In this column, Sandro Galea addresses what would be required to identify and implement solutions that can improve the health of populations. Galea suggests that two perspectives need to inform solutions that might prove successful. First, solutions that aim to improve the health of populations need to be grounded in clarity of purpose, aiming to tackle what matters most to population health. Second, a solutions-oriented approach toward improving the health of populations requires, inevitably, changing the public conversation about health and its production. Recognizing that solutions that tackle social and economic factors will inevitably be political, and that political solutions must rest on a base of public consensus and acceptance, the public conversation about health is an essential part of any attempt to find solutions that improve the health of populations. The current abysmal health indicators suggest that choosing the right solutions matters indeed. The question is whether we have the political will to pursue population health when we now know what improving population health entails.