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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 parts 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 doctorand even then there may be no real choiceit is the doctor 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 doctor must claim 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 doctor 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 related participantsthe doctor, 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 doctor; the payer generally meets most of the bills generated by the doctor /hospital, and for the most part of the patient plays a passive role. We estimate that about 7580 percent of healthcare choices are determined by doctors, not patients. For this reason, the economy aimed at patients or the general is relatively ineffective.

1.The author’s primary purpose in writing this passage is to_______.

A. urge hospitals to take back their decisionmaking authority

B. analyze some important economic factors in healthcare

C. inform potential patients of their healthcare rights

D. criticize doctors for placing too much control over patients

2.The followings are not the reasons why doctors can determine hospital policies except________.

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

B. some patients might reject taking their doctors’ advice

C. it is doctors who generate income for the hospital

D. a doctor undertakes eventually for a patient’s health

3.According to the author, what do doctors imply by telling a patient to “return next Wednesday”?

A. To instruct the patient to buy more medical services

B. To advise the patient to seek a second opinion.

C. To warn the patient that a hospital stay might be necessary.

D. To admit that the first visit is ineffective.

4.If the issue in the passage were solved, which of the following would take place?

A. The medical costs for patients would go down.

B. Some new medical treatments would be provided.

C. The economy in the US would be booming.

D. Quantities of US doctors would be laid off.

高二英语阅读理解中等难度题

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