Although usually there are in this situation four recognizable participants — the physician, the hospital, the patient, and the payer (generally an insurance carrier or government) — the physician makes the

　　12

　　for all of them. The hospital becomes an extension of the physician; the payer generally

　　13

　　most of the bills generated by the physician/hospital; and for the most part the patient plays a

　　14

　　role. We estimate that about 75-80 percent of health-care

　　15

　　are determined by physicians, not patients. For this reason, economy directed at patients or the general are relatively ineffective.

　　1. A. peculiar B. normal C. minor D. vital

　　2.

　　A. eager B. potential C. overseas D. reluctant

　　3. A. moreover B. therefore C. however D. instead

　　4. A. ordinary B. permanent C. stable D. intense

　　5. A. difficult B. conscious C. early D. purchasing

　　6. A. accept B. confirm C. challenge D. announce

　　7.

　　A. common B. serious C. mild D. preventable

　　8. A. significant B. rare C. changeable D. alternative

　　9. A. choice B. need C. disadvantage D. importance

　　10. A. balanced B. accurate C. independent D. final

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