关于地域医院的逻辑题

lisiberry

Small community hospitals in poor urban areas almost always operate at a loss due to an unfortunate cycle of factors. High revenue specialists, such as surgeons, flock to hospitals that are more prestigious and can afford to pay higher salaries. Aware of this, local residents patronize the more affluent nearby hospitals when they need specialty care or forgo care entirely, while only utilizing the local hospital for low-margin routine care. Further, a significant majority of the community uses government health plans, which reimburse poorly for routine care, or lacks insurance entirely and cannot pay. The local hospital then loses money and cannot afford to hire specialists to conduct the higher-margin specialty care.

Which of the following, if it could be accomplished, would best help small community hospitals to break the pattern described above?

(A) Negotiate higher reimbursement rates for specialty care with both government health plans and private insurers.
(B) Advertise the hospital's specialty care services in the local community as well as nearby communities to attract more business.
(C) Partner with a nearby affluent hospital to contract its specialists on a part-time, as-needed basis, which is more affordable than hiring these specialists full time.
(D) Launch a community outreach campaign to educate the public about the low reimbursement rates of government health plans compared with the high rates paid by private insurers.
(E) Negotiate with private insurers for higher reimbursement rates for routine care.

OA :C.
这道题中红色部分的内容不是很明白。reimburse是谁偿还谁的一种规制？而且 lacks insurance entirely and cannot pay是讲谁不能支付谁的呢。
还没看到选项就已经糊涂了。

如果有对医疗保险有些背景知识的NN在，能不能请讲解一下红色的这一句话。十分感谢。

gongxiaorong

应该是政府的health plans对特定人群不包括insurance，有的有垫付但是很低。病人routine的不来，看专科又去别的医院，社区综合医院出不起high salaries，医生就没有，病人更不来。医生没有病人没有，麻烦大了。头痛医头脚痛医脚是用不上了，头和脚一起痛，头痛还是脚引起的，头痛又引起脚更痛，先医头还是先医脚？

gongxiaorong

这题和那道gold=money题一样，说得复杂，但是可以简单看。题目里有的信息就是：病人因为community的医院吸引不来specialist 的医生，病人就只去specialist hospital看专科，只有routine 才去community医院。但是routine政府又不给足够的保险支持，病人更不来。没医生没病人没收入的循环要如何打破就是，要想富先修路，至少有了part time的专科医生就能有能挣大钱的专科病人，就有收入能发展打破僵局了。

lisiberry

明白了。这句话的意思呢就是说routine care的偿还率不高（又可以理解为保险公司压根不保这部分），因此穷人就不来地域医院了。简而言之，从多方面来说地域医院赚不到钱。

lisiberry

gongxiaorong 发表于 2017-3-19 00:59
应该是政府的health plans对特定人群不包括insurance，有的有垫付但是很低。病人routine的不来，看专科又去 ...

谢谢晓蓉，你最后一句比喻看起来像绕口令