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Most people would be impressed by the high quality of medicine available to most Americans. There is a lot of specialization, a great deal of attention to the individual, a vast amount of advanced technical equipment, and intense effort not to make mistakes because of the financial risk which doctors and hospitals must face in the courts if they handle things badly.

But the Americans are in a mess. The problem is the way in which health care is organized and financed. Contrary to public belief, it is not just a free competition system. To the private system has been joined a large public system, because private care was simply not looking after the less fortunate and the elderly.

But even with this huge public part of the system, which this year will eat up 84.5billion dollars—more than 10 percent of the U. S. budget—large numbers of Americans are left out. These include about half the 11 million unemployed and those who fail to meet the strict limits on income fixed by a government trying to make savings where it can.

The basic problem, however, is that there is no central control over the health system. There is no limit to what doctors and hospitals charge for their services, other than what the public is able to pay. The number of doctors has shot up and prices have climbed. When faced with toothache, a sick child, or a heart attack, all the unfortunate person concerned can do is pay up.

Two-thirds of the population are covered by medical insurance. Doctors charge as much as they want knowing that the insurance company will pay the bill.

The medical profession has as a result become America's new big businessmen. The average income of doctors has now reached $100,000 a year. With such vast incomes the talk in the doctor's surgery is as likely to be about the doctor's latest financial deal, as about whether the minor operation he is recommending at, several thousand dollars is entirely necessary.

The rising cost of medicine in the US is among the most worrying problem facing the country. In 1981 the country's health cost climbed 15.9 percent—about twice as fast as prices in general.

36．In the US patients can expect, in medical treatment, ______.

A．occasional mistakes by careless doctors

B．a(chǎn) great deal of personal attention

C．low charge by doctors and hospitals

D．slacking nurses and bad services

37．Doctors and hospitals try hard to avoid making mistakes because ______.

A．they fear to be sued by the patients

B．they care much about their reputation

C．they compete for getting more patients

D．they wish to join the private medical system

38．What do most Americans think about health care in the US?

A．It must be in total chaos.

B．It must be a free competition system.

C．It should cover the unemployed.

D．It should involve private care.

39．From paragraph 3 we know that ______ from the public health system.

A．millions of jobless people get support

B．those with steady income do not seek help

C．some people are made ineligible to benefit

D．those with private health care are excluded

40．According to the author, what is the key factor in the rise of health cost in the US?

A．The refusal of insurance companies to pay the bills.

B．The increase of the number of doctors and hospitals.

C．The lack of government control over the medical prices.

D．The merger of private health care with the public system.

41．It is implied that American doctors often ______.

A．trade their professionalism for financial benefits

B．fail to recognize the paying power of the patients

C．discuss about how to make money during the surgery

D．give the patients expensive but needless treatments

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