[求助]GWD-23-Q1

fengxx1110

1.         GWD-23-Q1

A major health insurance company in Lagolia pays for special procedures prescribed by physicians only if the procedure is first approved as “medically necessary” by a company-appointed review panel.  The rule is intended to save the company the money it might otherwise spend on medically unnecessary procedures.  The company has recently announced that in order to reduce its costs, it will abandon this rule.

 

Which of the following, if true, provides the strongest justification for the company’s decision? 

 

A.      Patients often register dissatisfaction with physicians who prescribe nothing for their ailments.

B.       Physicians often prescribe special procedures that are helpful but not altogether necessary for the health of the patient.

C.       The review process is expensive and practically always results in approval of the prescribed procedure.

D.      The company’s review process does not interfere with the prerogative of physicians, in cases where more than one effective procedure is available, to select the one they personally prefer.

E.       The number of members of the company-appointed review panel who review a given procedure depends on the cost of the procedure.

我选的是E 答案是C.不知原因？

fenglikang

医生给病人开出special procedures，只有当这样的procedures被保险公司委派的审查小组第一次就认定为必要的医疗治疗之后，保险公司才会支付相关的医疗费用。这样的规定主要是为了保险公司减少不必要的医疗赔付。但是，最近这个公司为了节省开支打算放弃这项规定。要支持这个决定，那么可能的情况有两个：1.这个规定并没有起什么作用；2.这个规定本身就会耗费大量的财力。B说这个审查过程本身就非常昂贵，并且绝大多数时候，prescribed procedure都是一次性通过的，所以没有发挥保险公司期待的作用，因此支持了公司的决定。其他为无关选项。

好好学习

同问

vivian0331

up

anistonlucky

My answer is B.

myloveavril

B,E都是无关选项，首先B的physician是不是prescribe这些helpful的special procedures是没有关系的，因为原文中说only if the procedure is first approved by a company-appointed panel,注意insurance company pay不pay是由这个panel决定的，而不是physician因此B无关。

E说的是组成panel的人数由这个procedure的成本决定，无关选项。

xiaolishally

up

caijia

cuikaka

可以使用manhattan的educatioanl guess的方法：

结合因果，条件结论在围绕cost讨论，所以选项必定与cost相关，且cost是core，纵观选项只有C在讨论cost；相反E就不是，是个trap，无关选项。

Jez

我D选项后半句都没看懂...有nn解释下D什么意思吗？