I strongly suspect that with a rational policy on driving, e.g. no taxi medallion system and in the presence of insurance generated internalization of expected driving externalities (with appropriate monitoring e.g. of speed by sattelite and of reflexes by simple in-car electronic tests), and with adequate wrongful death penalties we would end up with driving as a lower middle class profession, less traffic, faster traffic flow and very few auto fatalities.

I also don't think that it makes sense to even talk about the possibility of much better institutions without much better elite individual rationality. Good institutions don't evolve, fit ones do. Good institutions in a peaceful and fairly unified and hegemonic world have to be intelligently designed.