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  3. A few years back, many hospitals in America were embarrassed by revelations that some of their neediest patients, the uninsured,

A few years back, many hospitals in America were embarrassed by revelations that some of their neediest patients, the uninsured,

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问题     A few years back, many hospitals in America were embarrassed by revelations that some of their neediest patients, the uninsured, were being charged the most. These patients were getting slammed with the full list price for health care while those with insurance got negotiated discounts. The outcry prompted congressional hearings and state inquiries. All not-for-profit hospitals in Illinois have adopted voluntary guidelines, set by the Illinois Hospital Association, to dole out free or discounted care.
    But Illinois attorney general Lisa Madigan says that’s not nearly enough. Madigan announced recently that most Illinois hospitals spend less than 1 percent on charitable care. She proposed that hospitals be required by law to spend at least 8 percent of their operating costs on charity: free health care, community clinics. This is a terrible idea. For starters—amazing as this may sound—Madigan hasn’t calculated how much this law would cost hospitals. No overall cost, nor the cost to any single hospital in the state.
    The Illinois Hospital Association says her bill would require 133 hospitals to spend $739 million more a year on charity care. That, the LHA says, would push 45 of those hospitals into the red, and 28 hospitals that already operate at a loss would be pushed closer to bankruptcy. Madigan disputes those figures.
    How did Madigan settle on the magic 8 percent? She cites her office’s investigation of hospitals and a task force she convened. But the task force didn’t issue a report and may never do so. She all but acknowledges that her claim that Illinois hospitals provide a miserly 1 percent in charitable care isn’t the whole story. That figure excludes much of what hospitals absorb, including the gap between what they spend on Medicaid patients and what they receive for that care. The LHA argues convincingly that mandating a high percentage of revenues to be spent on free care ignores the reality that many hospitals operate in the red. Draining more money would weaken hospitals—and encourage cost-cutting in nursing care, equipment or other essentials.
    Why are we talking about charitable giving by hospitals, as opposed to muffler shops, fast-food restaurants or beauty salons? Because most hospitals are tax-exempt by law: They don’t pay any federal, state or local taxes. In return, they’re required to provide services to the needy. But the law doesn’t say exactly how much.
    So they do have a charitable obligation. And some hospitals—even some not-for-profit hospitals— have hefty revenues. It’s useful to see how much they’re giving back to their communities. But the hospitals also have an obligation to stay solvent. No one profits when a hospital closes its doors. Madigan’s proposed mandate carries too much risk.
Many American hospitals were troubled by the exposure of the fact that
选项 A、some of their neediest patients were uninsured.
B、the patients were interfering with their daily operation.
C、the IHA forced them to dole out free or discounted health care.
D、the uninsured patients had to pay much more than the insured.
答案D
解析 第一段讲到美国医院对没有医保的患者收取全价，而对有医保的患者却给予折扣，因此D项符合文意。A项只是客观事实，并不是困扰医院的原因；B项文中没有提到；文中IHA倡导的是非强制性方针，C项中的forced them to dole out与原文不符，且也非被曝光的事，故不选。
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