Other people who have also taken time to study how the system works will tell you that it is the issue.
Most people talk about ideas and politics without getting into the technical details of what's happening.
The Innovators Prescription[1] is written by 3 PhD's (2 in medical and running institutions and one in business) who provide an analysis as part of the book.
[1] https://www.amazon.com/Innovators-Prescription-Disruptive-So...