英語(yǔ)聽(tīng)力小短文走遍全世界30:即將來(lái)臨的醫(yī)保危機(jī)

英語(yǔ)聽(tīng)力原文：

Cripping health care bills, long emergency-room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily.

日益上漲的醫(yī)保費(fèi)用，急診室內(nèi)長(zhǎng)時(shí)間的等待，初級(jí)保健醫(yī)生的短缺，這些都只是患者日常面臨的一小部分問(wèn)題。

Primary care should be the backbone of any health care system. Countries with appropriate primary care resources score highly when it comes to health outcomes and cost. The U.S. takes the opposite approach by emphasizing the specialist rather than the primary care physician.

初級(jí)保健應(yīng)該是整個(gè)醫(yī)保制度的支柱。在談到健康狀況和醫(yī)療費(fèi)用時(shí)，初級(jí)保健資源完善的國(guó)家情況令人滿意。美國(guó)卻反其道而行，重視專門醫(yī)生而非初級(jí)保健醫(yī)生。

A recent study analyzed the providers who treat Medicare beneficiaries(老年醫(yī)保受惠人). The startling finding was that the average Medicate patient saw a total of seven doctors - two primary care physicians and five specialists - in a given year.

最近，一項(xiàng)研究對(duì)負(fù)責(zé)老年醫(yī)保受惠人的醫(yī)生進(jìn)行了調(diào)查分析。令人驚訝的發(fā)現(xiàn)是，每個(gè)受惠人每年平均看的醫(yī)生多達(dá)七位——兩個(gè)初級(jí)保健醫(yī)生和五個(gè)?？漆t(yī)生。

Contrary to popular belief, the more physicians taking care of you doesn't guarantee better care. Actually, increasing fragmentation of care results in a corresponding rise in cost and medical errors.

與人們普遍的想法相反，照顧你的醫(yī)生越多并不能證明醫(yī)療保健的效果越好。事實(shí)上，醫(yī)保越分散，醫(yī)療費(fèi)用會(huì)越高，醫(yī)療錯(cuò)誤也越多。

How did we let primary care slip so far? The key is how doctors are paid. Most physicians are paid whenever they perform a medical service. The more a physician does, regardless of quality or outcome, the better he's reimbursed(返還費(fèi)用). Moreover, the amount a physician receives leans heavily toward medical or surgical procedures.

為什么我們?nèi)绱瞬恢匾暢跫?jí)保健呢?問(wèn)題的關(guān)鍵在于醫(yī)生的收費(fèi)制度。大多數(shù)醫(yī)生，無(wú)論何時(shí)，只要他們給人看病就可以收取費(fèi)用。醫(yī)生出診的次數(shù)越多，無(wú)論醫(yī)療效果如何，他們獲得的費(fèi)用也會(huì)越多。另外，醫(yī)生在收費(fèi)時(shí)，在很大程度上是按看診過(guò)程或手術(shù)內(nèi)容進(jìn)行的。

A specialist who performs a procedure in a 30-minute visit can be paid three times more than a primary care physician using that same 30 minutes to discuss a patient's disease. Combine this fact with annual government threats to indiscriminately cut reimbursements, physicians are faced with no choice but to increase quantity to boost income.

一個(gè)專業(yè)醫(yī)生看診30分鐘收取的費(fèi)用是一個(gè)初級(jí)保健醫(yī)生同樣時(shí)間問(wèn)診費(fèi)用的3倍。考慮到以上原因，再加之政府每年隨意削減醫(yī)生診費(fèi)，醫(yī)生們別無(wú)他法，只能靠增加問(wèn)診次數(shù)來(lái)提高收入。

Primary care physicians who refuse to compromise quality are either driven out of business or to cash-only practices, further contributing to the decline of primary care.

不愿只求數(shù)量而忽視醫(yī)療效果的初級(jí)保健醫(yī)生或者關(guān)門歇業(yè)，或者棄醫(yī)從商，使初級(jí)保健的狀況進(jìn)一步惡化。

Medical students aren't blind to this scenario. They see how heavily the reimbursement deck is stacked against primary care. The recent numbers show that since 1997, newly graduated U.S. medical students who choose primary care as a career have declined by 50%. This trend results in emergency rooms being overwhelmed with patients without regular doctors.

醫(yī)科專業(yè)的學(xué)生并非沒(méi)有意識(shí)到這一情況，他們認(rèn)識(shí)到費(fèi)用返還制度對(duì)初級(jí)醫(yī)保極其不利。最近的數(shù)據(jù)顯示，自1997年以來(lái)，美國(guó)醫(yī)科畢業(yè)生選擇初級(jí)保健作為職業(yè)的人數(shù)已下降50%。這一趨勢(shì)導(dǎo)致急診室內(nèi)人滿為患，醫(yī)生短缺。

英語(yǔ)詞匯整理：

1. emergency - room 急癥室

eg: The emergency room was in disorder.

急診室里一片混亂。

同近義詞：

1)casualty n. 急診室

eg: They rushed her to casualty but she was dead on arrival.

他們趕緊把她送往急診室,但她被送到時(shí)已死亡。

短語(yǔ)：

casualty of (某事的)受害者

rush to casualty 送往急診室

2)emergency department n. 急診室

eg: The nearest Accident Emergency Department to the Chinese University is the Prince of Wales Hospital.

最接近中文大學(xué)之急癥室位于沙田威爾斯親王醫(yī)院。

2. primary adj. 主要的

eg: The primary task for socialism is to develop the productive forces.

社會(huì)主義的首要任務(wù)是發(fā)展社會(huì)生產(chǎn)力。

短語(yǔ)：

primary education 初等教育

primary evidence 基本證據(jù)

primary importance 頭等重要

primary school 小學(xué)

詞語(yǔ)用法：

1)primary的基本意思是“首要的,主要的,基本的”,形容在進(jìn)展順序上占首位,也指在重要性方面占主導(dǎo)地位,也可表示“最初的,初級(jí)的”。

2)primary不用于比較等級(jí),在句中只用作定語(yǔ)。

3. physician n. 醫(yī)師

eg: He is a prominent physician.

他是位著名的內(nèi)科醫(yī)生。

短語(yǔ)：

physician in charge 主治醫(yī)生

physician to the king 御醫(yī)

army physician 軍醫(yī)

visiting physician 出診醫(yī)生

詞義解析：

physician, doctor, surgeon

這組詞都可指“醫(yī)生”。doctor為普通用語(yǔ),泛指以看病為職業(yè)的各科醫(yī)生;physician主要指內(nèi)科醫(yī)生,也可指一般醫(yī)生,詞義莊重,在美式英語(yǔ)中較常用;surgeon指外科醫(yī)生。

4. scratch v. 抓;挖出

eg: That cat has scratched up all my young plants again!

那只貓又把我種的那些幼苗給扒出來(lái)了!

短語(yǔ)：

scratch about 扒,刨

scratch away 抓;刮

scratch from 從……中除名

scratch out 刮掉;劃去;勉強(qiáng)維持

scratch up 掘起,挖出

from scratch 白手起家;從頭做起

start from scratch 從頭開(kāi)始;白手起家

up to scratch 達(dá)到標(biāo)準(zhǔn)

without a scratch 安然無(wú)恙

on scratch 準(zhǔn)時(shí)，正點(diǎn)

scratch for oneself [美國(guó)口語(yǔ)]關(guān)心自身利益

5. backbone n. 骨干

eg: These men are the backbone of the country.

這些人是國(guó)家的中堅(jiān)力量。

短語(yǔ)：

to the backbone 徹底地，完完全全地，地地道道

backbone road 干道

backbone chain 主鏈

6. startling adj. 令人吃驚的

eg: The results were quite startling -- a 77% increase in six month.

結(jié)果非常令人吃驚--六個(gè)月增長(zhǎng)百分之七十七。

短語(yǔ)：

startling news 爆炸性新聞

startling effect 令人驚訝的效果;驚人效應(yīng)

7. given adj. 給定的，約定的

eg: You have to finish the work within the given time.

你們必須在規(guī)定時(shí)間內(nèi)完成這項(xiàng)工作。

短語(yǔ)：

given time 給定時(shí)間

given name 教名;名字

given value 給定值，已知值

given price 已知價(jià)格

be given to 有……癖好;傾向于

8. guarantee v. 確保

eg: Surplus resources alone do not guarantee growth.

僅有富足的資源并不能確保發(fā)展。

短語(yǔ)：

guarantee from 保證不

guarantee against 保證不……

bank guarantee 銀行擔(dān)保

legal guarantee 法律保證，法律擔(dān)保

letter of guarantee 保證書(shū)

9. fragmentation n. 分裂，破碎

eg: The fragmentation of society has been lamented for some time.

人們對(duì)社會(huì)分裂感到悲哀已有較長(zhǎng)一段時(shí)間了。

短語(yǔ)：

Sleep fragmentation 睡眠片斷化;睡眠斷斷續(xù)續(xù)

fragmentation bomb 碎裂彈

thermal fragmentation 熱裂

fragmentation test 碎片試驗(yàn)

10. corresponding adj. 一致的，相應(yīng)的

eg: All rights carry with them corresponding responsibilities.

一切權(quán)利都帶有與之相應(yīng)的責(zé)任。

短語(yǔ)：

corresponding to 與……一致的

corresponding period 同期

11. regardless of 不管，無(wú)論

eg: All our proposals were rejected, regardless of their merits.

我們所有的建議都遭到拒絕，不管這些建議的價(jià)值如何。

短語(yǔ)：

regardless of whether 不管不顧

regardless of the elements 風(fēng)雨不改

regardless of source 不論來(lái)源

regardless of my business 不關(guān)我的事

12. reimburse v. 償還，補(bǔ)償

eg: The company will reimburse you for travel expenses.

公司會(huì)為你報(bào)銷差旅費(fèi)。

短語(yǔ)：

reimburse expenses 賠償開(kāi)支

reimburse for 為......

13. indiscriminately adv.不加區(qū)別的，不加選擇的

eg: Investors dumped emerging market assets more or less indiscriminately in may and june.

今年5月份和6月份，投資者多少有些不加選擇地拋售新興市場(chǎng)資產(chǎn)。

短語(yǔ)：

bomb indiscriminately 狂轟濫炸

arrest indiscriminately 濫捕

14. reimbursement n. 退還

eg: Tell me what you have spent and I will reimburse you.

告訴我你花了哪些費(fèi)用，以便我還給你。

短語(yǔ)：

tax reimbursement 退稅

apply for reimbursement 報(bào)銷

15. scenario n. 事態(tài)

eg: What's your worst-case scenario for Asia?

你認(rèn)為在亞洲可能發(fā)生的最惡劣情形會(huì)是怎樣?

短語(yǔ)：

scenario analysis 情境分析;場(chǎng)景分析

scenario planning 情景規(guī)劃

usage scenario 使用場(chǎng)景

16. overwhelm v. 覆蓋，征服

eg: Flood overwhelmed the city.

洪水淹沒(méi)了那座城市。

短語(yǔ)：

overwhelm by 以…壓倒…

overwhelm with 被……壓倒;由于…使某人對(duì)…不知所措

佳句采摘：

Primary care physicians who refuse to compromise quality are either driven out of business or to cash-only practices, further contributing to the decline of primary care.

不愿只求數(shù)量而忽視醫(yī)療效果的初級(jí)保健醫(yī)生或者關(guān)門歇業(yè)，或者棄醫(yī)從商，使初級(jí)保健的狀況進(jìn)一步惡化