As the so-called debate over health care continues in the Senate, let me take a step back and look at actual health care reform

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问题    As the so-called debate over health care continues in the Senate, let me take a step back and look at actual health care reform through the lens of my daily experience as a physician, and yours as a patient. Not theory but practicality.
   The first relevant issue is computerization. Since 2009, Electronic Health Records have been obligatory. Although they can accelerate information exchange, they also saddle doctors to their chairs, where a routine 20-minute visit is doubled by the time the documentation is complete, but additional pay is nowhere to be seen.
   A physician survey by the consulting firm Deloitte back in 2013 revealed that six in 10 physicians reported that the practice of medicine is in jeopardy. The greatest reason given by primary care doctors was not enough time to spend with our patients. Instead we are dealing with the computer, reimbursements, approvals and referrals.
   We are increasingly unhappy because of shrinking reimbursements, fear of malpractice, and increasing regulations. We are also swamped with too many patients amid a growing doctor shortage. We will be more than 100, 000 doctors short by 2030. Obamacare added more cars to the train, but there are fewer engineers to drive it.
   I recently traveled to a health center in N.Y. which had received increased funding under the Affordable Care Act. The clinic was clearly doing its job coordinating care throughout the community for patients who had insurance or not. But a crucial concern of the clinic’s CEO was the lack of doctors available to work there.
   The solution to the health care crisis is that more health care providers must be trained and paid more by insurance. A recent survey found 31% of doctors won’t see new Medicaid patients, mostly because it doesn’t pay enough. Initiatives to reward quality outcomes too easily lose sight of the fact that we deserve to be paid for our time. Malpractice reform will take pressure off us to practice defensively, which will decrease unneeded tests and save the health care system billions of dollars.
   Insurance lobbyists may influence a health law, but they don’t provide actual health care. We doctors don’t want the same things that insurers do. To function effectively, doctors need less regulation and fewer insurance denials. Remember, more insurance options bring more choice to the doctor’s office, which means better quality health care. If we are paid more for our time and there are more of us and we are threatened with fewer meaningless lawsuits, we will be much happier and can take better care of you.
This passage is mainly concerned with______during this health care reform.

选项 A、what doctors really want to get
B、how to address the lack of doctors
C、the impact of insurance on hospitals
D、the fast development of clinical medicine

答案A

解析 本文是一位医生根据自己的日常工作所发表的感慨,反映的问题是普遍存在的。虽然美国临床医生收入很高,但文章作者认为还不够高,理由是工作时间延长了,工作量也增加了,而且面临的压力也加重。
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