大学英语四级考试阅读讲义(五十四)

Unit 3
　　(35 minutes)
　　Directions: There are 4 reading passages in this part. Each passage is followed by some questions or unfinished statements. For each of them there are four choices marked A), B), C) and D). You should decide on the best choice and mark the corresponding letter on the Answer Sheet with a single line through the centre.
　　Questions 21 to 25 are based on the following passage:
　　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 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 when 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 mosts 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.?
　　21. The author's primary purpose is to .
　　A) criticize doctors for exercising too much control over patients
　　B) analyze some important economic factors in health-care
　　C) urge hospitals to reclaim their decision-making authority
　　D) inform potential patients of their health-care rights
　　22. It can be inferred that doctors are able to determine hospital policies because .
　　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) some patients might refuse to accept their physician's advice
　　23. According to the author, when a doctor tells a patient to“return next Wednesday”, the doctor is in effect .
　　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
　　24. The author is most probably leading up to .
　　A) a proposal to control medical costs
　　B) a discussion of a new medical treatment
　　C) an analysis of the cause of inflation in the United States
　　D) a study of lawsuits against doctors for malpractice
　　25. With which of the following statements would the author be likely to agree?
　　A) Few patients are reluctant to object to the course of the treatment prescribed by a doctor or to question the cost of the services.
　　B) The more serious the illness of a patient, the less likely it is that the patient will object to the course of treatment prescribed or to question the cost of services.
　　C) The payer, whether insurance carrier or the government is less likely to acquiesce to demands for payment when the illness of the patient is regarded as serious.
　　D) Both A and B