, while all participate, only five of the 12 vote in any given year.

Such buying and selling is analogous to feeding more or less gas to a car. The FOMC chooses a short term interest rate to target just as a driver decides to drive at 55 mph or 70 mph. To raise interest rates, the Fed sells bonds. To lower them, it buys more.

The original Federal Reserve Act did not include such bond market actions. But discount window lending depended on banks seeking loans. If the economy needed more liquidity, but no banks came to borrow, available money did not change. Benjamin Strong, president of the New York Fed, implemented open-market operations in the 1920s. The New Deal Banking Acts of 1933 and 1935 incorporated them and created the current Fed structure. Over time, discount window lending dwindled and open-market operations dominated Fed control of the money supply.

The ability to create new bank reserves and thus more money is how central banks quelch financial crises of the type that plagued the U.S. economy prior to 1913. It can stop chains of bank failures that were once common. But this creates huge danger. If any central bank steps in too often and too drastically, it creates “moral hazard,” incentivizing banks to lend carelessly and excessively. Large banks that are deemed “too big to fail” get a “heads we win and tails the Fed loses” mentality. Which brings us to today. Such perverse incentives have plagued the U.S. financial system for 40 years.

Yes, the Fed failed to intervene effectively in the 1930s, contributing to the Great Depression. It let the money supply grow too fast in the 1970s, contributing to inflation. But then, in 1984, when Continental Illinois, the seventh largest U.S. bank, was going bust, the Fed and the Federal Deposit Insurance Corp. intervened to bail it out. This led critics, especially at the Minneapolis Federal Reserve and in key university economics departments, to warn of the enormous moral hazard thus created.

They were right. New legislation was intended to limit this, but in 1998, the Fed stepped in when a hedge fund, Long Term Capital Management, went broke. It later flooded the economy with liquidity after 9/11. And then, when a financial crisis in very short term lending broke out in August 2007, followed by the failure of investment banks Bear Stearns in March 2008, and Lehman Brothers that October, a panicked Fed opened money taps to an unprecedented degree. This included creating ways to directly buy mortgage-backed securities rather than only Treasury bonds.

It more than tripled its holdings of securities, Treasury and private, from about $900 billion in August 2008 to $2.9 trillion in August 2011. Then, fighting a recession that regulatory failures had helped create, it lifted this total to $4.5 trillion by late 2014. Pausing, it let its holdings ebb to $3.6 trillion in mid-2019. But the outbreak of COVID in 2020 prompted even greater injections, reaching $7 trillion in June 2020 and $9 trillion in mid-2022. What happens to all this extra money? In this case, it caused the inflation that ejected Trump, then Biden four years later, from office and stoked the roaring stock market, crypto, “private debt” and “private equity” bubbles dominating financial news today, as well as inflated house prices benefitting baby boomers at the cost of anyone younger. In short, moral hazard on steroids.

The monetary base has fallen from a peak in late 2021, but remains nearly seven times as high as in March 2008. The broader M2 money supply, currently at $22.4 trillion, is three times as high over the same period. Gross domestic product, the total value of all goods and services produced, has only doubled.

Kevin Warsh, Trump’s nominee to be the next Fed chair, has been outspoken in calling for the Fed’s balance sheet to be reduced. This means selling off many of the securities the Fed gorged on in a stair-step of crises over the last 18 years. Yet such a move would raise interest rates and slow the economy. Trump wants him to do the opposite. How this will play out is unknown.

The media, blind to the central role of the money supply, fails to see this conundrum. We’ve gotten pretty good at predicting and responding to disastrous weather events, but nearly everyone ignores looming financial storms to our perhaps greater, and longer-lasting, peril.

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St. Paul economist and writer Edward Lotterman can be reached at stpaul@edlotterman.com.

Red and blue states alike want to limit AI in insurance. Trump wants to limit the states

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By Darius Tahir, Lauren Sausser, KFF Health News

It’s the rare policy question that unites Republican Gov. Ron DeSantis of Florida and the Democratic-led Maryland government against President Donald Trump and Gov. Gavin Newsom of California: How should health insurers use AI?

Regulating artificial intelligence, especially its use by health insurers, is becoming a politically divisive topic, and it’s scrambling traditional partisan lines.

Boosters, led by Trump, are not only pushing its integration into government, as in Medicare’s experiment using AI in prior authorization, but also trying to stop others from building curbs and guardrails. A December executive order seeks to preempt most state efforts to govern AI, describing “a race with adversaries for supremacy” in a new “technological revolution.”

“To win, United States AI companies must be free to innovate without cumbersome regulation,” Trump’s order said. “But excessive State regulation thwarts this imperative.”

Across the nation, states are in revolt. At least four — Arizona, Maryland, Nebraska, and Texas — enacted legislation last year reining in the use of AI in health insurance. Two others, Illinois and California, enacted bills the year before.

Legislators in Rhode Island plan to try again this year after a bill requiring regulators to collect data on technology use failed to clear both chambers last year. A bill in North Carolina requiring insurers not to use AI as the sole basis of a coverage decision attracted significant interest from Republican legislators last year.

DeSantis, a former GOP presidential candidate, has rolled out an “AI Bill of Rights,” whose provisions include restrictions on its use in processing insurance claims and a requirement allowing a state regulatory body to inspect algorithms.

“We have a responsibility to ensure that new technologies develop in ways that are moral and ethical, in ways that reinforce our American values, not in ways that erode them,” DeSantis said during his State of the State address in January.

Ripe for Regulation

Polling shows Americans are skeptical of AI. A December poll from Fox News found 63% of voters describe themselves as “very” or “extremely” concerned about artificial intelligence, including majorities across the political spectrum. Nearly two-thirds of Democrats and just over 3 in 5 Republicans said they had qualms about AI.

Health insurers’ tactics to hold down costs also trouble the public; a January poll from KFF found widespread discontent over issues like prior authorization. (KFF is a health information nonprofit that includes KFF Health News.) Reporting from ProPublica and other news outlets in recent years has highlighted the use of algorithms to rapidly deny insurance claims or prior authorization requests, apparently with little review by a doctor.

Last month, the House Ways and Means Committee hauled in executives from Cigna, UnitedHealth Group, and other major health insurers to address concerns about affordability. When pressed, the executives either denied or avoided talking about using the most advanced technology to reject authorization requests or toss out claims.

AI is “never used for a denial,” Cigna CEO David Cordani told lawmakers. Like others in the health insurance industry, the company is being sued for its methods of denying claims, as spotlighted by ProPublica. Cigna spokesperson Justine Sessions said the company’s claims-denial process “is not powered by AI.”

Indeed, companies are at pains to frame AI as a loyal servant. Optum, part of health giant UnitedHealth Group, announced Feb. 4 that it was rolling out tech-powered prior authorization, with plenty of mentions of speedier approvals.

“We’re transforming the prior authorization process to address the friction it causes,” John Kontor, a senior vice president at Optum, said in a press release.

Still, Alex Bores, a computer scientist and New York Assembly member prominent in the state’s legislative debate over AI, which culminated in a comprehensive bill governing the technology, said AI is a natural field to regulate.

“So many people already find the answers that they’re getting from their insurance companies to be inscrutable,” said Bores, a Democrat who is running for Congress. “Adding in a layer that cannot by its nature explain itself doesn’t seem like it’ll be helpful there.”

At least some people in medicine — doctors, for example — are cheering legislators and regulators on. The American Medical Association “supports state regulations seeking greater accountability and transparency from commercial health insurers that use AI and machine learning tools to review prior authorization requests,” said John Whyte, the organization’s CEO.

Whyte said insurers already use AI and “doctors still face delayed patient care, opaque insurer decisions, inconsistent authorization rules, and crushing administrative work.”

Insurers Push Back

With legislation approved or pending in at least nine states, it’s unclear how much of an effect the state laws will have, said University of Minnesota law professor Daniel Schwarcz. States can’t regulate “self-insured” plans, which are used by many employers; only the federal government has that power.

But there are deeper issues, Schwarcz said: Most of the state legislation he’s seen would require a human to sign off on any decision proposed by AI but doesn’t specify what that means.

The laws don’t offer a clear framework for understanding how much review is enough, and over time humans tend to become a little lazy and simply sign off on any suggestions by a computer, he said.

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Still, insurers view the spate of bills as a problem. “Broadly speaking, regulatory burden is real,” said Dan Jones, senior vice president for federal affairs at the Alliance of Community Health Plans, a trade group for some nonprofit health insurers. If insurers spend more time working through a patchwork of state and federal laws, he continued, that means “less time that can be spent and invested into what we’re intended to be doing, which is focusing on making sure that patients are getting the right access to care.”

Linda Ujifusa, a Democratic state senator in Rhode Island, said insurers came out last year against the bill she sponsored to restrict AI use in coverage denials. It passed in one chamber, though not the other.

“There’s tremendous opposition” to anything that regulates tactics such as prior authorization, she said, and “tremendous opposition” to identifying intermediaries such as private insurers or pharmacy benefit managers “as a problem.”

In a letter criticizing the bill, AHIP, an insurer trade group, advocated for “balanced policies that promote innovation while protecting patients.”

“Health plans recognize that AI has the potential to drive better health care outcomes — enhancing patient experience, closing gaps in care, accelerating innovation, and reducing administrative burden and costs to improve the focus on patient care,” Chris Bond, an AHIP spokesperson, told KFF Health News. And, he continued, they need a “consistent, national approach anchored in a comprehensive federal AI policy framework.”

Seeking Balance

In California, Newsom has signed some laws regulating AI, including one requiring health insurers to ensure their algorithms are fairly and equitably applied. But the Democratic governor has vetoed others with a broader approach, such as a bill including more mandates about how the technology must work and requirements to disclose its use to regulators, clinicians, and patients upon request.

Chris Micheli, a Sacramento-based lobbyist, said the governor likely wants to ensure the state budget — consistently powered by outsize stock market gains, especially from tech companies — stays flush. That necessitates balance.

Newsom is trying to “ensure that financial spigot continues, and at the same time ensure that there are some protections for California consumers,” he said. He added insurers believe they’re subject to a welter of regulations already.

The Trump administration seems persuaded. The president’s recent executive order proposed to sue and restrict certain federal funding for any state that enacts what it characterized as “excessive” state regulation — with some exceptions, including for policies that protect children.

That order is possibly unconstitutional, said Carmel Shachar, a health policy scholar at Harvard Law School. The source of preemption authority is generally Congress, she said, and federal lawmakers twice took up, but ultimately declined to pass, a provision barring states from regulating AI.

“Based on our previous understanding of federalism and the balance of powers between Congress and the executive, a challenge here would be very likely to succeed,” Shachar said.

Some lawmakers view Trump’s order skeptically at best, noting the administration has been removing guardrails, and preventing others from erecting them, to an extreme degree.

“There isn’t really a question of, should it be federal or should it be state right now?” Bores said. “The question is, should it be state or not at all?”

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

Literary calendar for week of March 1

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DICAMILLO/LANGEMO: Award-winning Minnesota writer Kate DiCamillo and musician Jimmi Langemo team up for stories, music, inspiration and connection to benefit Joyce Uptown Foodshelf. Tickets required. For information, visit redballoonbookshop.com. 1 p.m. March 1, Judson Memorial Baptist Church, 4101 Harriet Ave., Mpls.

NINA McCONIGLEY: Colorado-based writer introduces her debut novel “How to Commit a Postcolonial Murder,” in conversation with Minnesotan V.V. Ganeshananthan. Free. 2 p.m. Saturday, Plymouth library, 15700 36th Ave. N., Plymouth, in partnership with Valley Bookseller of Stillwater.

SCOTT MESLOW: Presents “A Place Both Wonderful and Strange: The Extraordinary Untold History of Twin Peaks.” 7 p.m. Wednesday, Magers & Quinn, 3038 Hennepin Ave. S., Mpls.

IMANI PERRY: National Book Award winner of “South to America,” which argues you must understand the South to understand America, and “Black in Blues: How a Color Tells the Story of My People” discusses her writing in Friends of Hennepin County Library’s Pen Pals series. 7:30 p.m. Thursday, 11 a.m. Friday. Hopkins Center for the Arts, 1111 Mainstreet, Hopkins. $59-$49 in-person, $35 virtual. Call: 612-542-8112.

What else is going on

(Courtesy of Routledge)

Christopher Danielson, St. Paul author and educator, won the national Simons Laufer Mathematical Sciences Institute Mathical Book Prize for his picture book “How Did You Count?” for grades K-2. Images were taken by Minneapolis photographer and educator Asha Belk.

In the announcement the Mathical committee writes: “Young readers … are invited to share their thought process — and sometimes whimsical ways — for tallying things up — as they explore colorful photos featuring mathematical groups of everyday objects.”

Danielson, a former teacher at Normandale Community College and in St. Paul public schools, is director of strategic projects at CPM Educational Program. He’s the founder of Math On-a-Stick, an outdoor family math play event that takes place during the Minnesota State Fair. The Mathical prize is awarded in partnership with the National Council of Teachers of English, and the National Council of Teachers of Mathematics in coordination with Children’s Book Council. The winning book also has a companion teachers’ guide.

Attention all Barbara Kingsolver fans (and who isn’t?) Her new novel, “Partita,” releases in October. It’s the story of a gifted woman pianist who finds solace in music after her brother’s death. When she meets a mysterious man her life takes a turn to self-discovery and love.

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Readers and writers: Two adventures, one of which young readers can help draw

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Today’s offerings: a new mystery set in the years of the Raj in India, an imagination-stretching dry-erase book for the little ones and a congratulation.

(Courtesy of the author)

“The Star from Calcutta” by Sujata Massey (Soho Crime, $29.95)

Perveen Mistry steps into the world of Indian filmmaking in the fifth in this series featuring the only woman solicitor in Bombay in 1922.

Perveen, a partner with her father in their law firm, is excited about taking on as clients director Subhas Ghoshal and his beautiful wife, Rochana, a popular movie star who recently left a rival studio. It seems a simple contract dispute at first, until things turn deadly.

A man who is a member of the powerful censorship board, seen at a party with Rochana, is found dead by Perveen in a puddle caused by the monsoon. Then, Rochana disappears just before the first showing of her latest film. There are plenty of suspects and Perveen walks a fine line between doing her duty to her clients and investigating the man’s death with the risk of implicating them.

Behind the glitz of an Indian film community striving to overtake British and American companies, she finds bribery, deceit and marital affairs.

Sujata Massey, who grew up in St. Paul, introduces the fifth book in her Perveen Mistry series, “The Star from Calcutta,” March 3, 2026, at Once Upon a Crime bookstore in Minneapolis. (Courtesy of the author)

Perveen’s first case was “Widows of Malabar Hill” (2018), where readers learned of the tightrope Perveen has to walk as a female lawyer who uses her position to ask hard questions but must also back off so her conduct is never perceived as unseemly.

Her family belongs to the tight-knit Parsi community of the Zoroastrian faith who migrated from what was then Persia, and their young women must follow strict rules. For instance, when Perveen and her best friend, Alice, must spend the night at the studio both families are upset because women, even those in their 20s with careers, are expected to be home at night. Perveen, who left an abusive marriage, must hide her attraction to a handsome former civil service officer because she is technically still married and will be for the rest of her life.

Alice, who is gay, plays a crucial part in “The Star from Calcutta,” hiding a stunning secret from Perveen. Alice’s father is a British government official high in the ranks of Bombay society so her friendship with film star Rochana is frowned on by her strict mother.

As the story unfolds we also learn of relations between Indians and the colonial British and the awkward position of Anglo-Americans, as well as India’s diversity in languages and religious faiths.

This is the most complicated mystery in this series and a cast of characters would have been helpful for readers.

Massey was born in England and grew up in St. Paul’s University Grove neighborhood, attending the old Alexander Ramsey high school. She lives in Maryland with her husband Tony.

Before she started the Perveen series she wrote 11 award-winning mysteries featuring a Japanese-American antiques dealer based on her time living in Japan. Her Perveen books have also won awards. The new one is described by Kirkus Reviews as a “lush, leisurely, and well-researched 1920s historical mystery.”

Massey will introduce her book at a free reading at 6:30 p.m. Tuesday at Once Upon a Crime, 604 W. 26th St., Mpls.

TEASER QUOTE:

“She was standing in a film frame and felt transported. She was Rochana: the runaway almost-bride, and a fleeing film studio wife. But was she escaping one kind of danger only to find a new, unknown one?”

(Courtesy of Candlewick Press)

“This Superhero Needs Your Help!” by David LaRochelle and YOU” (Candlewick Press, $10.99)

Fans of Minnesotan David LaRochelle’s children’s books will be happy to see “This Superhero Needs Your Help!”, third in his interactive Draw & Erase Adventure series that offer youngsters 4 to 8 the chance to stretch their imaginations (after “This Sheep Needs Your Help!” and “This Pirate Needs Your Help!”)

Using the wipe-clean marker that comes with the board book, youngsters are invited to draw themselves as superheroes on dry-erase pages and help catch Dr. Dreadful who is creating chaos. The young superhero is asked to draw museum masterpieces in empty frames, draw happy faces on daycare babies, catch Dr. Dreadful as he escapes in his Robo-mobile by turning a trash heap into a playground, and finally catching the scoundrel.

The great thing about these books is they aren’t classwork, although teaching art is a wonderful thing that’s being taken away in many schools. It’s just the child and the book with no pressure to follow any drawing guidelines. The young superhero can erase and change the story at any point.

More good news: For the coming holidays LaRochelle will offer “These Elves Need Your Help!”

LaRochelle is the author of the Theodor Seuss Geisel award-winning “See the Cat” and its sequels as well as many other books for young readers.

And a shout-out

“February 22nd was a great day for America,” proclaims poet/author/baker Danny Klecko. He’s referring to the U.S. men’s hockey team’s winning gold and — equally important, he says — his poem “At Jimmy’s Corner” was his 10th published in the New York Times Metropolitan Diary feature, one of the oldest in that newspaper. In the poem Klecko weaves together boxer Frazier’s left hook, butterflies and gods. He believes he is one of the most-published poets in the Diary series. “I’m Danny Klecko, the hardest-working poet,” he says, “right up there with the hockey winners.”

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