The strong-willed crusader types are always problematic in leadership roles, mainly because their more intense focus results in bigger blind spots. Against the big medical/big pharma/big government alliance, the best leader would be a quiet, unassuming, but capable strategist without the official cabinet position. The Regime has done this quite successfully. The vast majority of Americans have no idea who is running the government, while the rest have some idea but are not 100% certain. It's hard to target someone who you don't see.