Question

【题目】阅读下列短文，从每题所给的四个选项中，选出最佳选项。

The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the peculiar roles of producer or “provider” and purchaser or “consumer” in the typical doctor-patient relationship. In most sectors of the economy, it is the seller who attempts to attract a potential buyer with various appealing factors of price, quality, and use, and it is the buyer who makes the decision. Such condition, however, is not common in most of the health-care industry.

In the health-care industry, the doctor-patient relationship is the mirror image of the ordinary relationship between producer and consumer. Once an individual has chosen to see a physician — and even then there may be no real choice — it is the physician who usually makes all significant purchasing decisions: whether the patient should return “next Wednesday”, whether X-rays are needed, whether drugs should be prescribed, etc. It is rare that a patient will challenge such professional decisions or raise in advance questions about price, especially when the disease is regarded as serious.

This is particularly significant in relation to hospital care. The physician must certify the need for hospitalization, determine what procedures will be performed, and announce when the patient may be discharged. The patient may be consulted about some of the decisions, but in general it is the doctor’s judgments that are final. Little wonder then that in the eye of the hospital it is the physician who is the real “consumer”. As a consequence, the medical staff represents the “power center” in hospital policy and decision-making, not the administration.

Although usually there are in this situation four identifiable participants— the physician, the hospital, the patient, and the payer (generally an insurance carrier or government)— the physician makes the essential decisions for all of them. The hospital becomes an extension of the physician; the payer generally meets most of the bills generated by the physician/hospital, and for the most part the patient plays a passive role. We estimate that about 75-80 percent of health-care choices are determined by physicians, not patients. For this reason, the economy directed at patients or the general is relatively ineffective.

【1】The author’s primary purpose in writing this passage is to ________.

A. urge hospitals to reclaim their decision-making authority

B. inform potential patients of their health-care rights

C. criticize doctors for exercising too much control over patients

D. analyze some important economic factors in health-care

【2】It can be inferred that doctors are able to determine hospital policies because ________.

A. most of patient’s bills are paid by his health insurance

B. it is doctors who generate income for the hospital

C. some patients might refuse to take their physician’s advice

D. a doctor is ultimately responsible for a patient’s health

【3】According to the author, when a doctor tells a patient to “return next Wednesday”, the doctor is in fact ________.

A. advising the patient to seek a second opinion

B. warning the patient that a hospital stay might be necessary

C. instructing the patient to buy more medical services

D. admitting that the first visit was ineffective

【4】The author is most probably leading up to ________.

A. a proposal to control medical costs

B. a study of lawsuits against doctors for malpractice

C. an analysis of the cause of inflation (通货膨胀) in the US

D. a discussion of a new medical treatment

Answer 1

【答案】

【1】D

【2】B

【3】C

【4】A

【解析】

试题分析：本文属于说明文，主要讲述了目前的医疗体系中主要是由于医生做最终的决定，作者提出这种系统是低效的，要改变这一情况。

【1】D 主旨大意题。根据文章最后一段前三句Although usually there are in this situation four identifiable participants— the physician, ......... the payer generally meets most of the bills generated by the physician/hospital, and for the most part the patient plays a passive role.可知文章主要分析了医疗保健领域的一些重要的影响相互之间经济关系的因素：医生、病人以及医院。故D项正确。

【2】B 推理搭配题。细节理解题。根据第三段最后一句As a consequence, the medical staff represents the “power center” in hospital policy and decision-making, not the administration.可知决定医学治疗的是医生，也就是说决定医院收入的也是医生。故B项正确。

【3】C 推理判断题。根据第二段第二句it is the physician who usually makes all significant purchasing decisions: whether the patient should return “next Wednesday”, whether X-rays are needed, whether drugs should be prescribed, etc.可知当医生让病人下周三再来的时候，实际上是由医生指导病人接受治疗的服务。故C项正确。

【4】A 推理判断题。根据文章最后一句For this reason, the economy directed at patients or the general is relatively ineffective.作者认为目前的医疗体系是无效的，作者以此建议对现行的医疗体系进行改革，改变目前由医生决定治疗过程的医疗程序。以此控制医疗费用。故A正确。