六级阅读第十四天完整版.pdf

Passage TwoQuestions 57 to 61 are based on the following passage.Crippling health care bills, long emergency-room waits and the inabilitytofinda primary carephysician justscratch thesurface ofthe problemsthatpatients face daily.Primary care should be the backbone of any health care system.Countries with appropriate primary care resources score highly when itcomestohealthoutcomesandcost.TheU.S.takestheoppositeapproachbyemphasizing the specialist rather than the primary care physician.A recent study analyzed the providers who treat Medicare beneficiaries（老年医保受惠人）. The startling finding was that the average Medicarepatient saw a total of seven doctors—two primary care physicians and fivespecialists—in a given year. Contrary to popular belief, the more physicianstaking care of you don ’ t guarantee better care. Actually, increasingfragmentation of care results in a corresponding rise in cost and medicalerrors.Howdidweletprimarycareslipsofar?Thekeyishowdoctorsarepaid.Mostphysiciansarepaidwhenevertheyperformamedicalservice.Themoreaphysiciandoes,regardlessofqualityoroutcome,thebetterhe’sreimbursed(返还费用). Moreover, the amount a physician receives leans heavily towardmedical or surgical procedures. A specialist who performs a procedure in a30-minute visit can be paid three times more than a primary care physicianusing that same 30 minutes to discuss a patient’s disease. Combine this factwith annual government threats to indiscriminately cut reimbursements,physiciansarefacedwithnochoicebuttoincreasequantitytoboostincome.Primary care physicians who refuse to compromise quality are eitherdriven out of business or to cash-only practices, further contributing to thedecline of primary care.Medicalstudentsarenotblindtothisscenario.Theyseehowheavilythereimbursement deck is stacked against primary care. The recent numbersshow that since 1997, newly graduated U.S. medical students who chooseprimary care as a career have declined by 50%. This trend results inemergencyroomsbeingoverwhelmedwithpatientswithoutregulardoctors.How do we fix this problem?Itstartswithreformingthephysicianreimbursementsystem.Removethepressure for primary care physicians to squeeze in more patients per hour,and reward them for optimally (最佳地) managing their diseases andpracticing evidence-based medicine. Make primary care more attractive tomedical students by forgiving student loans for those who choose primarycareasacareerandreconcilingthemarkeddifferencebetweenspecialistandprimary care physician salaries.We’re at a point where primary care is neededmore than ever.Within afewyears, thefirstwaveofthe76millionBabyBoomerswillbecomeeligibleforMedicare.Patientsolderthan85,whoneedchroniccaremost,willriseby50% this decade.Who will be there to treat them?57. The author’s chief concern about the current U.S. health caresystem is __________.A) the inadequate training of physiciansB) the declining number of doctorsC) the shrinking primary care resourcesD) the ever-rising health care costs58. We learn from the passage that people tend to believe that__________.A) the more costly the medicine, the more effective the cureB) seeing more doctors may result in more diagnostic errorsC) visiting doctors on a regular basis ensures good healthD) the more doctors taking care of a patient, the better59. Faced with the government threats to cut reimbursementsindiscriminately, primary care physicians have to __________ .A) increase their income by working overtimeB) improve their expertise and serviceC) make various deals with specialistsD) see more patients at the expense of quality60. Why do many new medical graduates refuse to choose primarycare as their career?A) They find the need for primary care declining.B) The current system works against primary care.C) Primary care physicians command less respect.D) They think working in emergency rooms tedious.61. What suggestion does the author give in order to provide betterhealth care?A)Bridgethesalarygapbetweenspecialistsandprimarycarephysicians.B) Extend primary care to patients with chronic diseases.C) Recruit more medical students by offering them loans.D)Reducethetuitionofstudentswhochooseprimarycareastheirmajor.每日一句（DailySentence） Every dog has its day.每个人都有时来运转的一天。

Words1.primary:['praɪmərɪ] adj. 首要的，主要的，最早的，原始的2.scratch:[skrætʃ] vt. 擦，刮，擦痛，擦伤3.appropriate:[ə'prəʊprɪət]adj. 适当的，恰当的，合适的4.startle:['stɑ:tl] vt. 使震惊，使大吃一惊，使惊跳，使惊吓5.contrary:['kɒntrərɪ] adj.相反的，违反的，反对的，对立的6.fragmentation:[ˌfræɡmen'teɪʃn] n. 分裂，破碎7.correspond:[ˌkɒrə'spɒnd] vi. 符合，一致，相应，通信8.procedure:[prəˈsi:dʒə(r)]n. 程序，手续，工序，过程，（议会的）议事程序9.indiscriminately:[ˌɪndɪ'skrɪmɪnətlɪ] adv.无差别，任意地，不分青红皂白地promise:['kɒmprəmaɪz] vi.折中解决，妥协，退让11.overwhelm:[ˌəʊvə'welm] vt.淹没，压倒，覆盖，压垮12.squeeze:[skwi:z] vt.榨取，汲取，轻轻地捏，向…勒索（或榨取）13.eligible:[ˈelɪdʒəbl] adj.合适的，在（法律上或道德上）合格的，有资格当选的14.chronic:['krɒnɪk] adj.慢性的，长期的，习惯性的15.regardless of: 不管，不顾题目解析57.选[C]。

题目问的是作者对美国的医疗系统最担心的是什么？本题是一道主旨大意题，需要通读全文才能发现的，也就是作者写这篇文章的核心纵观全文可知，作者整篇文章都在说美国的初级医疗护理（primarycare）的问题，。