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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
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.
Reform and Medical Costs
[A]Americans are deeply concerned about the relentless rise in health care
costs and health insurance premiums. They need to know if reform will help solve
the problem. The answer is that no one has an easy fix for rising medical costs.
The fundamental fix---reshaping how care is delivered and how doctors are paid
in a wasteful, dysfunctional system — is likely to be achieved only through
trial and error and incremental(渐进的) gains.
[B]The good news is that the bill just approved by the House and a bill
approved by the Senate Finance Committee would implement or test many reforms
that should help slow the rise in medical costs over the long term.” As a report
in The New England Journal of Medicine concluded, “Pretty much every proposed
innovation found in the health policy literature these days is contained in
these measures.”
[C]Medical spending, which typically rises faster than wages and overall
economy, is propelled by two things: the high prices charged for medical
services in this country and the volume of unnecessary care delivered by doctors
and hospitals, which often perform a lot more tests and treatment than a patient
really needs.
[D]Here are some of important proposals in the House and Senate bills to
try address those problems, and why it is hard to know how well they will
work.
[E]Both bills would reduce the rate of growth in annual Medical payments to
hospitals, nursing homes and other provides by amounts comparable to the
productivity sayings routinely made in other industries with the help of new
technologies and new ways to organize work. This proposal could save Medical
more than $100 billion over the next decade. If private plans demand similar
productivity sayings from provides, and refuse to let provides shift additional
coasts to them, the savings could be much larger. Critics say Congress will give
in to lobbyists and let inefficient providers off the hook(放过). That is far less
likely to happen if Congress also adopts strong “pay-go” rules requiring that
any increase in payments to providers be offset by new taxes or budget cuts.
[F]The Senate Finance bill would impose an excise tax(消费税) on health
insurance plans that cost more than $8,000 for an individual or $21,000 for a
family. It would most likely costs insurers to redesign plans to fall beneath
the threshold. Enrollers would have to pay more money for many services out of
their own pockets, and that would encourage them to think twice about whether an
expensive or redundant test was worth it. Economists project that most employers
would shift money from expensive health benefits into wages. The House bill has
no similar tax. The final legislation should.
[G] Doctor who has wrestled with multiple forms from different insurers, or
patients who have tried to understand their own parade of statements, know that
simplification ought to save money. When the health insurance industry was still
cooperating in reform efforts, its trade group offered to provide standardized
forms for automated processing. It estimated that step would save hundreds of
billions of dollars over the next decade. The bills would lock that pledge into
law.
[H] The stimulus package provided money to convert the inefficient,
paper-driven medical system to electronic records that can be easily viewed and
transmitted. This required open investments to help doctors convert. In time it
should help restrain costs by eliminating redundant tests, preventing drug
interactions, and helping doctors find the best treatment.
[I] Virtually all experts agree that the fee-for-service system---doctors
are rewarded for the quantity of care rather than its quality or
effectiveness---is a primary reason that the cost of care is so high. Most agree
that the solution is to push doctors to accept fixed payments to care for a
particular illness or for a patient’s needs over a year. No one knows how to
make that happen quickly. The bills in both houses would start pilot projects
within Medicare. They include such measures as accountable care organizations to
take charge of a patient’s needs with an eye on both cost and quality, and
chronic disease management to make sure the seriously ill, who are responsible
for the bulk of all health care costs, are treated properly. For the most part,
these experiments rely on incentive payments to get doctors to try them.
[J] Testing innovations do no good unless the good experiments are
identified and expanded and the bad ones are dropped. The Senate bill would
create an independent commission to monitor the pilot programs and recommend
changes in Medicare’s payment policies to urge providers to adopt reforms that
work. The changes would have to be approved or rejected as a whole by Congress,
making it hard for narrow-interest lobbies to bend lawmakers to their will.
[K] The bills in both chambers would create health insurance exchanges on
which small business and individuals could choose from an array of private plans
and possibly a public option. All the plans would have to provide standard
benefit packages that would be easy to compare. To get access to millions of new
customers, insurers would have a strong incentive to sell on the exchange. And
the head-to –head competition might give them a strong incentive to lower their
prices, perhaps by accepting slimmer profit margins or demanding better deals
from providers.
[L] The final legislation might throw a public plan into the competition,
but thanks to the fierce opposition of the insurance industry and Republican
critics, it might not save much money. The one in the House bill would have to
negotiate rates with providers, rather than using Medicare rates, as many
reformers wanted.
[M] The president’s stimulus package is pumping money into research to
compare how well various treatments work. In surgery, radiation or careful
monitoring best for prostate(前列腺) cancer? Is the largest and most expensive
cholesterol-lowering drug any better than its common competitors? The pending
bills would spend additional money to accelerate this effort.
[N] Critics have charged that this sensible idea would lead to rationing of
care. (That would be true only if you believed that patients should have an
unrestrained right to treatments proven to be inferior.) As a result, the bills
do not require, as they should, that the results of these studies be use to set
payment rates in Medicare.
[O]Congress needs to find the courage to allow Medicare to pay
preferentially for treatments proven to be superior. Sometimes the best
treatment might be the most expensive. But overall, we suspect that spending
would come down through elimination of a lot of unnecessary or even dangerous
tests and treatment.
[P]The House bill would authorize the secretary of health and human
services to negotiate drug prices in Medicare and Medicaid. Some authoritative
analysts doubt that the secretary would get better deals than private insurers
already get. We believe negotiation could work. It does in other countries.
[Q]Missing from these bills is any serious attempt to rein in malpractice
costs. Malpractice awards do drive up insurance premiums for doctors in
high-risk specialties, and there is some evidence that doctors engage in
“defensive medicine “by performing tests and treatments primarily to prove they
are not negligent should they get sued.
36.With a tax imposed on expensive health insurance plans, most employers
will likely transfer money from health expenses into wages.
37.Changes in policy would be approved or rejected as a whole so that
lobbyists would find it hard to influence lawmakers.
38.It is not easy to curb the rising medical costs in America.
39.Standardization of forms for automatic processing will save a lot of
medical expenses.
40. Republicans and the insurance industry are strongly opposed to the
creation of a public insurance plan.
41. Conversion of paper to electronic medical records will help eliminate
redundant test and prevent drug interactions.
42.The high cost of medical services and unnecessary tests and treatments
have driven up medical expenses.
43. One main factor that has driven up medical expenses is that doctors are
compensated for the amount of care rather than its effect.
44. Contrary to analysts ‘doubts, the author believes drug prices may be
lowered through negotiation.
45. Fair competition might create a strong incentive for insures to charge
less.
【试题解析】
36-40 FJAGL 41-45 HCIPK
36. 答案选F. 原文中“and that would encourage them to think twice about whether an
expensive or redundant test was worth it. Economists project that most employers
would shift money from expensive health benefits into wages.”, 与题干信息对应。
37. 答案选J. 原文中“The changes would have to be approved or rejected as a whole
by Congress, making it hard for narrow-interest lobbies to bend lawmakers to
their will.
” 与题干信息对应。
38. 答案选A. 原文中 “Americans are deeply concerned about the relentless rise in
health care costs and health insurance premiums. They need to know if reform
will help solve the problem.”与题干信息对应。
39. 答案选G. 原文中“its trade group offered to provide standardized forms for
automated processing. It estimated that step would save hundreds of billions of
dollars over the next decade.”与题干信息对应。
40. 答案选L. 原文中“The final legislation might throw a public plan into the
competition, but thanks to the fierce opposition of the insurance industry and
Republican critics, it might not save much money. " 与题干信息对应。
41. 答案选H. 原文中“In time it should help restrain costs by eliminating
redundant tests, preventing drug interactions, and helping doctors find the best
treatment.
" 与题干信息对应。
42. 答案选C. 原文中 " Medical spending, which typically rises faster than wages
and overall economy, is propelled by two things: the high prices charged for
medical services in this country and the volume of unnecessary care delivered by
doctors and hospitals, which often perform a lot more tests and treatment than a
patient really needs. " 与题干信息对应。
43. 答案选I. 原文中“doctors are rewarded for the quantity of care rather than its
quality or effectiveness---is a primary reason that the cost of care is so
high.”与题干信息对应。
44. 答案选P. 原文中“The House bill would authorize the secretary of health and
human services to negotiate drug prices in Medicare and Medicaid. Some
authoritative analysts doubt that the secretary would get better deals than
private insurers already get. We believe negotiation could work.” 与题干信息对应。
45. 答案选K. 原文中“To get access to millions of new customers, insurers would
have a strong incentive to sell on the exchange. And the head-to –head
competition might give them a strong incentive to lower their prices, perhaps by
accepting slimmer profit margins or demanding better deals from
providers.”与题干信息对应。
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发表于 2016-7-12 13:04:28