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There are many costs associated with using a third-party payment system in healthcare (Boyer & Hammersla, 2013).  Administrative costs associated with this system are much higher than actual clinical costs of receiving healthcare, it is proposed that this higher cost has to do with the man power required for insurance companies to process and receive payment for services (Boyer & Hammersla, 2013).  The high cost of healthcare is also associated with the abundance of specialty physicians in comparison to primary care providers and  the large amounts of money spent on highly sophisticated equipment that do not necessarily add to the general public’s health (Milstead, 2016).  These costs are very well hidden, making the average person generally willing to spend so much on insurance plans (Milstead, 2016).   The United States has continued to use the third-party payment option offered through employers because of the edge it has traditionally given in recruiting and retaining employees when the economy has not allowed for salary increases (Nickitas, Middaugh, & Aries, 2016).  Another benefit to employer-based health insurance is that the costs of the plans are exempt from income tax (Nickitas, Middaugh, & Aries, 2016).  I believe the part of the reason we have to have an entirely separate payment program for our elderly citizens is because we rely so much on this employer-based health insurance that does not necessarily cover us once we retire.

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