Of course there is the capacity for more horizontal organization, the problem is getting everyone up to speed at that point. If you are working in a complex medical field, everyone working within it is already at a certain level of competence, and even that level of competence is likely hierarchically barred within society by wealth, opportunity for education, etc.
The issue is how do you get to that point with everybody, or at least enough people to create a stable, self-replicated cultural apparatus, that can withstand challenges from highly hierarchical organizations.
Of course there is the capacity for more horizontal organization, the problem is getting everyone up to speed at that point. If you are working in a complex medical field, everyone working within it is already at a certain level of competence, and even that level of competence is likely hierarchically barred within society by wealth, opportunity for education, etc.
The issue is how do you get to that point with everybody, or at least enough people to create a stable, self-replicated cultural apparatus, that can withstand challenges from highly hierarchical organizations.