The global ubiquity of overuse and underuse of health-care resources and the gravity of resulting harms necessitate an investigation of drivers to inform potential solutions. We describe the community of influences that contribute to poor care and suggest that it’s pushed by parts that fall into three domains: cash and finance; knowledge, bias, and uncertainty; and energy and human relationships. In every space the drivers function on the international, nationwide, regional, and particular person level, and are modulated by the particular contexts within which they act. We deal with intimately drivers of poor care in every domain. Some folks get

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