It is a shame when people let current alliances override their actual thinking on general principles. I mean, it is necessary to make compromises for the sake of accomplishing things, but we should be aware of the fact that it is a compromise.

Also, I sort of wish the language around “big plans from the center of power” was more… nuanced I guess. Like we can believe that centralized organizations generally are not so bad for producing healthcare guidance but still not want them to make people’s healthcare decisions for them.

I feel for this. There's a "bothness" that's important for organizing from the center and from the edges. Either approach in isolation would utterly fail. Either approach overrepresented beyond the other fails to a lesser degree. Finding the razor edge balance that (1) supports the best decisions to navigate a model of the future that actually unfolds and (2) that's stable in a given context, that is the whole of the work imho