...Personally, I'm of the opinion that there's no large-scale social problem which is addressable by centralized rationality - which is to say, technocratic approaches. Science and engineering are the fortes of the technological approach. Once you get into macroeconomic affairs, human rationality reaches its limits.
Health care is a *fiendishly* macroeconomic complex, and the more technocrats attempt to centralize and rationalize the systems involved, the worse the situation will get. Any reforms essayed *have* to put their emphasis on decentralization, simplification, and reducing centralized oversight, or else it will just make things worse. A crowd isn't smarter than a single genius, but the crowd can manage its collective affairs better *in the aggregate* than the genius could for them.
It's a simple matter of economy of attention. Even the most brilliant of men can only concentrate on a few things at a time, no matter how excellently or effectively or quickly he organizes his thought. Even the dimmest member of the crowd has a significant fraction of the capacity for attention that the would-be technocrat has for that dimmest member's individual situation.
Yes, I know it's basically rote Hayek orthodoxy, but just because it's a truism, doesn't mean it isn't important. The world's full of brilliant people who aren't smart enough to run both their lives *and* mine. Full disclosure: I'm not a member of Mensa like the author of that post, nor would I be qualified for membership; at my best, I'm high-end normal on the IQ scale, and what little intelligence I have, is in verbal rather than rational or mathematical intelligence.
It's a matter of high irony that I ended up in a position where they have me helping write equations for custom fertilizer prescriptions, and proofing financial planner calculations. The president of the company is probably a genius, with a PhD in meteorology who works 16 hour days, at least seventy hours a week. He is *painfully* bright, and works way harder than I ever do, but he has a reputation for making messes because he tries to think through every project that comes to his attention - and then after he gets distracted by the next problem, others have to come along & work out what *supposed* to come next. It used to drive me batty when he'd do his own book-keeping chores, wasting *hours* on searches for a fifty-cent error - in essence, doing my job for me back when I was his receptionist & book-keeper. That was a long time ago, hopefully the people who replaced me in that job have long since broken him of that habit.
But what I'm saying, here, is that attention is the bottleneck of the technocratic economy, the one truly scarce resource. Centralizing economic decisions takes the precious attention of the truly brilliant, and uses it to replace the much more copious attention of the rest of society. It's a misallocation, wherein a monstrously expensive scarce resource is used to substitute for a dirt-cheap, technically inferior resource which is so ubiquitous as to be unworthy of valuation.