(1) Considering that industry analysts claim that hospital price calculations are arbitrary, we asked hospitals nationwide a sim

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问题     (1) 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 (磁共振成像), 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.
    (2) 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 $1529 to almost $183000, an Archives of Internal Medicine study reported in April. Within San Francisco alone, the range between the lowest and highest charge was nearly $172000.
    (3) 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.
    (4) 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.
    (5) As technology advances, those charges rise. Palmer had a client from Louisville, Kentucky, who was astonished to receive a charge of $45330 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 (偿还) the facility’s equipment costs. (本文选自 Reader’s Digest)
The phrase "an intricate vine" in Para. 4 refers to________.

选项 A、the difficulty for an inpatient hospital stay
B、the huge amount of hospital charges
C、the problem in calculating hospital charges
D、the complexity of hospital charges

答案D

解析 语义题。原文第四段第二句中an intricate vine的字面意思为“一根缠结交错的葡萄藤”,结合上下文可知,医院费用的计算受多种因素影响,且涉及的项目众多,因此此处的短语是指医院账单很复杂,而不是账单价高,故D为正确答案,同时排除B。文中并未提及A和C,故均排除。
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