While people who pay for their place at the front of the line worry about people skipping lines, the second tier allows people to use their money to leave. queue completely and seek their own choice of care. This creates an efficiency gain since individuals who remain in the original queue can move forward in place of those who left the queue to enter the second level. Along with the benefits of efficiency gains, new jobs and opportunities are created as new businesses open. As private practices open, jobs become available at various levels such as maintenance, internship, administration and healthcare professionals. These practices even allow students to gain experience in smaller medical environments. Support staff are extremely important when running a busy practice and as a result, private practices hire many people to fill staff, associate and associate positions to help the practice run without problem (PPA, 1998). The second level uses the flaws in the public insurance mechanism to create a new system of opportunity and efficiency, benefiting all health care and everyone.