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1、1考試時間2014年3月22日星期六下午2:005:00原創(chuàng)作者qq347952582SinceWouldWarIIconsiderableadvanceshavebeenmadeintheareaofhealthcareservices.Theseincludebetteraccesstohealthcare(particularlyfthepominities)improvementsinphysicalplantsincrease
2、dnumbersofphysiciansotherhealthpersonnel.Allhaveplayedapartintherecentimprovementinlifeexpectancy.Butthereismountingcriticismofthelargeremaininggapsinaccessunbridledcostinflationthefurtherfragmentationofserviceexcessivei
3、ndulgenceinwastefulhightechnology“gadgeteering”abreakdownindoctpatientrelationships.Inrecentyearsproposedpanaceasnewprogramssmalllargehaveproliferatedatafeverishpacedisappointmentsmultiplyatalmostthesamerate.Thishasledto
4、anincreasedpessimism—“everythinghasbeentriednothingwks”—whichsometimesbdersoncynicismevennihilism.Itistruethattheautomatic“passthrough”ofrapidlyspiralingcoststogovernmentinsurancecarrierswhichwassetinapublicizedenvironme
5、ntof“therichestnationinthewld”producedfatimeasenseofunlimitedresourcesallowedtodevelopamoodwherebyeverypractitionerinstitutioncould“dohisownthing”withoutundueconcernfthe“MedicalCommons.”Thepracticeoffullcostreimbursement
6、encouragedcapitalinvestmentnowtheindustryisovercapitalized.Manycitieshavehundredsofexcesshospitalbedshospitalshaveproliferatedasuperabundanceofhightechnologyequipmentstructuralostentationluxurywerethederoftheday.Inanygiv
7、endayonefourthofallcommunitybedsarevacantexpensiveequipmentisunderusedwseusedunnecessarily.Capitalinvestmentbringsrapidlyrisingoperatingcosts.Yetinpartthispessimismderivesfromexpectingtoomuchofhealthcare.Itmustberealized
8、thatcareisfmostpeopleapainfulexperienceoftenaccompaniedbyfearunwelcomeresults.Althoughthereisvastroomfimprovementhealthcarewillalwaysretainsomeunpleasantnessfrustration.Meoverthecapacitiesofmedicalsciencearelimited.Humpt
9、yDumptycannotalwaysbeputbacktogetheragain.Toomanyphysiciansarereluctanttoadmittheirlimitationstopatientstoomanypatientsfamiliesareunwillingtoacceptsuchrealities.Nisittruethateverythinghasbeentriednothingwksasshownbythepr
10、epaidgrouppracticeplansoftheKaiserFoundationatPugetSound.Inthemainhoweversuchundertakingshavebeendrownedbyaveritablefloodofpublicprivatemoneyswhichhavesupptedencouragedthecontinuationofconventionalpracticessubsidizedthei
11、rshtcomingsonamassivealmostunrestrictedscale.Exceptfthemostidealisticdedicatedtherewerenoincentivestoseekchangetopracticeselfrestraintfrugality.Inthisatmosphereitisnotfairtocondemnasfailuresallattemptedexperimentsitmaybe
12、meaccuratetosaymanyneverhadafairtrial.1.TheauthimpliesthattheKaiserFoundationPugetSoundplans(lines4748)differedfromotherplansby3again”meansthat(A)thecostofhealthcareserviceswillnotdecline(B)somepeopleshouldnotbecomedocts
13、(C)medicalcareisnotreallyessentialtogoodhealth(D)illnessisoftenunpleasantevenpainful(E)medicalsciencecannotcureeveryill7.Withwhichofthefollowingdeionsofthesystemfthedeliveryofhealthcareserviceswouldtheauthmostlikelyagree
14、(A)Itisbiasedinfavofdoctsagainstpatients.(B)Itishighlyfragmentedcompletelyineffective(C)Ithasnotembracednewtechnologyrapidlyenough(D)Itisgenerallyeffectivebutcanbeimproved(E)Itdiscouragespeoplefromseekingmedicalcare8.Whi
15、chofthefollowingbestdescribesthelogicalstructureoftheion(A)Thethirdparagraphisintendedasarefutationofthefirstsecondparagraphs.(B)Thesecondthirdparagraphsexplainputintoperspectivethepointsmadeinthefirstparagraph.(C)Thesec
16、ondthirdparagraphsexplainputintoperspectivethepointsmadeinthefirstparagraph.(D)Thefirstparagraphdescribesaproblemthesecondthirdparagraphspresenttwohnsofadilemma.(E)Thefirstparagraphdescribesaproblemtheseconditscausesthet
17、hirdapossiblesolution.9.Theauth’sprimaryconcernisto(A)criticizephysicianshealthcareadministratsfinvestingintechnologicallyadvancedequipment(B)examinesomeproblemsaffectingdeliveryofhealthcareservicesassesstheirseverity(C)
18、defendthemedicalcommunityfromgesthathealthcarehasnotimprovedsinceWldWarII(D)analyzethereasonsfthehealthcareindustry’sinabilitytoprovidequalitycaretoallsegmentsofthepopulation(E)describethepeculiareconomicfeaturesofthehea
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