Section B
Directions: In this section, you are going to read a passage with ten statements attached to it. Each statement contains information given in one of the paragraphs. Identify the paragraph from which the information is derived. You may choose a paragraph more than once. Each paragraph is marked with a letter. Answer the questions by marking the corresponding letter on Answer Sheet 2.
37、根据以下资料,回答37-46题:
The Case for Killing Granny
A.My mother wanted to die,but the doctors wouldn't let her.At least that’s the way it seemed to me as I stood by her bed hi an intensive—care unit,at a hospital in Hilton Head,S.C,five years ago.My mother was 79,a longtime smoker who was dying of emphysema(肺气肿).She knew that her quality of life was increasingly tied to an oxygen tank。That she was losing her ability to get about,and that she was slowly drowning,The doctors at her bedside were contrarotating various tests and procedures to keep her alive.but my mother.with a certain firmness I recognized,said no。She seemed puzzled and a bit frustrated that she had to be so insistent on her own death.
B.The hospital at my mother's assisted—living facility was sustained by Medicare,which pays by the procedure.I don’t think the doctors were trying to be greedy by pushing more treatments on my- mother.That’s just the way the system works.The doctors were responding to the expectations of almost all patients.As a doctor friend of mine puts it.“Americans want the best,they want the latest,
and they want it now.”we expect doctors to make heroic efforts-especially to save our lives and the fives of our loved ones。
C.The idea that we might ration health care to seniors(or lonely elsE. is political curse.Politicians do not dare breathe the word,lest they be accused-however wrongly-of trying to pull the plug on
Grandma.But the need to spend less money on the elderly at the end of life is the elephant in the room in the health,reform debate.Everyone sees it but no one wants to talk about it.At a more basic level.
Americans are afraid not just of dyin9.but of talking and thinking about death.Until Americans learn to regard death as more than a scientific challenge to be overcoat,our health—care system will remain unfixable.
D.Compared with other Western countries,the United States has more health care—but,generally
speakin9,not better health care.There is no way we can get control of costs,which have grown by nearly 50 percent in the past decade。without finding a way to stop over eating patients.In his address to Congress,President,Obama spoke airily about reducing inefficiency。but he slid past the hard choices t:hat will have to be made to stop health care from devouring ever-larger slices of the economy and tax dollar.A significant portion of the savings will have to come from the money we spend on seniors at the end of life because,as Willie Sutton explained about why he rubbed banks,that’s where the money’is.
E.As President Ob mna said.most of the uncontrolled growth in federal spending and the deficit cones from Medicare;nothing else comes close.Almost a third of the money spent by Medicare…about $66.8 bi]lion a year-goes to chronically ill patients in the last,two years of life.This might seem obvious…of smartarse the Costs come at the end,when patients are the sickest.But that can’t explain what researchers at Dartmouth have discovered:Medicare spends twice as much on similar patients in sonic parts of the country as hi others.The average cost of a Medicare patient in Miami is$1 6.351:the average in Honolulu is $5,311.In the.Bronx,N.Y.,it’s $12,543。In Far90,N.D.$5,738.1ittle average Medicare patient,undergoing end—of-life treatment spends 2 1。9 days in a blam_hat tan hospital.In Mason City,Iowa,he or she spends only 6.1 days.
F.An this treatment does not necessarily buy better care.In fact。the Dartmouth studies have found
worse outcomes in many states and cities where there is more health care.Why?Because just+going Into the hospital has risks-of infection,or error,or other lm foreseen complications.Some studies estimate that Americas are over treated by roughly 30 percent.—It's not about rationing care-that’s always the bogeyman(魔鬼)people use to block reform,”says Dr.Elliott Fisher,a professor’at Dartmouth Medical School.“The real problem.is unnecessary and unwanted care.”
G.But how do you decide which treatments to cut out?How do you choose between the necessary and the unnecessary?There has been talk among experts and lawmakers of giving more power to a panel of government experts to decide-Britain has one,called the National Institute for Health and Clinical
Excellence(known by the somewhat ironic acronym NICE..But no one wants the horror stories of
英语栏目推荐访问: