Thanks for the thoughtful response. Great summary. I think this is missing something:
We don't seem to have good social interfaces for large groups, perhaps because we cannot simulate large groups.
Not exactly what I was going for. Many actors + game theoretic concerns -> complex simulation. Eventually good simulation becomes intractable. However, when a common set of rules is enforced strongly enough, each individual's utility function aligns with that set of rules. This simplifies the situation and creates a higher level interface. This is why...
Hueristical decision-making is quick and practical. Experts tend to have better hueristics, and are usually in a better position to speculate about unfamiliar or uncertain treatments than laypeople. One good reason to be a fantasy-forbidding expert is that there are massive asymmetries in unvalidated medicine. The potential upside of taking vitamin X is probably small and bounded. The potential downside is unbounded.
That said, given the long history of traditional medicine, there are probably some effective treatments in the alternative medicine canon that just aren't yet well understood. Intellectual modesty is important.
Thanks for the link. Wish I'd read it earlier! That's a much better exposition of what I was trying to express here. :)
I do think that there's complication beyond even the two-layer model presented in "Studies on Slack". For example, maybe my company gives a lot of slack and looks at my value-add on a 5-year timeframe. At the same time, I have little personal slack around my annual bonus because I need to pay off loans. Perhaps the culture I live in has some different level of slack in its expectations for work. Although the two-layer model is a useful simplification, I'm not sure that the actual interactions are so neatly hierarchical.