I can't parse what distinction you're trying to draw here. When I say "collective action" I mean exactly things like exerting political pressure toward objectives like expanding rather than reducing healthcare coverage provided by governments, such as medicaid. The notion that solutions that involve changing the policy of governments "require[s] Washington's permission" seems to reject the notion that we exert power collectively via democracy, but your proposed example of what someone shouldn't accept suggests that this is an issue of how people fail to see the value in exerting said power, for which the prescription would presumably be doing so? I don't understand what you're driving at or even why you think we're in disagreement