Let me clarify slightly - a desire to improve the world on a large scale (like what a startup founder wants, which is what we are talking about) is synonymous w

Let me clarify slightly - a desire to improve the world on a large scale (like what a startup founder wants, which is what we are talking about) is synonymous with a "lust for power." If a person only wants to improve the world on their own small scale, like picking up after litterers or doing community service, then obviously that is not a lust for power. The definition of power is the ability to actualize ones will. When we approve of what someone is doing, we call use the positive term, "they are trying to change the world." When we disapprove, we say they are on a power-trip. It's the same thing though. Since Watsi is small and their mission is something that virtually everyone agrees with, everyone is unanimous that they are "trying to change the world." But if you look at a larger charity, that has more controversial missions, such as the Gates Foundation, you will see a lot of people of accusing the foundation of being on a power trip, of abusing their privileged position to play God with the lives of the poor and weak. There is a distinction between desiring money versus status versus influence/power. There is also a distinction between being ambitious and having ambition. The ambitious person has a vague sense they want to get ahead or improve the world. The person who has ambition has an actual reality they want to see realized. But there is not a distinction in motivations between the person who wants to change the world versus the person who wants power. The difference in terms comes from the outsider looking on, who will choose the positive or pejorative term based on the consequences of the actions.