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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.
The author is most probably leading up to______.
选项 A、a proposal to control medical cost
B、a discussion of new medical treatment
C、a comparison of hospitals and factories
D、an analysis of causes of inflation in the US
答案A
解析 本题的四个选项中，只有A项为正确答案。这可从文中最后一段的内容推知，即按照我们的估算，约有75～80％的医疗保健费用的决定是由医生而不是病人做出的。这也解释了为什么针对病人或一般民众所采取的经济措施，相对来说没有取得效果。由些可推测，接下来作者可能会提出一些建议。故答案为A。
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