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.