You mention farmers. They already have co-ops. If you’ve lived around those communities you know people can get apeshit about a semi of corn that might be a little wet.
I wouldn’t want to be on the local board that has to settle the account for aunt murtle’s 5th round of lung cancer while she’s on O2 and still on a pack a day. It’s easier to set guide rails - actually moral and responsible ones like not giving liver transplants to people with bac - when you didn’t grow up with aunt murtle’s kids.