passage4

注解：標(biāo)題為紅色，翻譯為藍(lán)色，分析為綠色。?

????????It is said that in England death is pressing難以忘卻的，緊急的（本文意思）, in Canada inevitable and in California optional. Small wonder【Small wonder這不足為奇】. Americans' life expectancy【life expectancy預(yù)期壽命】 has nearly doubled over the past century. Failing壞了的 hips髖骨?can be replaced, clinical臨床的（本文意思），冷淡的?depression抑郁癥 controlled, cataracts白內(nèi)障 removed in a 30-minute surgical procedure. Such advances offer the aging population【aging population老齡化人口】 a quality of life that was unimaginable when I entered medicine【entered medicine從醫(yī)】 50 years ago. But not even a great health-care system can cure death-and our failure to【failure to未能去】?confront that reality now threatens this greatness of ours.

????????Death is normal; we are genetically在基因上地?programmed按照特定的方式行事?to disintegrate瓦解 and perish消滅，毀滅, even under ideal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded保護(hù) by third-party payers【third-party payers第三方支付】 from the cost of our care, we demand everything that can possibly be done for us, even if it's useless. The most obvious example is late-stage晚期的 cancer care治療. Physicians-frustrated by their inability to cure the disease and fearing loss of hope in the patient-too often offer aggressive大膽的 treatment far beyond what is scientifically justified.

????????In 1950, the US spent $12.7 billion on health care. In 2002, the cost will be $1,540 billion. Anyone can see this trend趨勢(shì) is unsustainable. Yet few seem willing to try to reverse扭轉(zhuǎn)?it. Some scholars conclude that a government with finite有限的?resources should simply stop paying for medical care that sustains life beyond a certain age-say 83 or so. Former Colorado governor Richard Lamm has been quoted as saying that the old and infirm體弱的 "have a duty義務(wù) to die and get out of the way【get out of the way讓位】", so that younger, healthier people can realize their potential潛能.

????????I would not go that far【go that far極端】. Energetic精力充沛的?people now routinely work through their 60s and beyond, and remain dazzlingly非常地（本文意思），耀眼地?productive. At 78, Viacom chairman Sumner Redstonejokingly claims to be 53. Supreme Court Justice Sandra Day O' Connor is in her 70s, and former surgeon general C. Everett Koop chairs擔(dān)任主席?an Internet start-up新興公司?in his 80s. These leaders are living proof【living proof活生生的例子】 that prevention預(yù)防 works有效 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（資金）花費(fèi)?in this pursuit. As a physician, I know the most costly and dramatic measures may be ineffective and painful.I also know that people in Japan and Sweden瑞典,?countries that spend far less on medical care, have achieved longer, healthier lives than we have. As a nation, we may be overfunding the quest for unlikely cures while underfunding research on humbler不起眼的 therapies療法，治療 that could improve people's lives.

一、文章結(jié)構(gòu)分析?

這是一篇探討醫(yī)療上花費(fèi)大量財(cái)力去延緩自然死亡是否值得的文章。作者首先從死亡的不可避免性入手，指出耗費(fèi)大量財(cái)力去延緩自然死亡是不可取的，但同時(shí)作者亦指出歧視和放棄對(duì)老人的照顧也是不對(duì)的。最后他通過(guò)與其他國(guó)家的比較得出了一個(gè)解決辦法：更多地研究提高人們生活質(zhì)量的普通方法。

第一、二段：提出即使有再偉大的醫(yī)療衛(wèi)生體系，死亡也是無(wú)法戰(zhàn)勝的。但是我們現(xiàn)在卻不能面對(duì)這個(gè)現(xiàn)實(shí)，其表現(xiàn)就是人們把正常的死亡當(dāng)作問(wèn)題來(lái)解決，在醫(yī)療方面不擇手段。

第三、四段：指出由于政府用于醫(yī)療衛(wèi)生的資金與日俱增，有人呼吁停止某一年齡以上人群的醫(yī)療費(fèi)用。

最后，作者先通過(guò)舉例說(shuō)明老年人仍然可以保持創(chuàng)造力，對(duì)上面的觀點(diǎn)進(jìn)行反駁；接著呼吁社會(huì)應(yīng)該把資金更多地投入到研究提高人們生活質(zhì)量的平常方法上。

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.

36.文章第一句話暗示了什么？

【A】美國(guó)人在死亡面前比其他人更有準(zhǔn)備。

【B】美國(guó)人享受的生活質(zhì)量比從前更高。

【C】美國(guó)人對(duì)他們的醫(yī)療技術(shù)過(guò)于自信。

【D】美國(guó)人對(duì)他們較長(zhǎng)的壽命感到洋洋得意。

37.The author uses the example of caner 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

37.作者使用“癌癥病人”的例子是為了表明。

【A】醫(yī)療資源經(jīng)常被浪費(fèi)

【B】醫(yī)生對(duì)致命疾病束手無(wú)策

【C】有些治療方案過(guò)于大

【D】醫(yī)療費(fèi)正變得支付不起

38. The author's attitude toward Richard Lamm's remark is one of.

[A] strong disapproval

[B] reserved consent

[C] slight contempt

[D] enthusiastic support

38.作者對(duì)理查德·拉姆的言論持有的態(tài)度是。

【A】強(qiáng)烈反對(duì)。

【B】有保留地贊同

【C】稍有蔑視

【D】熱烈支持

39. In contras to the US, Japan and Sweden are funding their medical care.

[A] more flexibly

[B] more extravagantly

[C] more cautiously

[D] more reasonably

39.與美國(guó)相比，日本和瑞典對(duì)醫(yī)療衛(wèi)生事業(yè)的資助。

【A】更靈活

【B】更奢侈

【C】更謹(jǐn)慎

【D】更合理

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

40.文章所要表達(dá)的觀點(diǎn)是

【A】醫(yī)學(xué)將進(jìn)一步延長(zhǎng)人們的生命

【B】超過(guò)了一定限度，生命就不值得延續(xù)

【C】死亡應(yīng)該作為生命事實(shí)被人們接受

【D】過(guò)多的要求增加了醫(yī)療衛(wèi)生的開支

二、核心詞匯與超綱詞匯?

（1）life expectancy=expectation of life 預(yù)期壽命

（2）failing（a.）有缺陷的；失敗的；

如：failing health 健康衰弱，failing kidneys腎衰退，a failing business生意失敗

（n.）失敗，缺點(diǎn)，弱點(diǎn)，過(guò)時(shí)

（3）surgical（a.）外科的，外科醫(yī)生的，手術(shù)上的（n.）外科病房，外科手術(shù)；

surgeon（n.）外科醫(yī)生；

surgery（n.）外科，外科學(xué)；手術(shù)室，診療室

（4）disintegrate（v.）（使）分解；（使）碎裂；

integrate（v.）使成整體，結(jié)合

（5）shield（v.）（from）保護(hù)，防護(hù)（n.）保護(hù)物，護(hù)罩；盾，盾狀物

（6）unsustainable（a.）不能證實(shí)的/支持的/成立的；

sustainable（a.）可以忍受的/支撐的；養(yǎng)得起的；

sustain（v.）支撐，維持，持續(xù)，經(jīng)受，忍耐

（7）infirm（a.）弱的，不堅(jiān)固的，柔弱的；firm（a.）結(jié)實(shí)的，堅(jiān)硬的，堅(jiān)定的，穩(wěn)

固的

（8）overfunding（a.）對(duì)…提供資金過(guò)多；

underfunding（a.）對(duì)…提供資金不足；

前綴over-意為“太甚，過(guò)度”，

under-意為“少，不足”，

如：overpay多付（錢款），underpay不付足夠的款

三、閱讀答案：C A B D C

四、全文翻譯：?

????????據(jù)說(shuō)，在英國(guó)死亡迫在眉睫，在加拿大死亡不可避免，在加利福尼亞死亡可以選擇。這種說(shuō)法并不奇怪。在過(guò)去的一個(gè)世紀(jì)里，美國(guó)人的壽命幾乎延長(zhǎng)了一倍。髖骨不行了可以更換，臨床的憂郁癥得到了控制，白內(nèi)障在30分鐘手術(shù)中便可以切除。這些進(jìn)步給老年人口帶來(lái)的高質(zhì)量生活在50年前我剛從事醫(yī)學(xué)時(shí)是不可想象的。但是即使有一個(gè)偉大的醫(yī)療衛(wèi)生體系，死亡也是無(wú)法戰(zhàn)勝的一—而我們不能面對(duì)這個(gè)現(xiàn)實(shí)卻正危及著我們這個(gè)時(shí)代的偉大。

????????死亡是正?，F(xiàn)象；我們的基因決定我們即使在最理想的環(huán)境里也會(huì)解體和滅亡。我們所有人在某種程度上都懂得這一點(diǎn)，但是作為醫(yī)療消費(fèi)者，我們卻常將死亡視為一個(gè)問(wèn)題來(lái)解決。由于醫(yī)療費(fèi)用由第三方支付，我們常常要求用盡所有的醫(yī)療手段，即使它們不會(huì)有任何作用。最明顯的例子是晚期癌癥的治療。醫(yī)生由于不能治愈疾病，同時(shí)又擔(dān)心病人失去希望，于是常常采用極端大膽的治療方法，這些方法遠(yuǎn)遠(yuǎn)超出了科學(xué)能夠認(rèn)同的界限。

????????1950年，美國(guó)在醫(yī)療衛(wèi)生方面的開支是127億美元。2002年這項(xiàng)開支將達(dá)到15400億。

任何人都明白這個(gè)趨勢(shì)不可持續(xù)下去，但是很少有人愿意去扭轉(zhuǎn)它。有些學(xué)者總結(jié)說(shuō)，資金有限的政府應(yīng)該停止支付醫(yī)療費(fèi)用來(lái)延緩某一個(gè)年齡以上人群的壽命一—比如83歲左右。據(jù)說(shuō)，科羅拉多州前州長(zhǎng)理查德·拉姆曾經(jīng)說(shuō)，老年多病者“有義務(wù)死去和讓位”，以讓更年輕、更健康的人們?nèi)グl(fā)揮他們的潛能。

????????我不會(huì)說(shuō)得這么絕對(duì)，畢竟現(xiàn)在精力充沛的人們通常能工作到60歲，甚至更久，并仍然具有驚人的創(chuàng)造力。78歲的Viacom公司總裁薩姆勒·雷斯頓開玩笑說(shuō)他只有53歲。最高法院法官桑德拉·歐康奈70有余，前衛(wèi)生局醫(yī)務(wù)主任C·庫(kù)普80來(lái)歲還出任了一個(gè)互聯(lián)網(wǎng)公司的總裁。這些領(lǐng)導(dǎo)人就是活生生的證據(jù)，證明對(duì)疾病的防治是有意義的，證明我們能夠?qū)Ω赌挲g帶來(lái)的健康問(wèn)題。作為一名年僅68歲的人，我希望像他們一樣在老齡階段保持創(chuàng)造力。

????????然而在這樣的追求中，一個(gè)社會(huì)能夠承擔(dān)的費(fèi)用是有限的。作為一名醫(yī)生，我深知最昂貴和最激進(jìn)的手段也可能是無(wú)效的和痛苦的。我也深知在醫(yī)療開銷少得多的日本和瑞典，人們獲得了比我們更長(zhǎng)的、更健康的壽命。作為一個(gè)國(guó)家，我們可能在尋求不可能奏效的治療方法上花錢太多，而在研究能提高人們生活質(zhì)量的更平常的方法上花錢太少。