Predict the product for the following reaction sequence. 
Definitions:
Spending
The act of using money to purchase goods or services.
Costs
Costs refer to the amount of money required to purchase goods or services, or the expenditures incurred in the production of goods or services.
Single-tier System
A healthcare system in which all citizens have access to the same level of healthcare services, regardless of their personal income or social status.
Two-tier System
A system, often in healthcare, where two levels of service are available, with the higher quality or faster service being accessible to those who can pay more.
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