In fact it is actually mutliple things, depending on the situation. I think the people Ian is talking about really exist. But I don't think it applies to health care. In health care it's actually a cost saving effort by politicians not unskilled providers trying to hide their lack of knowledge, i.e. reason (5) not reason (1). Therefore educating them or the public is also not an helpful action. More reasonable would be to try to figure out the cause of lack of funds and how to counter it, or if there is no way back to help people along the way, e.g. by writing an article about how to find and read research papers oneself as a previous user of a social health care system.

If you don't believe it or don't understand what I mean, read on:

1) In software dev "Product Owners" who have no idea of their job (or simply see that nothing happens and therefore have better things to do in their life than focus all their energy on their job) say that to have some kind of goal to work towards. True. That's probably also where Ian got this idea from. In this situation it's not unreasonable to do that because if he can't even act like he would have a goal he could not stay in that leadership position.

2) Users also really want control when they can't trust the actual service provider. And that doesn't just mean incompetent providers. It also means providers with goals that compete with the users. E.g. many countries now try to figure out how they can do nextgen_after_4g without Huawei, because they fear the political goals that might stand behind Huawei. In this situation it's also not unreasonable to want control.

3) A third reason is people who know the user's situation better than the user (e.g. IT security experts) and who want to help the users. In that case they will basically do the reason (2) fight for the users without much help from the users. It's a naive but admirable position to take. Not unreasonable.

4) Some people act like they would do reason (3) but actually just try to play games with the users on the user's cost. Anti-Vaxxers are such a group of people. Or the nationalist political grups we saw rise up a few years ago. They take an existing fear of uneducated users, escalate that to unreasonable sizes and then act like they would offer some help in exchange for money or votes.

5) Politicians and highest level corp leaders will say "users want control" when they have an area where they were providing a service in the past that the user come to expect, but for political or market reasons they can't provide that for much longer. So they act like someone else would want it. If they stand there in front of the camera in their $5000 suit, $200 hair cut, and their $3000 wrist watch nobody would believe them if they would simply say "all right guys, there is no more money for that service, let's pull our belts tighter". The only practical alternative I've seen is what the new Pope is doing. But that really needs a fanatic who can live an asketic life style which simply is not for most people. If most people can choose between a $5000 suit and a $2 self-knitted, itching rope then most people would choose option 1. So either you need to put one of a very small number of people in a leadership position and defend them there (which will cost you a lot as well), or you need to accept that "users want control" is the strategy the existing leadership is driving.

Imo the best approach is to think about how to deal with reality instead of hoping or fighting for a reality that can't exist. But I can even see the reasons for why one rather dies dreaming than live in reality. ;-)