>most of it fairly trivial

Medical and government are the 2 examples I would think of as the least trivial places to work in. There is nothing to be discovered or invented in these sections. We all know what they need, its just close to impossible to get over the political hurdles to actually do it.

There's plenty to invent even there, even in the theoretical mathematical areas! There are all sorts of interesting ideas around provably correct elections implemented via things like zero knowledge proofs or calculations from various sorts of private keys.

Can I give you some sort of receipt when you vote that can't be used to figure out who you voted for but can be used to determine that your vote was tallied correctly? Quite possibly!

There are many, many things that these sectors need that are not yet invented. And quite frankly, while an existing solution might work in for their cases, unless it works in the confines of the regulatory environment of medical and government, then it’s not an actual solution.

Those peculiarities are part of the yet-to-be-discovered solutions, not just annoying barriers to adopting existing products.

I meant that the technology needed is fairly trivial. Building something that actually helps is of course a different thing.

Clearly there’s at least one major discovery waiting for someone: how to jump those hurdles

Its not a discovery. Its just being highly influential in the organization and actually wanting something to be done when it isn't profitable/would reduce your budget for the future.

Gaining that influence is a different type of problem than what was being discussed, yes. But health care has a huge set of competing political forces influencing it, and the key to figuring out how to untangle them effectively is to approach things systematically and creatively, just like with any other problem. The problem shouldn't be dismissed as a candidate for systematic examination or given less credence than other types of problems just because it's a political one; we have yet to discover how to build health care organizations that untangle those forces effectively.