No, it's not just a title. A Lord Paramount has hundreds of bannermen and lesser houses sworn to him, receipt of revenues and incomes etc. and land. How many names are on the small council indeed? Qyburn (disgraced maester) Varys (foreign eunuch) Aurane Waters (foreign bastard) and so on. It's not exactly the most prestigious people in the land, is it? And how many times have those positions changed hands over the course of the books? We've had what, seven Hands of the King alone? Anyone can get on it. Nobody outside of Stark, Lannister, Baratheon etc. has been a Lord Paramount for centuries. Not in any way comparable in terms of power or status.