题目内容
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 carder 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 bills generated by the physician/hospital, and for the most part the patient plays a passive role. We estimate that about 75 to 80 percent of healthcare expenditures are determined by physicians, not patients. For this reason, economy directed at patients or the general are relatively ineffective. It can be inferred from the passage that doctors are able to determine hospital policies because ______.
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Humanity’s primal (原始的) efforts to systematize the concepts of size, shapes, and number are usually regarded as the earliest mathematics. However, the concept of number and the counting process developed so long (67) the time of recorded history (there is archaeological (68) that counting was employed by humans as far back as 50,000 years ago) that the (69) of this development is largely conjectural (好推测的). Imaging how it probably came (70) is not difficult. The argument that humans, (71) in prehistoric times, had some number sense, at least (72) the extent of recognizing the concepts of more and less when some objects were (73) to or taken away from a small group, seems fair, for studies have shown that some animal possesses such a (74) . With the (75) evolution of society, simple counting became necessary. A tribe had to know how many members it had and how many enemies, and shepherd needed to know (76) the flock of sheep was decreasing in size. Probably the earliest way of keeping a count was by some simple tally (计算, 记录) method, (77) the principle of one-to-one corre-spondence. In (78) a count of sheep, for example, one finger per sheep could be (79) . Counts could also be (80) by making scratches in the dirt or on a stone, by cutting notches in a piece of wood, or by tying knots in a string. (81) , perhaps later, an assortment of vocal (82) was developed as a word tally against the number of objects in, a small group. And (83) later, with the development of writing, a set of (84) was invented to stand for these numbers. Such an imagined development is (85) by reports of anthropologists in their studies of present-day societies that are (86) to be similar to those of early humans.
Humanity’s primal (原始的) efforts to systematize the concepts of size, shapes, and number are usually regarded as the earliest mathematics. However, the concept of number and the counting process developed so long (67) the time of recorded history (there is archaeological (68) that counting was employed by humans as far back as 50,000 years ago) that the (69) of this development is largely conjectural (好推测的). Imaging how it probably came (70) is not difficult. The argument that humans, (71) in prehistoric times, had some number sense, at least (72) the extent of recognizing the concepts of more and less when some objects were (73) to or taken away from a small group, seems fair, for studies have shown that some animal possesses such a (74) . With the (75) evolution of society, simple counting became necessary. A tribe had to know how many members it had and how many enemies, and shepherd needed to know (76) the flock of sheep was decreasing in size. Probably the earliest way of keeping a count was by some simple tally (计算, 记录) method, (77) the principle of one-to-one corre-spondence. In (78) a count of sheep, for example, one finger per sheep could be (79) . Counts could also be (80) by making scratches in the dirt or on a stone, by cutting notches in a piece of wood, or by tying knots in a string. (81) , perhaps later, an assortment of vocal (82) was developed as a word tally against the number of objects in, a small group. And (83) later, with the development of writing, a set of (84) was invented to stand for these numbers. Such an imagined development is (85) by reports of anthropologists in their studies of present-day societies that are (86) to be similar to those of early humans.
Road courtesy is not only good manners, but good sense, too. It takes the most level-headed and good-tempered of drivers to resist the temptation to get their revenge when subjected to uncivilized behavior. On the other hand, a little courtesy goes a long way towards relieving the tensions and frustrations of motoring. A friendly nod or a wave of acknowledgement in response to an act of courtesy helps to create an atmosphere of good will and tolerance so necessary in modem traffic conditions. But such acknowledgements of courtesy are all too rare today. Many drivers nowadays don’t even seem able to recognize courtesy when they see it. Contrary to general opinion, young drivers (especially sports car owners, who take pride in their driving) have better manners than their seniors. But this attitude is short-lived in the world of modem driving where many drivers neither expect nor give any quarter. This may be a commendable trait on the battlefield but is out of place on the roads. Lorry drivers say they have almost abandoned the practice of signaling cars to overtake when the road is clear, because many of the cars took too long to pass. Their drivers couldn’t be bothered to select a lower gear. Others, after overtaking, slowed down again and hogged (多占) the road. Again, a motoring magazine has recently drawn attention to the increasing number of drivers who never wait for gaps. "They manufacture them by force, using their direction indicators as a threat rather than a warning." Slanging matches (互相谩骂) and even punch-ups are quite common. It can’t be long before we hear of pistols and knives being used: we can then call our dual carriageways "’duel carriageways", and solve a spelling problem in the process. Driving is essentially a state of mind. However technically skilled a driver may be, he can’t be an advanced motorist if he is always arrogant and aggressive. Ironically, misplaced courtesy can also be dangerous and selfish. Typical examples are the driver who brakes violently to allow a lone car to emerge from a side street at some hazard to following traffic, when a few seconds later the road would be clear anyway; or the man who waves a child across a pedestrian crossing into the path of oncoming vehicles that may be unable to stop in time. The same goes for encouraging old ladies to cross the road wherever and whenever they care to. It always amazes me that the highways are not littered with the corpses of these grannies. The word "them" (Line 5, Para. 3 ) refers to ______.
Humanity’s primal (原始的) efforts to systematize the concepts of size, shapes, and number are usually regarded as the earliest mathematics. However, the concept of number and the counting process developed so long (67) the time of recorded history (there is archaeological (68) that counting was employed by humans as far back as 50,000 years ago) that the (69) of this development is largely conjectural (好推测的). Imaging how it probably came (70) is not difficult. The argument that humans, (71) in prehistoric times, had some number sense, at least (72) the extent of recognizing the concepts of more and less when some objects were (73) to or taken away from a small group, seems fair, for studies have shown that some animal possesses such a (74) . With the (75) evolution of society, simple counting became necessary. A tribe had to know how many members it had and how many enemies, and shepherd needed to know (76) the flock of sheep was decreasing in size. Probably the earliest way of keeping a count was by some simple tally (计算, 记录) method, (77) the principle of one-to-one corre-spondence. In (78) a count of sheep, for example, one finger per sheep could be (79) . Counts could also be (80) by making scratches in the dirt or on a stone, by cutting notches in a piece of wood, or by tying knots in a string. (81) , perhaps later, an assortment of vocal (82) was developed as a word tally against the number of objects in, a small group. And (83) later, with the development of writing, a set of (84) was invented to stand for these numbers. Such an imagined development is (85) by reports of anthropologists in their studies of present-day societies that are (86) to be similar to those of early humans.
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