If we optimized human life quality globally everyone would get better healthcare etc., but since everyone makes the decisions that benefit them (+family and immediate surrounding), then we end up with worse healthcare for the vast majority of the population.
As such, it should probably be the job of governments (regulation, incentives) to make 'globally' optimized decisions more attractive (centralized healthcare). In a best case scenario at least.
I don't care to be this coarse, but I've been trying for 10 minutes to find a better way of putting it.
When the local maxima and global maxima do not align suffering occurs. This is why evoLuton picks a few broad things on a global scale, but at the local scale thing developed very differently