Engineers, medical people, scientific people, have an obsession with solving the problems of reality, when actually … once you reach a basic level of wealth in society, most problems are actually problems of perception.

Sutherland contrasts an engineering/medical/scientific mindset—optimizing objective, material conditions—with the way many late-modern “problems” function in affluent societies: as matters of experience, framing, status, and expectation. Once basic needs are met, additional gains in wellbeing often depend less on changing physical reality than on changing how reality is interpreted (e.g., convenience, trust, reassurance, perceived fairness, meaning). The quote reflects his broader argument from behavioral economics and advertising: small psychological interventions can outperform costly “real” fixes, and institutions that ignore perception may waste resources or even worsen outcomes by neglecting what people actually feel and value.