[求助]大全-69

raikey

    Public general hospitals originated in the almshouse infirmaries established as early as colonial times by local governments to care for the poor. Later, in the late eighteenth and early nineteenth centuries, the infirmary separated from the almshouse and became an independent institution supported by local tax money. At the same time, private charity hospitals began to develop. Both private and public hospitals provided mainly food and shelter for the impoverished sick, since there was little that medicine could actually do to cure illness, and the middle class was treated at home by private physicians.

    Late in the nineteenth century, the private charity hospital began trying to attract middle-class patients. Although the depression of 1890 stimulated the growth of charitable institutions and an expanding urban population became dependent on assistance, there was a decline in private contributions to these organizations which forced them to look to local government for financial support. Since private institutions had also lost benefactors; they began to charge patients. In order to attract middle-class patients, private institutions provided services and amenities that distinguished between paying and non-paying patients and made the hospital a desirable place for private physicians to treat their own patients. As paying patients became more necessary to the survival of the private hospital, the public hospitals slowly became the only place for the poor to get treatment. By the end of the nineteenth century, cities were reimbursing private hospitals for their care of indigent patients and the public hospitals remained dependent on the tax dollars.

    The advent of private hospital health insurance, which provided middle-class patients with the purchasing power to pay for private hospital services, guaranteed the private hospital a regular source of income. Private hospitals restricted themselves to revenue-generating patients, leaving the public hospitals to care for the poor. Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services, the Blue Cross (blue cross: 蓝十字(毒气)) plans developed around the needs of the private hospitals and the inpatients they served. Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians. Additionally, since World War II, there has been a tremendous influx of federal money into private medical schools and the hospitals associated with them. Further, large private medical centers with expensive research equipment and programs have attracted the best administrators, physicians, and researchers. As a result of the greater resources available to the private medical centers, public hospitals have increasing problems attracting highly qualified research and medical personnel. With the mainstream of health care firmly established in the private medical sector, the public hospital has become a “dumping ground (dumping ground: 垃圾堆积场, 倾销市场).”

6.     The author cites all of the following as factors contributing to the decline of public hospitals EXCEPT.

(A) Government money was used to subsidize private medical schools and hospitals to the detriment of public hospitals.

(B) Public hospitals are not able to compete with private institutions for top flight managers and doctors.

(C) Large private medical centers have better research facilities and more extensive research programs than public hospitals.

(D) Public hospitals accepted the responsibility for treating patients with certain diseases.（E）

(E) Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.

我认为:  选项D包含在although那部分里,不是导致(紧接着的那句)reimbursement for ambulatory care 很少 的原因,.

               文章认为reimbursement for ambulatory care和provision of outpatient care还有Additionally......这三个原因导致public hospitals decline.

所以 "&"无法得到"public hospitals decline"的结论.于是选D.

而E和around the needs of  inpatients they served表达的意思一致.也就是说E可以导致reimbursement for ambulatory care很少,进而使public hospitals decline.

请NN们指点一下我的理解错在哪里? 另解释一下Blue Cross是啥东东?一种保险?

8.     The author implies that any outpatient care provided by a hospital is

(A) paid for by private insurance

(B) provided in lieu of (in lieu of: 代, 代替) treatment by a private physician

(C) supplied primarily by private hospitals

(D) a source of revenue for public hospitals（B）

(E) no longer provided by hospitals, public or private

受although那句影响,我认为"Blue Cross原本应该是一种兼顾public和private的东东,但却只针对了private".   再加上后面那句"Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital",使我觉得"原本能考虑到public利益的Blue Cross都无法提供outpatient care, 并且private hospital也不提供outpatient care, 由此暗示outpatient care将不复存在".故选了E.

答案B肯定是定位在in part because private patients can afford to pay for the services of private physicians这一句,但我认为该句仅仅是修饰前面那个词"private hospital", 没提及public hospital的outpatient care会怎样. 如果B正确,那也就是承认public hospital的outpatient care也被priate physician所取代.似乎不大对头.

再一次,Blue Cross给我的理解带来了影响,请大虾们帮助纠正我的思路.

*最好能叙述一下作者第三段的行文思路.

wei_wangyan

Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services, the Blue Cross
                    plans developed around the needs of the private hospitals and the inpatients they served. Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians.

第6和8题都在这一段里了。

6、(E) Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.BC保险不赔付那些在公共医院发生的费用，这不正好说明这些费用要由病人自己来付吗？这样医院不会有损失的，故不认为是contribute to the decline...。

8、根据原文，私家医院不怎么提供outpatient服务，所以outpatient的服务就由公共医院来提供了。问题：The author implies that any outpatient care provided by a hospital，这半句是问由医院（注意是hospital,没有说明公共还是私家）提供的outpatient服务是怎么样的，既然前面已经说明私家医院不提供这种服务，所以肯定是由公共医院提供的。既然是公共医院所提供，那么就肯定不是私人医生提供的了，即is provided in lieu of
                                treatment by a private physician.
                            理解了in lieu of的意思，这题就应该理解了。

raikey

啊!原来reimbursement用在"保险"这一行业里是"赔款"的意思.我原来一直疑惑:  " '付还'for ambulatory care" 倒底是啥意思呢.

这下彻底明白了.,长知识了!

谢谢楼上的

 

sch

Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services, the Blue Cross
     plans developed around the needs of the private hospitals and the inpatients they served. Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians.

--------

我也有疑问,研究半天,读不出这一段的逻辑关系啊. 有哪位NN可以帮忙翻译一下这句话.

"Thus",承接的是什么逻辑关系啊,thus引导的这句,和前面一句有什么逻辑关系么?

 

同问第六题:

(D) Public hospitals accepted the responsibility for treating patients with certain diseases.（E）
        

我选的也是D,因为我看到原文是,"Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services..." (尽管公立医院一直提供传染病治疗,门诊服务,和紧急服务....),我的理解是,作者只是这么提到公立医院的现状啊,好像并没有建立起 提供上述3个服务,就会导致公立医院的decline 逻辑必然啊,所以我选了D,理由是,这是一个无关项,D的行文不导致decline.

还有(E):

(E) Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.

我怎么没从原文读出来,原文有提到选项E这个情况啊?真惭愧.

原文不是说".....(但是)BC计划,满足了私立医院和其住院病人的需求.这样,在BC计划下,ambulatory的赔付,被最小化了,并且门诊服务不再是私立医院的主要服务了....." 哪里有说"BC计划不再支付公立医院里发生的费用了"?

 

 

看来还是原文没有读懂啊,有哪位大大解释一下原文逻辑关系么?

 

我选的也是D,因为我看到原文是,"Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services..." (尽管公立医院一直提供传染病治疗,门诊服务,和紧急服务....),我的理解是,作者只是这么提到公立医院的现状啊,好像并没有建立起 提供上述3个服务,就会导致公立医院的decline 逻辑必然啊,所以我选了D,理由是,这是一个无关项,D的行文不导致decline.

还有(E):

(E) Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.

我怎么没从原文读出来,原文有提到选项E这个情况啊?真惭愧.

原文不是说".....(但是)BC计划,满足了私立医院和其住院病人的需求.这样,在BC计划下,ambulatory的赔付,被最小化了,并且门诊服务不再是私立医院的主要服务了....." 哪里有说"BC计划不再支付公立医院里发生的费用了"?

 

 

看来还是原文没有读懂啊,有哪位大大解释一下原文逻辑关系么?

 

 

[此贴子已经被作者于2007-5-27 13:22:48编辑过]

qianrene

Thus, reimbursement for ambulatory流动的 care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians

这句的意思是对于流动（即来即走的门诊病人）的赔付变得很少，所以门诊病人服务已经不是私立医院的主要项目了，因为病人能够副得起住院的费用，也就是In patient

结合前面的这句来看 private institutions provided services and amenities that distinguished between paying and non-paying patients and made the hospital a desirable place for private physicians to treat their own patient意思就是私立医院里越来越多是是private physician了，原来他们只在家里服务，随着私立医院对middle class的吸引，这些医生也在私立医院任职了。

那么第6题E答案就可以排除了

(E) Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.并没说不赔偿（一秆子打死所有公力医院的病人，以为他们都是门诊病人），只是不赔偿outpatient，迎合了private医院的需要：the Blue Cross (blue cross: 蓝十字(毒气))
                                plans developed around the needs of the private hospitals

第8题也可以选出来了，因为门诊病人越来越多的被private phsician代替（他们提供的住院服务）