单选题 {{B}}第三篇{{/B}}

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. In the health care industry, however, the doctor-patient relation- ship is the mirror image of the ordinary relationship between producer and consumer. Once an individual has chosen to see a physician, the physician usually makes all significant purchasing decisions: whether the patient should return "nest Wednesday" whether X-rays are needed, whether drugs should be prescribed, etc.
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 these decisions, but in the main it is the doctor' s judgments that are final. Little wonder then that in the eyes 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 physicians; the payer generally meets most of the bona fide bills generated by the physician/hospital and for the most part, the patient's plays a passive role. In routine or minor illness or just plain worries, the patient's options are of course, much greater with respect to use and price. But in illnesses that are of some significance, such choice tends to evaporate. And it is for these illnesses that the bulk of the health care dollar is spent. We estimate that about 75 N 80 percent of health care expenditures are determined by physicians, not patients. For this reason, economy measures directed at patients or the general public are relatively ineffective.

单选题 The author's primary purpose is______。

【正确答案】 B

【答案解析】[主旨归纳] 要知道作者的意图，我们就必须先通解全文。本文是有关医疗行业情况的经济学研究。医疗行业和其它行业的不同之处在于医生可以决定病人的消费。医疗行业从根本上说一种卖方市场的经济模式。多数行业是买方市场的经济模式。然而在医疗卫生行业有着自身的特点。医疗卫生中医生有权决定许多事情，比如病人是否需要住院，何时进出院等等。医生是医院权利的核心，决定医疗事情。医疗中出现4个主体即医生，医院，病人和掏医疗费的人(保险公司)，而所有的决定都是由医生做出的。因此我们可以认为医疗费用的多少是由医生决定的。文章论述了医生—病人—医院—医疗费用支付者之间的关系，指出医生是医疗消费中决定性的一方。由此可推断，作者的目的是分析医疗保健中的一些未被人们注意到的因素。

单选题 It can be inferred that doctors are able to determine hospital policies because______.

【正确答案】 C

【答案解析】[前后呼应] 文章的第二段提到：“the medical staff represents the”power center“in hospital policy and decision—making，not the administration”。医疗人员代表了医院政策与医疗决策中的权力中心，而非行政(执行机构)。在第三段提到：“The hospital becomes，an extension of the physicians”。由此可知，医生是医院政策的决定因素，因为医院管理者缺乏对医生的决策提出质疑的专业知识。医院(反倒)成了医生的外延(机构)。

单选题 According to author, when a doctor tells a patients to "return next Wednesday, doctor is in fact______.

单选题 The author is most probably leading up to______.

【正确答案】 A

【答案解析】[句意辨析] 根据文章末尾两句：“about 75～80 percent of health care expenditures are determined by physicians，not patients。For this reason，economy measures directed at patients or the general public are relatively ineffective．”约有75％～80％的医疗开支是由医生决定的而非由病人决定的。因此，由病人或公共大众制定的经济政策相对而言效率不高。如果还有下文，则文章将会探讨如何针对医生制定经济政策，并提出控制医疗费用的建议。