I too have lived in the third world. But I also have cooked in a commercial setting for immune-compromised people, where I found health department guidelines enormously valuable.

> You're implying that the primary reason restaurants aren't making people sick, en masse, is because of rules and regulations.

No. The primary reason restaurants aren't making people sick is good hygiene all along the food supply chain. But good hygiene isn't easy. It gets harder the more industrial your operation gets. And short-term financial incentives cut against it, especially when you're working at scale.

I will happily eat from one of the probably-unlicensed hot dog carts in my neighborhood because a) I can inspect their kitchen, b) I see them around and so can know who's got a track record, c) I can see who's moving a lot of product, and d) they just can't carry a lot of inventory.

But I won't be nearly as casual with restaurants, because there is so much more opportunity for poor hygiene to impact food. Happily, I live in San Francisco, a city with vigorous restaurant inspection, one where the scores are posted physically in every restaurant. Here, I'll try new restaurants at the drop of a hat, because I'm not worried about shitting my guts out, something that happened to me repeatedly in my third-world eating adventures. My folks, who lived in Mexico for many years years, had a complicated set of heuristics around where to go and what dishes were most likely to be safe. Nobody in SF does that.

Your theory is that this is terrible for restaurateurs trying to do new things, but San Francisco is one of the best food cities in the world, with new, bold things opening frequently and often doing quite well. Unregulated sanitation strongly advantages chains, because people know they're getting a safe product. Strongly regulated sanitation enables entrepreneurs, because it removes safety from consideration when looking at a new restaurant.

People opening restaurants here complain about many barriers, but I've never heard one grumble about health code regulation. It's mostly what good cooks do anyhow, so they're happy to be held to a high standard, especially if it disadvantages competitors who would otherwise be cutting corners.