Centralized power has a problem: the individual. Every person is a potential disrupter of The Plan, and disruption must be forbidden. Otherwise, why have a central plan? This applies regardless of whether the planning is economy-wide or for particular sectors, such as medical services. (See F. A. Hayek's The Road to Serfdom.)
I have an issue with people who think that central political authority can be trusted to act as some benevolent provider and protector of the people. Central political authority almost always acts for the benefit of those people who wield the authority, at the expense of everyone else. That should always be assumed to be the default situation.
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