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Re:NHS £13bn IT programme to be overhauled - good luck with ... by pmjordan on Tuesday July 13, 2010 @06:20AM (#1510919)
More to the point, unlike bottom-up the top-down approach tends to be a solution in search of a problem.
Re:NHS £13bn IT programme to be overhauled - good luck with ... by Gormo on Tuesday July 13, 2010 @02:28PM (#1512287)
And centralized financing and management of large segments of the economy tends to encourage top-down decision making.

I think one of the biggest problems with modern society is that due to the scale of institutions, there are way too many layers of abstraction and aggregation between decision-makers and the decisions they make. This breaks the feedback loop, since decision-makers can only operate against generalities and not actual knowledge, and it encourages a great deal of risk aversion that prevents the exploration and variation necessary to create real solutions.