Basically, he argues (persuasively) that engineering-oriented folks focus primarily on planning as a function of organization, and that self-interest is largely unimportant. They believe, he argues, that "incentives don’t matter [very much]."
Economics-oriented individuals, on the other hand, believe that incentives matter a great deal; that "people find that when they pursue their own interests, they are also meeting the needs of others."
You can see the problem.
His thesis is fairly simple, and therein lies its elegance:
"[M]ost people in health policy take the engineering approach. That is why there have been so many mistakes and so many failures of policy – ranging from Obamacare to Ebola control."
Read the whole thing for his explication of this unfortunate truth. You'll be glad you did.