There is ironically a connection to the resurgence of conservatism during the Reagan administration and more so during the Bush junior administration. The same characters play a role. Chaney and Rumsfeld leading the pack. What they cemented was growing trend for Eisenhower's military industrial complex to spread to all segments of the economy. In the medical community it took the form of the replacement of small medical practices with corporate medicine tied to the pharmaceutical industry. The argument being that for capitalism to work efficiency was the deciding factor. Anti trust laws would no longer be enforced and the advantages of the Matthew Effect would not be regulated. Small business including small medical practices didn't have a chance of surviving.

Libertarians will argue that it is the governments fault and that if government had not interfered in the form of Medicare and legal advantage granted to large corporations the capitalist system would have worked. I have my doubts. When government was relatively small huge corporations that controlled the market place such as Standard Oil and Bell Telephone were common. In a way it comes down to what are you willing to give up in the name of "efficiency". In the medical industry the individual got lost in favor of efficiency. The problem is how do you define efficiency. In a way Obama care represents the same loss of the individual as the growth of corporate medicine. Instead of measuring efficiency in terms of profit it measured efficiency in terms of giving the most people access to healthcare. It would be reasonable to argue that both failed for the same reason, how efficiency is measured.

A free market is the most inefficient imaginable. That is if you think only in terms of profit and cost or universal access. Sometimes efficiency has to measured in terms of available options. That is because complex chaotic systems are irreducible. You can't predict how they will behave or comprehensively control them. The natural solution is bottom up design. It's painful and slow and defies traditional ideas of efficiency. What people seem unable to comprehend is that everything depends on random mutations. Take a computer system for example. Without random inputs they tend to go into meaningless loops. If the system is sufficiently complex it is hard to predict where and when those loops will develop. Another example is genius. High intelligence is a necessary but insufficient condition. What sets genius apart from high intelligence is imagination or random inputs.

The question becomes is anything really by design. That is the problem with most conspiracy theories. The only time absolutes actually come into play is with abstractions. They are necessary for languages including math and logic. They are a way of reducing the chaos of complex systems. Often conspiracy theories sound crazy because of this absolute nature of languages. If language is going to be useful it requires absolute definitions. The problem is that since absolutes only exist in the abstract the idea of something should never be confused with the thing itself. Since we use absolutes to approximate reality we tend to confuse them with reality. We think that the design of things are the thing itself. Rarely if ever is that completely the case. You can always argue that some detail means that the idea doesn't represent the thing itself which is a form of tautology. It's true but mostly meaningless. As a practical matter design or intent matters. If the design is only profit or universal access they will be distorted and a poorly representation as they are manifested in reality.