Payment systems efficiency

As a general mle, co-payment systems should be transparent for the patient and should be kept as simple as possible. In particular the pharmacist, who in most instances is the agent charged with collecting co-payments, will cooperate most readily with co-payment schemes that are simple, efficient and easy to implement. 

The choice of a payment system is clearly influenced by the objectives such as quality of care, cost, and patient-throughput. However, with multiple stakeholders, the objectives may often be in conflict. In general, the ex post elements of the payment system perform better in terms of access, provider risk, revenue, and quality, while the ex ante elements do better in establishing the optimal levels of services, efficiency, and cost. 

Carbon taxes are dynamic economic instruments that offer a continuum incentive to reduce emissions. In fact, technological and procedural improvements and their subsequent efficient diffusion lead to reductions in tax payment. In addition, trading systems are able to self-adjust because emission goals will be easier to meet there will be a decrease in permits demand and in their price but not as rapidly as taxes. 

However, the extensive and varied experience undergone in Europe and its trend towards greater participation by the user in the financing of pharmaceuticals does not seem to have made any substantial contribution to cost containment. Practically all European countries use drag co-payment with the imphcit objective of making the user jointly responsible for the cost, but not as an essential source of revenue for the public health care system, nor has it proved to be a political instrument with the ability to contain costs or substantially improve efficiency. 

The basic concept of the CGO within CREST remains the same—that is, the provision of secure settlement for gilt-edged securities through an efficient and reliable system of electronic book-entry transfers in real time against an assured payment. The CGO is a real-time, communication-based system. Settlement on the specified business day (T + 1 for normal gilt trades) is dependent on the matching by CGO of correctly input and authenticated instructions by both of the parties and the successful completion of presettlement checks on the parties stock account balances and credit headroom. 

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