Fair questions, dthelmers. As usual with such questions, there is more than one possible answer. Basic assumptions have to be examined first though. For example, who is "we" and how did "we" become responsible for ensuring food safety for anyone other than for ourselves and those with whom we engage in food-related interactions? Sure, no one I know wants to contract or to be exposed to someone who has tuberculosis, but does that give me a right to regulate whether and under what circumstances they can buy and sell food? My answer is no, it doesn't.
We, in my opinion, is our elected government, and I think that it is necessary for that elected government to ensure some measure of regulation so that I can safely buy food from people I don't personally know. This may be an argument in favor of eating local, where the kind of bad practices that sometimes occur in centralized operations just can't happen, because these are your neighbors. However, even with all the regulation we have in place, we still have e. coli outbreaks from mishandled hamburger that would not have happened if the industry wasn't so centralized. So the regulations don't guarantee safety, but can make it harder on the small producer, the one-man outfit. Regulatory bodies have been set up by our elected government, but I feel that they then take on too much autonomy, and become a self-perpetuating bureaucracy, with little regard for the electorate. I'd like to have some protection, but I also want choice, and to make my own decisions. I'd rather see raw milk more readily available, but if there was intentional disregard for health by a dairy owner, send him to jail. Right now, suits can be brought for that sort of thing; I'd rather see criminal prosecution.
As to whether we could have less regulation, yes, that is clearly possible. Food regulation varies considerably around the world, ranging from none to "tightly controlled", yet humanity survives.
Yes, food regulation does vary quite a lot in other countries. In France you can get raw milk from a vending machine now, and artisanal practices that are not allowed here are practiced there. But in China, you can get milk that has been adjuncted with melamine to make the protein content appear higher, and yet that is a very regulated government, perhaps the most. And yes, humanity survives, but individuals have died from bad practice. An example is the dairy industry in New York City that prompted these regulations in the first place. Practices were very poor, and children sickened and died, so we decided to pasteurize and regulate to keep people from doing it anymore; but perhaps we should have just called it racketeering and sent them to Sing Sing so they weren't undercutting the honest and careful dairymen.