> Both healthcare and education faced similar pressures in the 20th century. As knowledge expanded exponentially, systems needed to scale up to serve more people. The solution? Standardization. Create protocols, establish benchmarks, develop universal procedures. It worked – sort of.<p>I'm not so sure standardisation due to scaling is really as the cause of this. None of the problems the author points out are really novel observations; I've been hearing this sort of thing my entire adult life, 25 years now. So why doesn't anything change?<p>I suspect the cause is more a lack of trust in people, as well as a fear of things going wrong. Maybe that comes out of scaling: no one really knows what anyone is doing and everyone is a "stranger". So we have all these controls because we don't trust the nurses to nurse, the teachers to teach, etc.<p>I feel this matters because without identifying the cause, you're not going to find a solution, which is probably to think of ways to increase trust, and to increase societal acceptance that sometimes things go wrong and that's okay, because sometimes the cure is worse than the disease.<p>I'm not really sure how to go about that though – a big part of the problem are toxic media outlets that will abuse any incident to attack $disfavoured_politician without regard for truth or fairness. The incentives for politicians are pretty skewed.<p>I don't think that "self-directed learning pods" or "community-funded clinics" are really the path forward. It all sounds very nice, but you can't really run the entire country's system on this for a number of reasons. Sounds more of a libertarian pipe dream than anything else.