2014年華中科技大學考博英語

考試時間 2014年3月22日星期六下午2:00-5:00 原創作者qq 347952582
Passage 72(9/22)
SinceWould War II considerable advances have been made in the area of health-careservices. These include better access to health care (particularly for the poorand minorities), improvements in physical plants, and increased numbers ofphysicians and other health personnel. All have played a part in the recentimprovement in life expectancy. But there is mounting criticism of the largeremaining gaps in access, unbridled cost inflation, the further fragmentationof service, excessive indulgence in wasteful high-technology “gadgeteering,”and a breakdown in doctor-patient relationships. In recent years, proposed panaceas and new programs,small and large, have proliferated at a feverish pace and disappointmentsmultiply at almost the same rate. This has led to an increasedpessimism—“everything has been tried and nothing works”—which sometimes borderson cynicism or even nihilism.
Itis true that the automatic “pass through” of rapidly spiraling costs togovernment and insurance carriers, which was set in a publicized environment of“the richest nation in the world,” produced for a time a sense of unlimitedresources and allowed to develop a mood whereby every practitioner andinstitution could “do his own thing” without undue concern for the “MedicalCommons.” The practice of full-cost reimbursement encouraged capital investmentand now the industry is overcapitalized. Many cities have hundreds of excesshospital beds; hospitals have proliferated a superabundance of high-technologyequipment; and structural ostentation and luxury were the order of the day. Inany given day, one-fourth of all community beds are vacant; expensive equipmentis underused or, worse, used unnecessarily. Capital investment brings rapidlyrising operating costs.
Yet,in part, this pessimism derives from expecting too much of health care. It mustbe realized that care is, for most people, a painful experience, oftenaccompanied by fear and unwelcome results. Although there is vast room forimprovement, health care will always retain some unpleasantness andfrustration. Moreover, the capacities of medical science are limited. HumptyDumpty cannot always be put back together again. Too many physicians arereluctant to admit their limitations to patients; too many patients andfamilies are unwilling to accept such realities. Nor is it true that everythinghas been tried and nothing works, as shown by the prepaid group practice plansof the Kaiser Foundation and at Puget Sound. In the main, however, suchundertakings have been drowned by a veritable flood of public and privatemoneys which have supported and encouraged the continuation of conventionalpractices and subsidized their shortcomings on a massive, almost unrestricted scale.Except for the most idealistic and dedicated, there were no incentives to seekchange or to practice self-restraint or frugality. In this atmosphere, it isnot fair to condemn as failures all attempted experiments; it may be moreaccurate to say many never had a fair trial.