What does cost driven system and driver even mean? The cost of something is the ratio of demand to supply.

If something is not costing a lot, then it means there is sufficient supply that obtaining it is not going to require sacrifices elsewhere.

If something does cost a lot, then it means there isn't sufficient supply, and obtaining it is going to require sacrifices elsewhere.

Healthcare is obviously one of those things, especially with a top heavy population age histogram, where supply is not going to be sufficient so costs will remain high. And if costs are high, then obviously they will decide how resources get allocated, that is the very nature of something that is high cost.