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1、考试时间2014年3月22日星期六下午2:00-5:00原创作者qq347952582SinceWouldWarIIconsiderableadvanceshavebeenmadeintheareaofhealth-careservices.Theseincludebetteraccesstohealthcare(particularlyforthepoorandminorities),improvementsinphysicalplants,andincreasednumbersofphysiciansandotherhealthperson
2、nel.Allhaveplayedapartintherecentimprovementinlifeexpectancy(lifeexpectancy:n.平均寿命(=expectationoflife)).Butthereismountingcriticismofthelargeremaininggapsinaccess,unbridledcostinflation,thefurtherfragmentationofservice,excessiveindulgenceinwastefulhigh-technology“gadgeteerin
3、g,”andabreakdownindoctor-patientrelationships.Inrecentyears(inrecentyears:最近几年中)proposedpanaceasandnewprograms,smallandlarge,haveproliferatedatafeverishpaceanddisappointmentsmultiplyatalmostthesamerate.Thishasledtoanincreasedpessimism—“everythinghasbeentriedandnothingworks”—
4、whichsometimesbordersoncynicismorevennihilism.Itistruethattheautomatic“passthrough”ofrapidlyspiralingcosts(spiralingcosts:螺旋式上升的费用)togovernmentandinsurancecarriers,whichwassetinapublicizedenvironmentof“therichestnationintheworld,”producedforatime(foratime:adv.暂时,一度)asenseofu
5、nlimitedresourcesandallowedtodevelopamoodwherebyeverypractitionerandinstitutioncould“dohisownthing”withoutundueconcernforthe“MedicalCommons.”Thepracticeoffull-costreimbursementencouragedcapitalinvestmentandnowtheindustryisovercapitalized.Manycitieshavehundredsofexcesshospita
6、lbeds;hospitalshaveproliferatedasuperabundanceofhigh-technologyequipment;andstructuralostentationandluxuryweretheorderoftheday(orderoftheday:议程,<口>流行的事物,风尚).Inanygivenday,one-fourthofallcommunitybedsarevacant;expensiveequipmentisunderusedor,worse,usedunnecessarily.Capitalinv
7、estmentbringsrapidlyrisingoperatingcosts(operatingcosts:生产费用,营业成本).Yet,inpart,thispessimismderivesfromexpectingtoomuchofhealthcare.Itmustberealizedthatcareis,formostpeople,apainfulexperience,oftenaccompaniedbyfearandunwelcomeresults.Althoughthereisvastroomforimprovement,heal
8、thcarewillalwaysretainsomeunpleasantnessandfrustration.Moreover,thecapaciti