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求教一道逻辑题,多谢

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楼主
发表于 2012-4-9 09:16:16 | 只看该作者 回帖奖励 |倒序浏览 |阅读模式
题目如下,大多数TX应该都做过的。我对于该题的意思是清楚地:美国医院主要靠政府或者私人的医保来获利并cover无法付费的病人支出。目前由于保险业政策收紧,他们将仅仅付给医院刚刚好的或者低于实际损失的费用。

我不明白的地方在于美国医院的运作机制。是投保病人到医院后不会付费给医院,之后由医院进行向保险公司索赔吗?按照中国的看病流程,是病人先付全款,可以索赔的部分由病人向保险公司索赔,如果按照这种逻辑,就不会存在因为保险公司少付而使医院出现损失的情形了......所以我觉得我在这道题的理解偏差在于社会文化,而非语言层面了...各位的理解呢?谢谢啦

United States
hospitals have traditionally relied primarily on revenues from paying patients to offset losses from unreimbursed care.Almost all paying patients now rely on governmental or private health insurance to pay hospital bills.Recently, insurers have been strictly limiting what they pay hospitals for the care of insured patients to amounts at or below actual costs.
Which of the following conclusions is best supported by the information above?


(A) Although the advance of technology has made expensive medical procedures available to the wealthy, such procedures are out of the reach of low-income patients.



(B) If hospitals do not find ways of raising additional income for unreimbursed care, they must either deny some of that care or suffer losses if they give it.



(C) Some patients have incomes too high for eligibility for governmental health insurance but are unable to afford private insurance for hospital care.



(D) If the hospitals reduce their costs in providing care, insurance companies will maintain the current level of reimbursement, thereby providing more funds for unreimbursed care.



(E) Even though philanthropic donations have traditionally provided some support for the hospitals, such donations are at present declining.

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沙发
发表于 2012-4-9 09:43:39 | 只看该作者
感觉LZ有一点点想多了,其实个人感觉只要理解到这个层面就可以了:医院某些服务需要依靠付钱的病人,付钱的病人依靠保险支付,现在保险支付被限制了,所以会对医院有影响。至于具体是怎么运作的应该不是GMAC要考的内容。
A 技术先不先进无关,药贵不贵无关,有钱人还是穷人无关,或从文章推不出
B 和文章直接相关,涉及的都是文章提到的元素
C 病人收入无关,或从文章推不出
D 不能简单的用有关无关判断,但感觉不是一个结论
E 捐赠无关,或从文章推不出

个人意见,仅供参考
板凳
 楼主| 发表于 2012-4-9 09:49:55 | 只看该作者
如果保险是先由个人垫付给医院,然后由个人向保险公司索取,那么对于医院的收入是没有影响的;

当然,如果是个人不做支付,由医院最后向保险公司索取,在索取不到的情况下,自然会对医院收入造成影响。

两种支付情况对于医院的影响是完全不同的,这也是为什么我产生疑问的原因。大概思维太发散了~勿怪哈
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