There is often a tendency to over-simplify issues affecting the provision and costs of health care at a system level.Utilizing data based on the population of the province of Alberta, Canada, as well as data derived from electronic medical records and from population and provider surveys, we have been able to gain an understanding of the complexities and intricate relationships between all parts of health care.Beginning with the most complex, high-needs patients who classically are cited as costing the system the most (the "5% that use 60% of resources"), we identified that most of the medical issues that lead to such patients becoming high-needs are the end stages of the most common chronic diseases.Thus, if one focuses solely on these high-needs patients, progress will not be made as this population will soon be replaced by the next cohort of chronic disease patients marching inexorably towards end-stage complications.However, we found that chronic disease management is surprisingly excellent amongst providers.Where care gaps exist, they are usually not related to sub-optimal care on the part of providers, rather they are due to patient and systemrelated issues such as poor access, non-compliance, and challenges in lifestyle and behavior change.