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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.Allhaveplayedapartintherecentimp
2、rovementinlifeexpectancy(lifeexpectancy:n.平均寿命(=expectationoflife)).Butthereismountingcriticismofthelargeremaininggapsinaccess,unbridledcostinflation,thefurtherfragmentationofservice,excessiveindulgenceinwastefulhigh-technology“gadgeteering,”andabreakdownindoctor-patientrelationships.Inrecentyea
3、rs(inrecentyears:最近几年中)proposedpanaceasandnewprograms,smallandlarge,haveproliferatedatafeverishpaceanddisappointmentsmultiplyatalmostthesamerate.Thishasledtoanincreasedpessimism—“everythinghasbeentriedandnothingworks”—whichsometimesbordersoncynicismorevennihilism.Itistruethattheautomatic“passthr
4、ough”ofrapidlyspiralingcosts(spiralingcosts:螺旋式上升的费用)togovernmentandinsurancecarriers,whichwassetinapublicizedenvironmentof“therichestnationintheworld,”producedforatime(foratime:adv.暂时,一度)asenseofunlimitedresourcesandallowedtodevelopamoodwherebyeverypractitionerandinstitutioncould“dohisownthing”
5、withoutundueconcernforthe“MedicalCommons.”Thepracticeoffull-costreimbursementencouragedcapitalinvestmentandnowtheindustryisovercapitalized.Manycitieshavehundredsofexcesshospitalbeds;hospitalshaveproliferatedasuperabundanceofhigh-technologyequipment;andstructuralostentationandluxuryweretheorderof
6、theday(orderoftheday:议程,<口>流行的事物,风尚).Inanygivenday,one-fourthofallcommunitybedsarevacant;expensiveequipmentisunderusedor,worse,usedunnecessarily.Capitalinvestmentbringsrapidlyrisingoperatingcosts(operatingcosts:生产费用,营业成本).Yet,inpart,thispessimismderivesfromexpectingtoomuchofhealthcare.Itmustbere
7、alizedthatcareis,formostpeople,apainfulexperience,oftenaccompaniedbyfearandunwelcomeresults.Althoughthereisvastroomforimprovement,healthcarewillalwaysretainsomeunpleasantnessandfrustration.Moreover,thecapacitiesofmedicalscie
