Those looking for centralized solutions to healthcare, jobs and other “macro-problems” will suffer inevitable disappointment. The era in which further centralization provided the “solution” has passed: additional centralization (Medicare for All, No Child Left Behind, federal job training, Universal Basic Income, central banking “free money for financiers”, etc.) have all entered Diminishing Returns.
The systemic costs of centralization–corruption, cronyism, soaring prices, declining quality, over-reach, insider rackets, regulatory capture by corporations and oligarchs– are soaring as the benefits of centralization plummet.
ObamaCare was the penultimate flowering of centralization: every self-serving healthcare cartel and racket had a say in the centralized sausage-making, and the results were entirely predictable: highly profitable to the healthcare cartels and rackets, and soaring costs that rendered the program unaffordable.
ObamaCare institutionalized staggering distortions, profiteering and injustices, as those who didn’t qualify for a subsidy were ripped off to pay for all the skims and scams: meds that went from $3 to $600 overnight, etc.
All the sound and fury around a centralized one-size-fits-all “solution” signifies nothing–the solution is decentralized and local, not federal. Centralization of power, capital and control paid big dividends early on–central governments corralled the productive elements of the nation to wage wars, and capitalists forged immensely profitable integrated supply chains that fed centralized production facilities in which iron ore entered the plant and finished automobiles exited.
The benefits of centralization outpaced the costs: this was the boost phase:
The returns on centralization diminished in the waning years of the 20th century, and are now in free-fall. Whatever has been centralized–federal jobs training, federal takeover of the mortgage market, federal takeover of student loans/debt-serfdom, central bank policies that favored the super-wealthy at the expense of the bottom 95%– have been disastrous wastes of irreplaceable time and political/financial capital.