Considering that industry analysts claim that hospital price calculations are arbitrary, we asked hospitals nationwide a simple

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问题     Considering that industry analysts claim that hospital price calculations are arbitrary, we asked hospitals nationwide a simple question: How do you calculate your sticker prices? Five declined to comment or didn’t provide an answer, leaving Murray Askinazi, senior vice president and CFO of Lawrence Hospital Center in Bronxville, New York, to offer this explanation: For an outpatient MRI, as an example , his hospital calculates its charge based on such factors as the cost of buying or leasing the machinery, the wear and tear on that machine, staff salaries, the climate control and electric bill, cleaning costs, local competitive pricing, and other costs related to the hospital’s overhead, like malpractice insurance.
    Surprisingly, medical services can vary wildly from one hospital to the next. The median charge for acute appendicitis admissions at 289 medical centers and hospitals throughout California, for example, ranged from $1,529 to almost $183,000, an Archives of Internal Medicine study reported in April. Within San Francisco alone, the range between the lowest and highest charge was nearly $172,000.
    But hospital sticker prices matter only to a limited extent because they typically get trumped by a higher power; the amounts that insurance companies are willing to pay for those services. The figures are determined by a negotiated contract that dictates the rate at which the companies will reimburse the hospital on the patient’s behalf. (In addition, the rates paid by Medicare and Medicaid, Askinazi adds, often fail to cover the hospital’s cost of providing the service in the first place, which means some of those costs are often shifted to commercially insured patients.)
    Now, all those factors affect the math for one simple outpatient test. For an inpatient hospital stay, those computations sprout into an intricate vine in which every service (from radiology to pathology) generates its own charges. The hospital also has facility charges, covering room and board, certain room-use fees (such as the operating room) , and nursing services, all of which get consolidated into the bill sent to you and your insurance company.
As technology advances, those charges rise. Palmer had a client from Louisville, Kentucky, who was astonished to receive a charge of $45,330 for a prostate surgery and an overnight stay (insurance would cover only $4,845). The billing department told Palmer that the steep price was not only because it was a robotic procedure but also because patients who receive the high-tech surgery shortly after the hospital starts offering it are helping to recoup the facility’s equipment costs.
According to Murray Askinazi, the charge for an outpatient MRI is based on the following factors EXCEPT ______.

选项 A、the maintenance of the machinery
B、staff salaries
C、local taxation
D、malpractice insurance fees

答案C

解析 细节题。根据题干关键词Murray Askinazi定位到第一段。该段最后一句列举了门诊病人做核磁共振成像的账单花费的影响因素——购买或租赁仪器的成本,仪器磨损或损坏的成本,员工工资,温度控制费和电费,清理费用,当地公开招标价格,以及其他相关的医院费用,如医疗事故保险,因此排除A项B项和D项。文中提到了local competitive pricing,但是并未提到taxation,C项符合题干要求,故为正确答案。
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