In 2017, consumers directly paid for 10% of all healthcare spending in the U.S., as compared to 48% in 1960. The rest was paid by governments (49%), private insurance companies (34%), and other entities. Such payers are called "third-parties" because they do not deliver or receive healthcare. In other words, they are not patients or caregivers. Government policies have driven the steep rise of third-party payments over the past half century, and this has been a major factor in the growth of healthcare costs. Per the Encyclopedia of Health Care Management: "Because most medical care is delivered with third-party payments, and the purchaser is in dire need of the services, the typical patient has little interest in price."