Give and take without any drastic changes to the ATX standard.
They went from 5V to 12V for the reasons you cite. Higher voltage, lower amperage.
But the +12V rail ALWAYS existed. When CPU's went from 5V to 12V rail, you didn't have to buy a new PSU. If your PSU didn't have the 4-pin CPU power connector, you could use a Molex to 4-pin adapter. Start regulating CPU voltage off of a 24V rail and everyone's going to have to buy a new PSU when they replace their motherboard!
And then of course... the added cost of regulating that much further down for the Vcore.
Same argument is true of single DC voltage PSU's. You could have a more efficient, cheaper PSU if it only had to regulate one output voltage. But then all of your component costs will go way up because more regulation would have to be done at the component.
Your argument makes sense. It's just not pratical. Take a look in a (real) server room some time. There's a lot of expensive propietary equipment running off of 24V and 48VDC power supplies. Why can they do it? They're not adhering to an industry wide, consumer level compatibility standard like PC's have to. All they have to make sure of is if the chassis fits inside an 18" rack!
