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  3. The new US health-insurance rules are designed to help those caught in Medicare’s "doughnut hole", offer seniors more preventati

The new US health-insurance rules are designed to help those caught in Medicare’s "doughnut hole", offer seniors more preventati

admin2012-07-05  50
问题     The new US health-insurance rules are designed to help those caught in Medicare’s "doughnut hole", offer seniors more preventative (预防性的) care, and limit how much of their customers’ money health-insurance companies can keep for overhead and profit.
    The new rules include:
    A provision that limits what health insurers can do with the money their customers send in as premiums (保险金).
    The rule requires that insurers spend at least 80 percent of this money on the customers themselves. The companies must either spend this money to pay insurance claims or use it for activities that improve customers’ health.
    For policies that are sold to large groups instead of small companies and individuals, the number is even higher: 85percent. The remaining 15 or 20 percent of the money can be used for a company’s salaries, marketing and overhead—or kept as profit.
    Previously, there was no federal restrictions on insurance companies’ spending. The federal government says some insurers kept 30 or even50percent. Insurance companies say this could cause them to cut back on the services they offer, or even pull out of states where administrative costs are higher. State officials also worry that the companies might cut the fees they pay to insurance brokers. That, they fear, would eliminate key middlemen who help individuals navigate a complicated insurance system.
    A provision that provides prescription-drug discounts for seniors in Medicare’s "doughnut hole".
    The doughnut hole is a controversial gap in the Medicare prescription-drug benefit passed in 2003. In 2010, for instance, Medicare paid for part of the cost of drugs, until the total cost of the drugs hit $ 2 830.
    After that, seniors were responsible for 100 percent of the cost of their drugs, until they had spent $ 3 610 of their own money. That was the other side of the doughnut hole, and federal insurance kicked in again. This provision will give Medicare recipients stuck in the doughnut hole a 50 percent discount on the price of brand-name prescription drugs. Health-care activists are worried, however, that drugmakers will jack up their prices. In that case, customers would receive 50 percent off that higher number, which might not be much less than what they were paying before.
Why does the federal government restrict insurance companies’ spending?
选项 A、Because there were no federal restrictions before.
B、Because the federal government wants companies to cut back on the services.
C、Because the federal government wants to eliminate key middlemen.
D、Because the federal government wants to limit too much money some companies keep.
答案D
解析 推理判断题。本段主要讲述了联邦政府对保险公司费用的限制原因及限制所带来的后果。原因是联邦政府认为有的保险公司截留了30％到50％的保险金。可能产生的后果是保险公司服务质量会变差，退出某些行政成本高的州，减少支付给保险经纪人的费用有可能造成他们的消失。题干是针对联邦政府对保险公司费用的限制原因，故D)“因为联邦政府想限制保险公司截留过多的保险金”为正确答案。
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