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

The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the

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问题     The health-care economy is filled with unusual and even unique economic relationships. 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. Such condition, however, does not prevail in most of the health-care industry.
    In the health-care industry, the doctor-patient relationship is the mirror image of the ordinary 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 decisions: 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 disease 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 it is the doctor’s judgments that are final. Little wonder then that in the eye 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 for all of them. The hospital becomes an extension of the physician; the payer generally meets most of the bills generated by the physician/hospital, and for the most part the patient plays a passive role. We estimate that about 75-80 percent of health-care expenditures are determined by physicians, not patients. For this reason, economy directed at patients or the general are relatively ineffective.
When a doctor tells a patient to return "next Wednesday" , the doctor is in effect______.
选项 A、instructing the patient to buy more medical services
B、warning the patient that a hospital stay might be necessary
C、advising the patient to seek a second opinion
D、admitting that the initial visit was ineffective
答案A
解析 由题干关键词“next wednesday”定位至第二段第二句，由定位句可知，医生最终做出了所有的购买决定，而病人则是“毫无选择地”接受，从中可以推知，这里是让病人增加更多的医疗开支，故选A)“指导病人购买更多的医疗服务”。
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