Passage One
Questions 52 to 56 are based on the following passage.
There is nothing like the suggestion of a cancer risk to scare a parent, especially one of the over-educated, eco-conscious type. So you can imagine the reaction when a recent USA Today investigation of air quality around the nation’s schools singled out those in the smugly（自鸣得意的）green village of Berkeley, Calif., as being among the worst in the country. The city’s public high school, as well as a number of daycare centers, preschools, elementary and middle schools, fell in the lowest 10%. Industrial pollution in our town had supposedly turned students into living science experiments breathing in a laboratory’s worth of heavy metals like manganese, chromium and nickel each day. This in a city that requires school cafeterias to serve organic meals. Great, I thought, organic lunch, toxic campus.
Since December, when the report came out, the mayor, neighborhood activists（活跃分子）and various parent-teacher associations have engaged in a fierce battle over its validity: over the guilt of the steel-casting factory on the western edge of town, over union jobs versus children’s health and over what, if anything, ought to be done. With all sides presenting their own experts armed with conflicting scientific studies, whom should parents believe? Is there truly a threat here, we asked one another as we dropped off our kids, and if so, how great is it? And how does it compare with the other, seemingly perpetual health scares we confront, like panic over lead in synthetic athletic fields? Rather than just another weird episode in the town that brought you protesting environmentalists, this latest drama is a trial for how today’s parents perceive risk, how we try to keep our kids safe—whether it’s possible to keep them safe—in what feels like an increasingly threatening world. It raises the question of what, in our time, “safe” could even mean.
“There’s no way around the uncertainty,” says Kimberly Thompson, president of Kid Risk, a nonprofit group that studies children’s health. “That means your choices can matter, but it also means you aren’t going to know if they do.” A 2004 report in the journal Pediatrics explained that nervous parents have more to fear from fire, car accidents and drowning than from toxic chemical exposure. To which I say: Well, obviously. But such concrete hazards are beside the point. It’s the dangers parents can’t—and may never—quantify that occur all of sudden. That’s why I’ve rid my cupboard of microwave food packed in bags coated with a potential cancer-causing substance, but although I’ve lived blocks from a major fault line(地质断层) for more than 12 years, I still haven’t bolted our bookcases to the living room wall.
52. What does a recent investigation by USA Today reveal?
A) Heavy metals in lab tests threaten children’s health in Berkeley.
B) Berkeley residents are quite contented with their surroundings.
C) The air quality around Berkeley’s school campuses is poor.
D) Parents in Berkeley are over-sensitive to cancer risks their kids face.
53. What response did USA Today’s report draw?
A) A heated debate.
B) Popular support.
C) Widespread panic.
D) Strong criticism.
54. How did parents feel in the face of the experts’ studies?
A) They felt very much relieved.
B) They were frightened by the evidence.
C) They didn’t know who to believe.
D) They weren’t convinced of the results.
55. What is the view of the 2004 report in the journal Pediatrics?
A) It is important to quantify various concrete hazards.
B) Daily accidents pose a more serious threat to children.
C) Parents should be aware of children’s health hazards.
D) Attention should be paid to toxic chemical exposure.
56. Of the dangers in everyday life, the author thinks that people have most to fear from __________.
A) the uncertain
B) the quantifiable
C) an earthquake
D) unhealthy food
Passage Two
Questions 57 to 61 are based on the following passage.
Crippling 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.
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.
A recent study analyzed the providers who treat Medicare beneficiaries（老年医保受惠人）. The startling finding was that the average Medicare patient saw a total of seven doctors—two primary care physicians and five specialists—in a given year. Contrary to popular belief, the more physicians taking care of you don’t guarantee better care. Actually, increasing fragmentation of care results in a corresponding rise in cost and medical errors.
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 (返还费用). Moreover, the amount a physician receives leans heavily toward medical or surgical procedures. 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.
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.
Medical students are not 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.
How do we fix this problem?
It starts with reforming the physician reimbursement system. Remove the pressure for primary care physicians to squeeze in more patients per hour, and reward them for optimally (最佳地) managing their diseases and practicing evidence-based medicine. Make primary care more attractive to medical students by forgiving student loans for those who choose primary care as a career and reconciling the marked difference between specialist and primary care physician salaries.
We’re at a point where primary care is needed more than ever. Within a few years, the first wave of the 76 million Baby Boomers will become eligible for Medicare. Patients older than 85, who need chronic care most, will rise by 50% this decade.
Who will be there to treat them?
57. The author’s chief concern about the current U.S. health care system is __________.
A) the inadequate training of physicians
B) the declining number of doctors
C) the shrinking primary care resources
D) the ever-rising health care costs
58. We learn from the passage that people tend to believe that __________.
A) the more costly the medicine, the more effective the cure
B) seeing more doctors may result in more diagnostic errors
C) visiting doctors on a regular basis ensures good health
D) the more doctors taking care of a patient, the better
