I adres a few things and I jump a little, I can't convince you of anything or even have too.

I'm very much ok to break open my suggestion for a real possible outcome of a free society. It was not my intention to close everything of
I didn't mean that YOU close everything of, but that your story is build in such a way that every possibility for the 5% or even .01% to have their own health care which they pay for, instead of the centralized, is closed off. That's only guessing that something like that would happen. I can not say anything sensible about your hypothetical story, I can't look in the future. You can give many stories like: "And how is this going to be done" I can not answer them. Sorry.

Those questions/story sound to my ears like someone, in the time when slavery was still normal, asking; But without slavery who's gonna pick the cotton. Could anybody guess that machines would do that in the future. And even if someone proposed it, would it be enough for the person asking the question to be certain enough to see the abolishment of slavery as an option. Also the machines probably would not have been invented if slavery wasn't abolished because there was no need for them because there are slaves. (slavery wasn't abolished b.t.w., it just morphed into some other form of slavery)

I jump a little to another part.

Why do you hang on centralized institution. What do you mean by that, do you see a supermarket as a centralized institution, or a private protection agency that work in an arbitrarily chosen territory, or do you want a NWO centralized kind of thing. Do you see a small self sustaining natural community as centralized enough, or do they have to obey all the rules made by some people hundreds miles away, or the nearest community which could be a technological community (their opposite) or what ever.

When starting a new free community, it can only be started when some ideas are in place how to start the community. I'm pretty sure that when absolutely no rule is in place, the community will fail.
Maybe they will fail. Maybe they will not.

The people that start that community will find that out themselves, or maybe a community start with someone lives somewhere with some ideas/rules, and people with the same ideas/rules move there.

What is it to me how, for instance, the Amish decide to live. Or some communistic community in Spain that live there voluntary with each other without cops or anything. Or some art community in Italy for instance. All those communities exist already why would you, me, or anybody demand from them, that they must have centralized protection a central hospital or even a blockchain vote system. I can't see myself saying to them: "You must do this or that cause else I'm pretty sure it won't work."

Well to close off I don't know how the future is gonna be.
And people go on living the way they live or they are going to do something different. I live my life somewhat different, that's how things are. I don't have to convince anyone that; "My way of living" is "The way of living", because it ain't, their life belongs to them. I can tell them about what I think, but that's it.