I suspect massive companies like late stage GOOG and AMZN will always be dominated by an oppressive machine in the rank and file. It seems inevitable at this scale.
But the wonderful thing about these places is they can create/acquire/prop-up small subsidiaries. If they're self-aware enough to know the oppressive force at their size, they leave these offshoots alone (until too big, where the cycle repeats anyways). These are the parts where you can still experience the magic being discussed.
Presumably working at X Development (formerly Google X) still has a lot of this energy and autonomy.
I'm decades older, and it seems to have always been a rare thing to be part of a small team of talented people building something special and relevant to the future. These were and are exceptional places and that's arguably why they produced something we're talking about today.
Watch Office Space if you haven't already. That's what most of the irl white-collar existence really reflected throughout my career. And unless you actively pursued (and arguably created in part yourself by seeking out, showing up, and participating) something special even back then at a startup, you were very likely missing out then as much as now.
There are still people making things, irl even. I'd be surprised if Tenstorrent didn't have an environment like you're pining for, or Tilt Five.
I don't know of any others, and it's a horrible idea for anything used on public roads.. even on the race track these cars were notorious for leaving a cloud of debris/dust in their wake
It's not strictly a US health care problem either - I've been dumbfounded by foreign coworkers pressing for totally unnecessary medical interventions as if there's no risk associated with doing such things. It's most apparent from the socialized states where the healthcare is ~free.
My impression is this is a modern civilization stupidity in general.
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