I will only comment on medicine, since I am an expert there. Almost all the advances was brought by a few key developments early to mid twentieth century. Antiobiotics, statins, angioplasty, insulin - all home runs, that we never managed to get close to them in the last 25 years or so. Mortality is up, but you can argue that QALY (quality-adjusted life years) are stagnant if not down. And since COVID; mortality is down due to all the drug overdoses.

The problem in capitalism healthcare as practiced in the US, is that it’s entirely regulatory captured by big companies. It’s broken on such a fundamental level; it’s hard to describe in words. It’s late-stage crony capitalism were a senator daughter capturing a key drug and shaping the regulatory environment to kill all possible competitors is just another Tuesday.

My solution is to let the market take care of it, but it’s so corrupt now - that it’s need a radical, if brief, intervention.