2016年考研英语冲刺指导：时文泛读之医疗消费

　　2016考研进入复习冲刺期，每天阅读一篇英语时文，，保持阅读的感觉，对考研人来说是不错的选择。今天给大家推荐一篇“医疗消费”，话题有深度且涉及社会热点，希望能对你有所帮助。

　　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.

　　卫生保健行业存在着许多不同寻常的、甚至是独一无二的经济关系。其中人们了解最少的，包括在典型的医患关系中扮演生产者或“供应者”与购买者或“消费者”之间的奇特的角色关系。在大部分经济领域，是销售者努力用价格、质量、用途等各种诱惑来吸引潜在的购买者，而做决定的是购买者。然而，在卫生保健行业，多数情况下并不是这样的。

　　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.

　　卫生保健行业中的医患关系与一般的生产者-消费者之间的关系刚好相反。一旦某人选择了请某个医生看病——即使在那时可能并没有真正的选择余地——通常是由医生做出所有重要的购买决定：病人是否应该“下个星期三”来复诊，是否需要拍X光片，是否需要开些药，等等。很少有精明的病人会质疑这些专业人员的决定，或者提前询问价钱，尤其是当其病情非常严重的时候。

　　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.

　　当需要住院治疗时，这种关系尤为明显。医生必须证明住院的必要性，决定需要哪些治疗过程，宣布病人何时可以出院。其中某些决定可能会征求病人的意见，但一般情况下，医生的决定才具有决定性。难怪在医院看来，医生才是真正的“消费者”。这样做的结果是，代表医院“权力中心”来制定政策及决策的是医护人员，而不是行政人员。

　　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 decisions 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 t/he 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, the economy directed at patients or t.he general is relatively ineffective.

　　虽然在这种情况下通常有四方可识别的参与者——医生、医院、病人及付款者（一般为保险公司或政府）——但是医生替各方做最重要的决定。医院成了医生的延伸：付款者通常支付医生／医院开出的大部分费用，而在很大程度上病人都是一个被动的角色。据估计，卫生保健费用的75%-80%是由医生而不是病人决定的。因此，这种针对病人或普通老百姓的经济体制相对而言是无效的。