It is said that inEngland death is pressing, in Canada inevitable and in California optional.Small wonder. Americans life expectancy has nearly doubled over the past century. Failinghips can be replaced, clinical depression controlled, cataracts removed in a30-minute surgical procedure. Such advances offer the aging population aquality of life that was unimaginable when I entered medicine 50 years ago. Butnot even a great health-care system can cure deathand ourfailure to confront that reality now threatens this greatness of ours。 Death is normal; we are genetically programmed to disintegrate andperish, even under ideal conditions. We all understand that at some level, yetas medical consumers we treat death as a problem to be solved. Shielded bythird-party payers from the cost of our care, we demand everything that canpossibly be done for us, even if it s useless. The most obvious example islate-stage cancer care. Physiciansfrustrated by theirinability to cure the disease and fearing loss of hope in the patienttoo oftenoffer aggressive treatment far beyond what is scientifically justified。 In 1950, the U.S. spent $12.7 billion on health care. In 2002, thecost will be $1,540 billion. Anyone can see this trend is unsustainable. Yet fewseem willing to try to reverse it. Some scholars conclude that a governmentwith finite resources should simply stop paying for medical care that sustainslife beyond a certain agesay 83 or so. Former Colorado governor Richard Lamm has been quotedas saying that the old and infirm have a duty to dieand get out of the way so that younger, healthier people can realize their potential。 I would not go that far. Energetic people now routinely workthrough their 60s and beyond, and remain dazzlingly productive. At 78, Viacomchairman Sumner Redstone jokingly claims to be 53. Supreme Court Justice SandraDay O Connor is in her 70s, and former surgeon general C. Everett Koop chairsan Internet start-up in his 80s.These leaders are living proof that preventionworks and that we can manage the health problems that come naturally with age.As a mere 68-year-old, I wish to age as productively as they have。 Yet there are limits to what a society can spend in this pursuit.Ask a physician, I know the most costly and dramatic measures may beineffective and painful. I also know that people in Japan and Sweden, countriesthat spend far less on medical care, have achieved longer, healthier lives thanwe have. As a nation, we may be overfunding the quest for unlikely cures whileunderfunding research on humbler therapies that could improve people s lives。 36. What is implied in the first sentence? [A] Americans are better prepared for death than other people。 [B] Americans enjoy a higher life quality than ever before。 [C] Americans are over-confident of their medical technology。 [D] Americans take a vain pride in their long life expectancy。 37. The author uses the example of cancer patients to show that [A] medical resources are often wasted。 [B] doctors are helpless against fatal diseases。 [C] some treatments are too aggressive。 [D] medical costs are becoming unaffordable。 38. The author s attitude to ward Richard Lamm s remark is one of [A] strong disapproval。 [B] reserved consent。 [C] slight contempt。 [D] enthusiastic support。 39. In contras to the U.S. ,Japan and Sweden are funding theirmedical care [A] more flexibly。 [B] more extravagantly。 [C] more cautiously。 [D] more reasonably。 40. The text intends to express the idea that [A] medicine will further prolong people s lives。 [B] life beyond a certain limit is not worth living。 [C] death should be accepted as a fact of life。 [D] excessive demands increase the cost of health care。 名师解析 36. What is implied in the first sentence? 第一句话暗示什么? [A] Americans are better prepared for death than other people。 美国人对于死亡的准备超过其他人。 [B] Americans enjoy a higher life quality than ever before。 美国人比先前享受更高的生活质量。 [C] Americans are over-confident of their medical technology。 美国人对他们的医学技术过于自信。 [D] Americans take a vain pride in their long life expectancy。 美国人对于他们的长寿有一种虚荣的自豪感。 【答案】 C 【考点】 推断题。 【分析】 该题问的是篇首第一句的含义。这句话说的是据说,在英国死亡是迫在眉睫的,在加拿大死亡是不可避免的,在加利福尼亚死亡是可以选择的。从这句话中,我们可以看出美国人自认为美国拥有先进医疗技术,死亡是可以控制的。所以[C]项是正确的。[A]项毫无道理,因为从文章中可以看出美国人还是害怕死亡的。[B]项是将美国人的现状与过去相比,与本句无关。[D]项说的是美国人对于他们的长寿有一种虚荣的自豪感,也是不正确的,因为分析第一段就发现,作者谈论的,或者说作者自己进行解释的是美国人对医疗技术的自信,所以[D]不正确。 37. The author uses the example of cancer patients to show that 作者用癌症病人的例子来说明 [A] medical resources are often wasted. 医疗资源常常被浪费。 [B] doctors are helpless against fatal diseases. 医生对于致命的疾病也无计可施。 [C] some treatments are too aggressive. 有一些治疗过去大胆。 [D] medical costs are becoming unaffordable. 医疗费用越来越支付不起。 【答案】 A 【考点】 作者意图题。 【分析】 在第二段中,作者用晚期癌症患者为例,指出医生们往往采取一些激进的缺乏科学根据的治疗方法。结合文章来看,我们发现它的作用是为了说明人们通常浪费了医疗资源,过度地投入在已经没有用处的的事情上。因此我们可以推断出作者的意图,即不应该浪费医疗资源在那些无可救药的人身上。[B]、[C]选项都不能表达作者意图。文中提及第三方支付人支付很多费用,因此[D]项内容是错误的。 38. The authors attitude toward Richard Lamms remark is one of 作者对待Richard Lamm所说的话的态度是 [A] strong disapproval. 强烈反对。 [B] reserved consent. 有保留的赞同。 [C] slight contempt. 略有蔑视。 [D] enthusiastic support. 热烈支持。 【答案】 B 【考点】 作者态度题。 【分析】 通过关键词Lamm可以定位到第三段Lamm所说的话,老年人有义务死亡,以免挡住道路。在第四段,作者对于Lamm的观点发表了看法,I would not go that far。接着,作者举出了许多例子,说明老年人可以活得很有价值。这很容易让人认为作者是反对Lamm的观点的。但是接下来的一段中,作者从另外一个角度发表了自己的看法。作者说,最昂贵和最引人注目的医疗手段未必就是高效率的和无疼痛的。作者举例日本和瑞士,老年医疗开支不高,但是寿命更长,更加健康。作者说我们在那些无药可救的疾病方面,也许投入过大,但是在那些事关人民生活质量的研究上投入过低。所以选[B],作者对Lamm的观点基本同意,但有所保留。 39. In contrast to the U.S., Japan and Sweden are funding theirmedical care 与美国相比,日本和瑞典对医疗的资金投入的方式 [A] more flexibly. 更灵活。 [B] more extravagantly. 更奢侈。 [C] more cautiously. 更谨慎。 [D] more reasonably. 更合理。 【答案】 D 【考点】 推断题。 【分析】 定位到最后一段,作者举例说明了虽然日本和瑞典在医疗保健上的花费比美国少,但寿命却比美国人长,身体也更健康。接着作者提到我们也许在那些无药可救的疾病方面,也许投入过大,但是在那些事关人民生活的研究上投入过低。因此我们可以推断出,日本和瑞典在医疗保健上的投资比美国更加合理,因此选择[D]项,其它选项不能表达出这个意思。 40. The text intends to express the idea that 本文试图表达的观点是 [A] medicine will further prolong peoples lives. 医学将进一步延长人们的生命。 [B] life beyond a certain limit is not worth living. 超过了一定的限度,生命就不值得延续。 [C] death should be accepted as a fact of life。 死亡应该被当成一种生命的事实来接受。 [D] excessive demands increase the cost of health care。 过多的要求增加了医疗的成本。 【答案】 C 【考点】 文章主旨题。 【分析】 本题要求考生判断文章主旨。这个时候需要通篇浏览。文章第一段说,即使有一个伟大的医疗卫生体系,死亡也无法战胜,但是如果我们不能面对这样一个事实,就会影响到我们国家的伟大。第二段又说,死亡是正常的,但是我们却试图使用一切可能的方法来延缓自己的生命。第三段作者提出医疗资源不应该用在一些已经没有挽救意义的人身上。第四段提到作者承认老年生活可能也是很有价值的。但是第五段作者提出日本人和瑞典人的例子,指出生活的质量,寿命的长短,靠的不仅仅是医疗,还有其它办法。既然如此,不如将有限的资源用于需要的地方上去。因此文章的中心思想应该是[C]选项。[A]项与作者观点相反。[B]项也不正确,因为作者已经提到老年人的晚年也同样可以很有价值,但是只是作者不同意将过多的医疗资源浪费在没有价值地延缓生命上。[D]项是事实,但却不是文章主要表达的思想。 难句解析: 1. Failing hips can be replaced, clinical depression controlled,cataracts removed in a 30-minute surgical procedure。 【结构分析】本句是省略结构,controlled的前面和removed的前面省均略了can be。这其实是含有三个分句的并列句。如果完整的写出来就是Failing hips can be replaced, clinical depression can be controlled,cataracts can be removed in a 30-minute surgical procedure。。这样一来显得很罗嗦和重复,因此去掉can be,可以显得很简练。 2. Shielded by third-party payers from the cost of our care, wedemand everything that can possibly be done for us, even if its useless。 【结构分析】本句的主干是we demand everything,everything的后面紧跟了一个that引导的定语从句,主句的前面是过去分词短语作状语,主句的后面是even if引导的让步状语从句。 3. Physiciansfrustrated by their inability to cure the disease and fearing lossof hope in the patienttoo often offer aggressive treatment far beyond what isscientifically justified。 【结构分析】本句的主干结构是physicians offer treatment,两个破折号之间过去分词结构和现在分词结构做定语。介词beyond之后跟了一个what引导的宾语从句,构成介宾结构。 全文翻译: 据说,死亡在英国令人感到迫在眉睫,在加拿大不可避免,在加利福尼亚可以选择。这没什么大惊小怪的,在过去的一个世纪里,美国人的寿命几乎翻了一番。髋骨坏了可以更换,临床的忧郁症可以得到控制,白内障仅用30分钟手术便可切除。这些进步给老年人所带来的高质量生活是50年前我刚从事医学时无法想像的。但是即使一个伟大的医疗卫生体系也无法战胜死亡,由于这个现实我们不能面对,正在危及我们国家的伟大。 死亡是正常的;我们的基因注定我们都会解体和灭亡,即使在最理想的环境里也是如此。我们所有人在某种程度上都懂得这一点,但是作为医疗消费者,我们常将死亡视为一个问题来解决。由于有医疗费用由第三方支付这个挡箭牌,我们常常要求采用一切医疗手段,即使它们不会有任何用处。最明显的例子是晚期癌症的治疗。医生由于不能治愈疾病,同时又担心病人失去希望而感到挫折,因此常常采用激进的科学上认为不合理的治疗方法。 1950年,美国在医疗卫生方面的开支是127亿美元。2002年,这项开支将达到15,400亿。任何人都明白这个趋势是不可持续的,但是很少有人愿意扭转它。有些学者总结说,资金有限的政府应该停止支付延缓某一个年龄以上人群寿命的医疗费用比如83岁左右。据说科罗拉多州前州长理查德拉姆曾经说过,老年多病者有责任死亡和让路,以让更年轻、更健康的人们去实现他们的潜能。 我不会走得那么远,如今精力充沛的人们通常能工作到60岁,甚至更久,并仍然保持着令人炫目的创造力。78岁的Viacom公司总裁萨姆勒雷斯顿开玩笑地声称自己只有53岁。最高法院法官桑德拉欧康奈70有余,前卫生局医务主任库普80来岁还出任了一个互联网公司的总裁。这些领导人就是活生生的证据,证明了疾病的防治是有效果的,证明了我们能够应付年龄带来的健康问题。作为一名才68岁的人,我希望能像他们一样在老龄阶段仍然保持创造力。 然而在这方面的追求中,一个社会能够承担的开支是有限的。作为一名医生,我知道最昂贵和最激进的手段也可能是无效的和痛苦的。我同样知道医疗开销少得多的国家日本和瑞典,老百姓获得了比我们更长的、更健康的寿命。作为一个民族,我们可能在寻求不可能奏效的治疗方法上花钱太多,而在研究能提高人们生活质量的更平常的方法上花钱太少。
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