单选题 If national health insurance would not cure the problems of the American healthcare system, what, then, is responsible for them? Suspicion falls heavily on hospitals, which make up the largest component of the system. In 1988 hospitals accounted for 39% of all health expenditures-more than doctor, nursing homes, drugs, and home health care combined.
Although U. S. hospitals provide outstanding research and frequently excellent care, they also exhibit the classic attributes of insufficient organizations: increasing costs and decreasing use. The average cost of a hospital stay in 1987—＄3,850—was more than double the 1980 cost. A careful government analysis published in 1987 revealed the inflation of hospital costs, over and above general price inflation, as a major factor in their growth, even after allowances were made for increases in the population and in intensity of care. While the rate of increase for hospital costs was 2796 greater than that for all medical care and 163% greater than that for all other goods and services, demand for hospital services fell by 34%. But hospitals seemed oblivious of the decline: during this period the number of hospital beds shrank only by about 396, and the number of full-time employees grew by more than 240, 000.
After yet another unexpectedly high hospital-cost increase last year, one puzzled government analyst asked: "Where's the money going?" Much of the increase in hospital costs—amounting to ＄180 billion from 1965 to 1987—went to duplicating medical technology available in nearby hospitals and maintaining excess beds. Modern Healthcare, a leading journal in the field, recently noted that "anecdotes of hospitals' unnecessary spending on technology abound". Medical technology is very expensive. An operating room outfitted to perform open-heart surgery costs hundreds of thousands of dollars. From 1982 to 1989 the number of hospitals with open-heart-surgery facilities grew by 33%, and the most rapid growth occurred among smaller and moderate-sized hospitals. This growth was worrisome for reasons of both costs and quality. Underused technology almost inevitably decreases quality of care. In medicine, as in everything else, practice makes perfect. For example, most of the hospitals with the lowest ra6rtaiity rates for coronary-bypass surgery perform at least fifty to a hundred such procedures annually, and in some cases many more: the majority of those with the highest mortality rates perform fewer than fifty a year.

单选题 According to the passage, the American health-care system______.
【正确答案】 C
【答案解析】推断题。
题意为：“根据本文，美国医疗系统______。”根据文章首句(如果国家医疗系统不能解决美国医疗系统的问题，那么什么对它们负责呢?)，可知选项C“不是很有效率”为正确答案。选项A“运转顺利”；选项B“是世界上最好的系统”；选项D“正在崩溃”。
单选题 In 1980, the average cost of a hospital stay was __
【正确答案】 B
【答案解析】推断题。
题意为：“1980年，住院费平均是______。”根据文章第二段第二句(1987年的平均住院费是3850美元，是1980年的两倍还多。)，可知选项B“低于1925美元”为正确答案。
单选题 When demand for hospital services fell, hospitals______.
【正确答案】 D
【答案解析】细节题。
题意为：“当医院的护理需求降低，医院______。”根据文章第二段末句(但是医院似乎忘记了需求的降低：这一时期医院的病床的数量只减少了大约3%，而全职雇员的数量的增加超过了240000。)，可知选项D“继续雇用更多的全职医疗工作者”为正确答案。选项A“采取有效措施减少他们的开支”；选项B“对形势有清醒的认识并采取相应的措施”；选项C“大量地减少病床的数量”。
单选题 According to the passage, hospital costs went up greatly mainly because______.
【正确答案】 A
【答案解析】细节题。
题意为：“根据本文，医院开支大幅度增长主要是因为_______。”根据文章第三段第二句话(医院开支的增长……主要是用于重复研究别的医院已经有的医疗技术和维持多余的病床。)，可知选项A“医院把钱浪费在医疗技术上”为正确答案。选项B“医院购买了太多昂贵的手术设备”；选项C“医院雇用了太多没有技术的医疗工作者”；选项D“医院管理较差”。
单选题 It is implied in the last paragraph that if a hospital uses its medical technology to the full,______.
【正确答案】 D
【答案解析】推断题。
题意为：“在最后一段，作者暗示，如果一所医院充分运用了它的医疗技术， ______。”根据该段倒数第三句(不能充分地使用技术几乎不可避免地意味着医疗质量的降低。)，可知选项D“它就能保持较好的医疗质量”为正确答案。选项A“它的医疗质量就会降低”；选项B“它的医疗开支就会增加”；选项C“它的外科手术的死亡率会较高”。