And I find it equally weird that each separate state gets to define health care regulations, such that separate companies are required in each different state. Lots of duplicated efforts.
There are certainly some functions that are best managed locally, and I suppose there must be some value to the "laboratory of the states" notion (though there are way, way too many variables for any of these experiments to actually be informative).
But in general, yeah, there's a bunch of stuff that I'd just as soon see pushed up rather than down. It would save a lot of headaches. There is surely some stuff that could be pushed down, as well.