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

The health-care economy is full with unusual and even unique economic relationship. One of the least understood involves the pec

admin2010-06-30  100
问题    The health-care economy is full with unusual and even unique economic relationship. 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 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. Where circumstances permit the buyer no choice because there is effectively only one seller and the product is relatively essential, government usually asserts monopoly and places the industry under price and other regulations. Neither of these conditions prevails in most of the health care industry.
   In the heath-care industry, the doctor-patient relationship is the mirror image of the original 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 decision: 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 ailment 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 in the main ’ii’ 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 physician, 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 physician; the payer generally meets most of the bona fide bills generated by the physician/hospital; and for the most part the patient plays a passive role. In routine or minor illness, or just plain worries, the patient’s options are, of course, much greater with respect to use and price.
   In illness that is of some significance, however, such choices tend to evaporate, and it is for ill ness that the bulk of the health-care dollar is spent. We estimate that about 75-80 percent of health care expenditures are determined by physicians, not patients. For this reason, economy measures directed at patients or the general public is relatively ineffective.
By saying" mirror image" ( Line 1, Paragraph 2), the author means that
选项 A、doctors and patients always put themselves in the other’s shoes.
B、the doctor-patient relationship is the same as the ordinary relationship between producer and consumer.
C、the doctor-patient relationship reverses the ordinary relationship between producer and consumer.
D、the role of doctors is a contrast to the role of their patients.
答案C
解析 文章第二段第一句说医生与病人之间的关系是普通生产者与消费者之间关系的镜像，即两者正好相反。接下来的例子也是说明医生是如何决定病人的消费的。A文章未提及。D与文意相反。D文章未提及医生与病人的角色形成对照。
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