阅读理解 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 inducements of price, quality, and utility, and it is the buyer who makes the decision. Such condition, however, .does not prevail 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 a rare and sophisticated patient who 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 15atient may be consulted about some of these decisions, but in the main 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 decision 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 expenditures are determined by physicians, not patients. For this reason, economy directed at patients or the general are relatively ineffective.
单选题 The author''s primary purpose in writing this passage is to______.
【正确答案】 D
【答案解析】主旨大意题。作者主要客观地分析了医疗行业不同寻常的经济关系,影响病人医疗消费的往往是医生,而不是病人自己。并分析了这种经济因素产生的原因。[D]与此相符。其他选项在文中并未提及。
单选题 It can be inferred from the passage that doctors are able to determine hospital policies because______.
【正确答案】 A
【答案解析】推理判断题。第三段提到,病人需不需要住院以及何时出院,通常是医生做出最终决定,因此院方把医生视为顾客,[A]符合题意。其他三项没有看到医生与医院之间的关系。
单选题 According to the author, when a doctor tells a patient to "return next Wednesday", the doctor is in effect______.
【正确答案】 C
【答案解析】推理判断题。医生是提供者,病人是消费者,医生掌握着大权,医生叫病人再来意味着病人要购买更多的医疗服务,return next Wednesday 属于暗喻。[C] 项符合题意。其他选项的表述没有联系上下文, 属于过度推测。
单选题 The author is most probably leading up to______.
【正确答案】 A
【答案解析】推理判断题。根据文章最后所述,大多数病人的医疗消费都是由医生决定的,而不是病人自己,所以作者认为病人们缺乏经济指导。也就是说作者建议控制医疗消费,[A]与此意相符,为答案。文章没有提到新的疗法、针对医生的诉讼以及通货膨胀,因此排除其他三个选项。
单选题 With which of the following statements would the author be likely to agree?
【正确答案】 D
【答案解析】事实细节题。根据第二段最后一句,病人极少提出质疑,尤其是得重病的时候(especially when the disease is regarded as serious),可以推断出[D]。医生和病人的关系与平常意义上的买卖关系恰好相反,主要是医生决定病人的购买行为,[A]与原文相悖。病人很少质疑或反对医生的决定,[B]项内容与此相反。支付人一般都遵照医生的要求支付,[C]与原文不符。