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Health Minister Nicola Roxon’s latest proposal that patients be allocated to doctors on a list?basis is straight out of the playbook of Britain’s National Health Service.

Let’s think about this from the patient’s point of view. Some doctors are better than others, the?same as some plumbers are better than others. The reason may be a better bedside manner; it may?be they are more competent; it may be just that there is a simple personality clash—it may just be?that, at times, the patient wants a second opinion. Or it might be that the patient has a potentially?embarrassing problem that he or she does not want to discuss with his or her regular general practitioner.

Some people who are ill-suited to their career choice are always going to slip through the system.?In other words, if you are allocated a doctor you don’t like or who is a dud, you are likely to?be stuck with him. Of course, the government will make some noises about “freedom of choice";?but in the end, a doctor who hangs up his shingle and succeeds or fails according to the quality of?service he offers is going to provide a better quality of service than a public employee.

Now, all doctors, including general practitioners, must be members of the appropriate professional?body, which accredits them as qualifi ed practitioners. This means they must first finish?medical school and then qualify as surgeons, physicians, ophthalmologists or psychiatrists.

This postgraduate training is arduous and expensive, and practitioners naturally expect a return?on their investment of time, energy and money—the average medical graduate is left with?tens of thousands of dollars in university fees.

Much is made of the top professionals who make millions, but the average GP is running a?practice that gives him a barely adequate return on his investment in professional development.?Indeed, many GPs complain they are virtually government employees relying on Medicare to pay?their bills, but the “virtually” is important. They remain independent professionals who succeed?or fail according to the service they provide.

The recent moves to widen the scope of nurse practitioners concern many GPs. While nurse practitioners?may have a role in isolated areas, a nurse is not a substitute for a general practitioner, who?has years of undergraduate and postgraduate training in family medicine. Expanding the role of nurse?practitioners may simply be an axe to wield again the ancient enemy, the family GP. Many nurses have?specialist training, which makes them indispensable in the medical system; but a nurse is not a substitute?for professionally-trained general practitioners with years’ more education behind them.

Minister Roxon’s move to cut Medicare payments for cataract surgery again fl ies in the face?of reality. On the face of it, it may seem plausible—better technology equals cheaper prices.?If the Fred Hollows Foundation can do cataract surgery for $25, why can’t an Australian?ophthalmologist? The reason is that an Australian eye-doctor is running a practice. He has to pay?a receptionist, an accountant, rent for his rooms and so on—in other words, he has fixed costs,?which means the money goes into a lot of pockets apart from his own. In fact, he can’t absorb the?cost cuts that the government is asking him to accept.

From News Weekly, November 28, 2009

1. What did the Health Minister propose?
A. to cut the medical profession all over the country
B. to allocate the patients to doctors on a list basis
C. to increase the incentives of the medical workers
D. to revise the policy on the medical profession

2. The patient may think some doctors are better than others NOT because ________.
A. some doctors are more competent
B. there is a simple personality clash
C. they have more diffi cult problems
D. they sometimes want a second opinion

3. When doctors fi nish medical school, they may not qualify as ________.
A. surgeons B. physicians C. opticians D. psychiatrists

4. Which of the following statements about nurse practitioners is NOT true?
A. They may have a role in some isolated areas.
B. They are not a substitute for general practitioners.
C. They have less education background than GP.
D. They are the same as family general practitioners.

5. According to the passage, which of the following statements is correct?
A. People not well-suited to their career choice are going to slip through the system.
B. Average GP is given abundant return on his investment in professional development.
C. Most of the general practitioners are working for the government-controlled service.
D. Australian ophthalmologists have fi xed costs so they cannot do cataract surgery.

答案與解析：

答案：1. B
試題分析：本題為細(xì)節(jié)題。根據(jù)全文第一句“Health Minister Nicola Roxon’s latest?proposal that patients be allocated to doctors on a list basis is...”可知應(yīng)當(dāng)選B。

答案：2. C
試題分析：本題為概括題。根據(jù)第二段可知原因可能是“some doctors have a better?bedside manner”，“they are more competent”，或者病人“there is a?simple personality clash”，“wants a second opinion”，“has a potentially?embarrassing problem that he or she does not want to discuss with his or her regular?general practitioner”。只有C沒(méi)有提到。

答案：3. C
試題分析：本題為細(xì)節(jié)題。根據(jù)第四段“This means they must first finish medical school?and then qualify as surgeons, physicians, ophthalmologists or psychiatrists.”可知只有C選項(xiàng)opticians（眼鏡商）沒(méi)有提到。

答案：4. D
試題分析：本題為概括題。根據(jù)第七段“nurse practitioners may have a role in isolated?areas”，“a nurse is not a substitute for a general practitioner”，“a nurse is not?a substitute for...general practitioners with years’ more education behind them”可知
A、B、C都正確，而根據(jù)本段內(nèi)容nurse practitioner（護(hù)士）又不同于family GP（家庭全科醫(yī)師），故選D。

答案：5. A
試題分析：本題為概括題。根據(jù)第三段“Some people who are ill-suited to their career?choice are always going to slip through the system”可知A正確；根據(jù)第六段“the average GP...that gives him a barely adequate return on his investment in?professional development”可知B錯(cuò)誤；根據(jù)第六段“They remain independent?professionals”可知C錯(cuò)誤；根據(jù)最后一段“If the Fred Hollows Foundation can?do cataract surgery for $25, why can’t an Australian ophthalmologist?”無(wú)法判斷澳大利亞眼科醫(yī)生無(wú)法做白內(nèi)障手術(shù)，可知D錯(cuò)誤。