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  3. The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the

The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the

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问题      The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the peculiar roles of producer of "provider" and purchaser of "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 patient may be consulted about some of these decisions, but 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 hospital, the physician, the patient, and the payer (generally an insurance carder or government )—the physician makes the essential 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.
The passage is most probably leading up to
选项 A、a proposal to control medical costs.
B、a discussion of a new medical treatment.
C、an analysis of the cause of the conflicts between physician and patients.
D、a study of lawsuits against doctors for malpractice.
答案A
解析 本题考查推理判断。文章花费大量笔墨说明了在医疗经济中是医生，而不是真正的消费者——病人，决定了绝大多数的医疗花费，最后一句提出了节约的问题，可见作者前面的分析是为他后面关于控制医疗花费的建议所做的铺垫。
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