see, I don't think the state is very good at dealing with issues like this because from such a high viewpoint, the state can either apply a one-size-fits-all policy, or provide a localised but drastically oversimplified strategy for specific regions that will require more overhead for managing the many regional subdivisions. Providing for social healthcare is a good thing (at least within the context of how our nation states currently operate), but I think it should be devolved down to local authorities with perhaps a state-level overseer to monitor their performance.

I'm of the strong belief that central management at scale is unilaterally inferior to decentralised and devolved decision-making that can more effectively take local variables into account.

> But for a task of this scale, which has to provide benefits to everyone in the country, I only trust the state with it, and not a private entity.

Trusting the nation state and trusting a private (presumably either commercial or charitable) entity are not the only two options. The charity and taxation options can both occur at a local authority, or a community, level.

Too much centralization is definitely bad (for an extreme example see the Soviet economy that was centralized to a ridiculous extent). But government doesn't have to mean centralized, to take the Swedish system once again, the healthcare is handled at a regional level, within the national legal framework. This does take local variables into account, which is important - different parts of Sweden can actually have significant differences in the medical situation.

It's still state-run in the important sense that the legal mandate comes from the state. This is a major advantage over private initiatives in my opinion. To take a simple example, say there's a legal requirement that people who cannot use their legs are entitled to receive a wheelchair. When that's the law, it means the government (regional, local, whatever applies) has to make it happen, even when it's inconvenient or expensive. When it's a charity or a private initiative, it might not have enough money/incentive/commercial interest/insert reason here to cover everyone.

Admittedly my views on centralized vs. regional governance aren't sophisticated due to my background. I live in a country of 10 million, which isn't too big globally, and I moved here from a very centralized country of 2 million where devolved decision making only makes sense in truly local issues.

that seems reasonable to me. To recontextualise it in software terms, the requirement comes from the state but the solution comes from the local level. As long as the requirement isn't overly prescriptive (e.g. "people who can't use their legs are entitled to a wheelchair" vs "local authorities must invest 50M SKR in departments X, Y and Z") that's a good solution. My aversion to the idea of a central state (though I don't have a proposed solution to this) is that because there is no antagonist to push back on poorly thought out requirements, states trend towards centralised prescriptive solutionising which I believe to be the root cause of the problem with centralisation. A classic example was the Soviets as you mentioned earlier, with their economic planning committee (Gosplan) explicitly telling factories how much steel to produce and who to send it to. It's one of those problems that pops up in different areas like software development and management practices too.

Markets are good at preventing this because they separate the requirements (the customers) from the solution (the producers) and provide a Darwinian process to optimise for the best performers, but markets have their own problems and inefficiencies that make them a poor fit (like markets' tendency to ignore customers with unique or rare requirements, meaning people with rare diseases or multiple problems get rejected or priced out by medical markets). There are market-oriented solutions that libertarians propose, such as evening out costs through medical insurance, but markets will always leave cracks people can fall though (such as those who cannot afford insurance, or immigrants with pre-existing health conditions) and introducing state mandates into the market often fundamentally break the market itself (see: US health insurance market). State legislation leaves cracks too when written badly, so neither is a perfect solution in practice. I don't have a solution to these problems because I think they're rooted in patterns of thinking rather than systemic design, but they're interesting to think about.

Ideally, the "requirements" (laws) that the state creates are kept reasonable by the "producers" (population) through democratic mechanisms. Or, put it more simply, if the government passes stupid laws, the elected officials can be voted out and replaced. This is a check that only exists in a democratic system - in the case of Soviet economic planning, there existed no democratic mechanism to change the system.

I was amazed by the concept of free markets when first learning about it, and it seemed like letting market forces play out should result in an optimal situation for consumers, though now I am more cynical and mostly expect bad consequences like monopolists putting effort into not allowing competition.

So due to the different nature of efficiencies and inefficencies of state and private actors, I currently prefer a system where the government is very involved in key areas of human rights, social welfare and basic needs (so education, healthcare, welfare payments, management of physical/mental disabilities, the justice system), and the private sector is mostly handling technical innovation, consumer goods, manufacturing, most services, etc.

Hopefully we've not yet reached the global optimum of these systems and can see both government and markets evolve positively.