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1、考试时间2014年3月22日星期六下午2:00-5:00SinceWouldWarIIconsiderableadvanceshavebeenmadeintheareaofhealth-careservices.Theseincludebetteraccesstohealthcare(particularlyforthepoorandminorities),improvementsinphysicalplants,andincreasednumbersofphysiciansandotherhealthpersonnel.A
2、llhaveplayedapartintherecentimprovementinlifeexpectancy(lifeexpectancy:n.平均寿命(=expectationoflife)).Butthereismountingcriticismofthelargeremaininggapsinaccess,unbridledcostinflation,thefurtherfragmentationofservice,excessiveindulgenceinwastefulhigh-technology“gadget
3、eering,”andabreakdownindoctor-patientrelationships.Inrecentyears(inrecentyears:最近几年中)proposedpanaceasandnewprograms,smallandlarge,haveproliferatedatafeverishpaceanddisappointmentsmultiplyatalmostthesamerate.Thishasledtoanincreasedpessimism—“everythinghasbeentriedan
4、dnothingworks”—whichsometimesbordersoncynicismorevennihilism.Itistruethattheautomatic“passthrough”ofrapidlyspiralingcosts(spiralingcosts:螺旋式上升的费用)togovernmentandinsurancecarriers,whichwassetinapublicizedenvironmentof“therichestnationintheworld,”producedforatime(for
5、atime:adv.暂时,一度)asenseofunlimitedresourcesandallowedtodevelopamoodwherebyeverypractitionerandinstitutioncould“dohisownthing”withoutundueconcernforthe“MedicalCommons.”Thepracticeoffull-costreimbursementencouragedcapitalinvestmentandnowtheindustryisovercapitalized.Ma
6、nycitieshavehundredsofexcesshospitalbeds;hospitalshaveproliferatedasuperabundanceofhigh-technologyequipment;andstructuralostentationandluxuryweretheorderoftheday(orderoftheday:议程,<口>流行的事物,风尚).Inanygivenday,one-fourthofallcommunitybedsarevacant;expensiveequipmentisu
7、nderusedor,worse,usedunnecessarily.Capitalinvestmentbringsrapidlyrisingoperatingcosts(operatingcosts:生产费用,营业成本).Yet,inpart,thispessimismderivesfromexpectingtoomuchofhealthcare.Itmustberealizedthatcareis,formostpeople,apainfulexperience,oftenaccompaniedbyfearandunwe
8、lcomeresults.Althoughthereisvastroomforimprovement,healthcarewillalwaysretainsomeunpleasantnessandfrustration.Moreover,thecapacitiesofmedicalscie
