首页
登录
职称英语
Modern lore has it that in England death is imminent, in Canada inevitable a
Modern lore has it that in England death is imminent, in Canada inevitable a
游客
2025-05-02
0
管理
问题
Modern lore has it that in England death is imminent, in Canada inevitable and in California optional. Small wonder. Americans’ life expectancy has nearly doubled over the past century. Failing hips can be replaced, clinical depression controlled, cataracts removed in a 30-minute surgical procedure. Such advances offer the aging population a quality of life that was unimaginable when I entered medicine 50 years ago. But not even a great health-care system can cure death—and our failure to confront that reality now threatens this greatness of ours.
Death is normal. We are genetically programmed to disintegrate and perish, even under optimal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded by third-party payers from the cost of our care, we demand everything that can possibly be done for us, even if it’s futile. The most obvious example is late-stage cancer care. A vast industry pushed for aggressive and expensive therapy for prostate cancer, despite a lack of demonstrable benefit for many patients. Physicians—frustrated by their inability to cure the disease and fearing loss of hope in the patient—too often offer aggressive treatment far beyond what is scientifically justified.
Meanwhile, the kind of palliative care provided in hospices is taught derogatorily to medical students as a treatment of last resort. In 1950 the United States spent $ 12. 7 billion, or 4. 4 percent of gross domestic product, on health care. In 2002 the cost will be $ 1. 54 trillion—nearly 14 percent of GDP, by far the largest percentage spent by any developed country.
Anyone can see that this trend is unsustainable. Yet few seem willing to try to reverse it. Some ethicists conclude that a government with finite 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 "have a duty to die and get out of the way" so that younger, healthier people can realize their potential.
I wouldn’t go that far. Not long ago similar arguments were used to justify mandatory retirement ages as young as 55 for employees in industry, academia and government. The message was "Step aside—I want your desk and your paycheck. " Energetic people now routinely work through their 60s and beyond, and remain dazzlingly productive. At 78, Viacom chairman Sumner Redstone jokingly claims to be 53. Supreme Court Justice Sandra Day O’Connor is in her 70s, and former surgeon general C. Everett Koop chairs an Internet start-up in his 80s. These leaders are living proof that prevention works and that we can manage the maladies that come naturally with age. As a mere 68-year-old, I aspire to age as productively as they have.
Yet there are limits to what a society can spend in this pursuit, or should. I’ve watched as the lives of my family members and friends have been painfully prolonged. It’s a stark contrast with the inexpensive and compassionate deaths of my parents a generation ago.
As a medical consumer, I may want Medicare to buy me multiple coronary bypass operations or a desperate round of bone-marrow transplantation. As a taxpaying citizen, I know—intellectually, if not emotionally—that the value of such measures must be weighed against other social goods, such as housing, defense and education. And 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, 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 therapies that could improve peoples’ lives; For example, the field of alternative and complementary medicine receives just a 5 percent chunk of the National Institutes of Health budget.
To create a humane system of health care, we must acknowledge that death and dying are not themselves the enemies. As the post-World War II British epidemiologist Archie Cochrane once observed, cures in medicine are rare, but the need for "care" —attention and reassurance from approachable, sympathetic physicians and caregivers—is widespread. Cochrane worried that by pursuing cures at all cost, we would restrict the supply of care that patients can receive. This is precisely the crisis of contemporary medicine: billions for cures, and pennies for care. Medicine can accomplish great things for the generation now passing 50, but only if we’re wise enough not to ask too much of it. [br] The government with finite resources had better______.
选项
A、balance its budget for research into cures and that into therapies that can help people live healthier and happier lives
B、stop paying for medical care that sustains life beyond age 83 so that younger and healthier people can realize their potential
C、make it a rule that people in industry, academia and government who are over 55 should retire
D、spend less on health and more on housing, defense and education
答案
A
解析
题目考查“政府的有限资源应该怎样分配”。最后一段倒数第二句:This is preciseIy the crisis of contemporary medicine:billions for cures,and pennies for care.通过这句话可知,政府在“cures”和“care”的花费上应该平衡一下,不能偏向于哪一边,即正确答案为A。其余选项在文中没有确切的表示。
转载请注明原文地址:https://www.tihaiku.com/zcyy/4059117.html
相关试题推荐
Wouldyoupleasebringmesome______catalogues?Thesearetooold.A、modernB、fas
CaliforniansandNewEnglandersspeakthesamelanguageand_____bythesamefede
Anannouncementoffurthercutsingovernmentexpenditureis______.A、imminentB、
ModernlorehasitthatinEnglanddeathisimminent,inCanadainevitablea
YouhavejustcomebackfromCanadaandfoundamusicCDinyourluggagetha
YouhavejustcomebackfromCanadaandfoundamusicCDinyourluggagetha
Agoodmodernnewspaperisanextraordinarypieceofreading.Itisremarkab
Agoodmodernnewspaperisanextraordinarypieceofreading.Itisremarkab
Agoodmodernnewspaperisanextraordinarypieceofreading.Itisremarkab
Enragedbybeingtaxedwithoutbeinggivenrepresentation,NewEnglanderstipped
随机试题
Competitionmakeslosersaswellaswinners.Thisfactmakesasimplerulef
Intheearly1450sculturalchangeinEuropefueledagrowingneedforthera
JasonBraddockknewhehadtopayforhiscollegeeducation,sohewenttow
变更地籍测量的基本要求包括( )。A.一般采用解析法 B.暂不具备条件的可以
审慎合规地确定贷款资金在借款人账户的停留时间和金额是贷款自主支付的操作要点之一。
共用题干 PromisingResultsFromCancerStud
共用题干 患者女性,81岁,退休干部。冠心病住院治疗,住院前3天与护士们关系融
市场经济条件下,()不仅体现了企业经济效益的高低,而且表明企业竞争能力的大小,一
女性,25岁,新婚6天。突起寒战高热,体温39.6℃,伴尿频、尿急、尿痛。体检:
信贷档案是确定借贷双方法律关系和权利义务的重要凭证,是贷款管理情况的重要记录。(
最新回复
(
0
)