At the Imagine Solutions conference, the watchword was change. Whether they wanted to bring down the national debt (like Niall Ferguson), reform Washington (like David Walker), halt global climate change (like Carter Roberts), or reinvent health care (like Patch Adams), everyone agreed that the world needed changing, even if they didn't quite agree on the specifics of what that change should look like. Yet it became clear as the conference progressed that the speakers also disagreed on how much change was enough. When tackling daunting problems in health care, the environment, politics, or the economy, can incremental adjustments make a real difference? Or is anything less than total transformation not even worth the effort?