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      When a dealer bank purchases Treasury securities in table legs a quarterly Treasury bond auction, it acts as underwriter and distributor. Gold and silver are soft metals that can lose weight through scratches and abrasions, but this is nothing by comparison to fiat currencies, where billions of dollars can be injected ("printed") into the market within moments. Stability aside, commodity-based currencies may have a tendency to restrain growth in a very active economy. Such programs typically include: A set of selected providers that furnish a comprehensive array of health care services to enrollees; Explicit standards for selecting providers; Formal utilization review and quality improvement programs; An emphasis on summit compact refrigerator preventive care; and Financial incentives to encourage enrollees to use care efficiently. Provider networks can be used to reduce costs by negotiating favorable fees from providers, selecting cost effective providers, and creating financial incentives for providers to practice more efficiently.[46] Network-based plans may be either closed or open