题目内容:
Questions are based on the following passage. Saying they can no longer ignore the rising prices of health care, some of the most influentialmedical groups in the nation are recommending that doctors weigh the costs, not just the effectivenessof treatments, as they make decisions about patient care.The shift, little noticed outside the medical establishment but already controversial inside it,suggests that doctors are starting to redefine their roles, from being concerned exclusively aboutindividual patients to exerting influence on how healthcare dollars are spent.In practical terms, the new guidelines being developed could result in doctors choosing one drugover another for cost reasons or even deciding that a particular treatment—at the end of life, forexample—is too expensive.In the extreme, some critics have said that making treatment decisionsbased on cost is a form of rationing.Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones areexpected to make doctors more conscious of the economic consequences of their decisions, eventhough there's no obligation to follow them.Medical society guidelines are also used by insurancecomoanies to help determine reimbursement (报销) policies.Some doctors see a potential conflict in trying to be both providers of patient care and fmancial
Overseers."There should be forces in society who should be concerned about the budget, but they shouldn'tbe functioning simultaneously as doctors," said Dr.Martin Samuels at a Boston hospital.He saiddoctors risked losing the trust of patients if they told patients, "I'm not going to do what I think is bestfor you because I think it's bad for the healthcare budget in Massachusetts." Doctors can face some grim trade—offs.Studies have shown, for example, that two drugs are about
equally effective in treating macular degeneration, and eye disease.But one costs $ 50 a dose and theother close to $ 2,000.Medicare could save hundreds of millions of dollars a year if everyone used thecheaper drug, Avastin, instead of the costlier one, Lucentis.But the Food and Drug Administration has not approved Avastin for use in the eye.and using itrather than the alternative, Lucentis, might carry an additional, although slight, safety risk.Shoulddoctors consider Medicare's budget in deciding what to use?"I think ethically (在道德层面上) we are just worried about the patient in front of us and nottrying to save money for the insurance industry or society as a whole," said Dr.Donald Jensen.Still, some analysts say that there's a role for doctors to play in cost analysis because not manyothers are doing so."In some ways," said Dr.Daniel Sulmasy, "it represents a failure of wider society
to take up the issue."
What do some most influential medical groups recommend doctors do? A.Reflect on the responsibilities they are supposed to take.
B.Pay more attention to the effectiveness of their treatments.
C.Take costs into account when making treatment decisions.
D.Readjust their practice in view of the cuts in health care.
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