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  3. In most sectors of the economy, it is the seller who attempts to act a potential buyer with various inducements of price, qualit

In most sectors of the economy, it is the seller who attempts to act a potential buyer with various inducements of price, qualit

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问题     In most sectors of the economy, it is the seller who attempts to act a potential buyer with various inducements of price, quality, and utility, arid it is the buyer who makes the decision. In the health care industry, however, the doctor-patient relationship is a mirror image of the ordinary relationship between producer and consumer. Once an individual has chosen to see a physician, the physician usually makes all significant purchasing decisions: whether the patient should return"next Wednesday", whether X-rays are needed, whether drugs should be prescribed, etc.
    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 it 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 decision 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 illnesses, or just plain worries, the patient’s options are, of course, much greater with respect to use and price. But in illnesses that are of some significance, such choice tends to evaporate. And it is for these illnesses 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 are relatively ineffective.
It can be inferred that doctors are able to determine hospital policies because______.
选项 A、it is doctors who generate income for the hospital
B、most of a patient’s bills are paid by his health insurance
C、a doctor is ultimately responsible for a patient’s health
D、administrations lack the expertise to question medical decisions
答案A
解析 本题的四个选项中，只有A项为正确答案。这可从文中的内容推知，即医生必须要证明需要住院，决定采用什么医疗方法，宣布病人出院时间等。病人也许会对以上决定提出咨询，不过最后的决定还是要由医生做出。这就是为什么在医院看来医生才是真正的消费者。这就导致在医院的规定和决策中代表权力中心的是医疗人员，而不是医院的管理人员。
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