Shortage of Primary Care Threatens Health Care System
Increasing 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 support 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. The surprising finding was that the average Medicate 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 doesn't guarantee better care. Actually, increasing fragmentation of care results in a corresponding rise in cost and medical errors.
How did we take little care of primary care? 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. 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 randomly 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 aren't blind to this action. They know how heavily the reimbursement is 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 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?
1.The author’s chief concern about the current U.S. health care system is _________.
A.the ever-rising health care costs B.the declining number of doctors
C.the inadequate training of physicians D.the shrinking primary care resources
2.We learn from the passage that people tend to believe that _________.
A.the more doctors taking care of a patient, the better
B.visiting doctors on a regular basis ensures good health
C.seeing more doctors may result in more diagnostic errors
D.the more costly the medicine, the more effective the cure.
3.Faced with the government threats to cut reimbursements randomly, primary care physicians have to __________.
A.make various deals with specialists B.improve their expertise and service
C.see more patients at the expense of quality D.increase their income by working overtime
4.What suggestion does the author give in order to provide better health care?
A.Extend primary care to patients with chronic diseases.
B.Recruit more medical students by offering them loans.
C.Reduce the tuition of students who choose primary care as their major.
D.Bridge the salary gap between specialists and primary care physicians.
A young man was getting ready to graduate from college. For many months he had admired a beautiful sports car in a dealer’s showroom, and knowing his father could well afford it, he told him that was all he wanted.
As Graduation Day approached, the young man awaited signs that his father had purchased the car. Finally, on the morning of his graduation, his father called him into his private study. His father told him how proud he was to have such a fine son, and told him how much he loved him. He handed his son a beautiful wrapped gift box. Curious, but somewhat frustrated, the young man opened the box and found a lovely, leather-bound Bible, with the young man’s name embossed in gold. Angrily, he raised his voice to his father and said, “With all your money you give me a Bible?” He then stormed out of the house, leaving the Bible.
Many years passed and the young man was very successful in business. He had a beautiful home and a wonderful family, but realizing his father was very old, he thought perhaps he should go to see him. He had not seen him since that graduation day. Before he could make the arrangements, he received a telegram telling him his father had passed away, and willed all of his possessions to his son. He needed to come home immediately and take care of things.
When he arrived at his father’s house, sudden sadness and regret filled his heart. He began to search through his father’s important papers and saw the still new Bible, just as he had left it years ago. With tears, he opened the Bible and began to turn the pages. As he was reading, a car key dropped from the back of the Bible. It had a tag with the dealer’s name, the same dealer who had the sports car he had desired. On the tag was the date of his graduation, and the words… “PAID IN FULL”.
How many times do we miss blessings because they are not packaged as we expected? Do not spoil what you have by desiring what you have not; but remember that what you now have was once among the things you only hoped for.
Sometimes we don’t realize the good fortune we have or we could have because we expect “the packaging” to be different. What may appear as bad fortune may in fact be the door that is just waiting to be opened.
1.What’s the best title for this passage?
A.A Kind Father. B.A Key of a Car.
C.A leather-bound Bible. D.An Unforgettable Graduation Ceremony.
2.What does the underlined word “frustrated” in Paragraph 2 probably mean?
A.Disappointed. B.Unconcerned. C.Puzzled. D.Bored.
3.What does the last paragraph want to tell us?
A.There is no fence for ill fortune.
B.Good fortune favors the brave and courageous.
C.We must not look only at the surface of things.
D.A strong man will struggle with the storms of fate.
4.From the passage, we can learn that _________.
A.the young man accepted the gift at first
B.the young man regretted what he’d done to his father
C.the young man accompanied his father for a long time
D.the young man was successful in business with the help of his father
More than half the young children and teenagers in China are nearsighted, according to a survey by top government agencies, which called for intensified efforts to prevent and control the condition.
The survey, which was conducted last year, found that eight of 10 senior middle school students were nearsighted, compared with 71.6 percent in junior middle school, 36 percent in primary school and 14 percent of 6-year-olds in kindergarten. Overall, 53.6 percent were nearsighted. The prevalence (流行程度) of a high degree of myopia also became alarming as the percentage of senior students in high school, who wear glasses stronger than six diopters, has mounted to 21.9 percent. Up to 80 percent of the country’s young adults suffer from nearsightedness, according to a report in the medical journal Lancet. In contrast, the overall rate of myopia in the UK is about 20-30 percent. If you walk the streets of China today, you’ll quickly notice that most young people wear glasses. In Shanghai, for instance, 86 percent of high school students suffer from myopia, or nearsightedness, according to Xinhua News Agency.
The growing prevalence of myopia is not only a Chinese problem, but it is an especially East Asian one. According to a study published in The Lancet medical journal in 2012, by Ian Morgan, of the Australian National University, South Korea leads the pack, with 96 percent of young adults (below the age 20) having myopia; and the rate for Seoul is even higher. In Singapore, the figure is 82 percent. To say that Asia is having an eye problem is an understatement.
Several factors are associated with the high rate of nearsightedness in China's children and teenagers, including lack of outdoor physical activity, lack of adequate sleep due to heavy work and excessive use of electronics products. And some biologists compared Singaporeans living in Singapore to those living in Australia. They found that 29 percent of the Singaporean students had myopia compared with just 3 percent in Sydney. The main correlation was once again, time spent outside.
“The big difference was the Chinese children in Australia were outdoors a lot more than their matched peers in Singapore,” says Ian Morgan, a retired biologist at Australian National University, who coauthored the 2008 study. “This was the only thing that fit with the huge difference in prevalence.”
1.From paragraph 2, according to the survey we can know that ____________.
A.the rate of myopia in Shanghai is the highest
B.the rate of myopia in the UK is higher than that in China
C.the rate of junior middle school students who suffer from myopia is the highest
D.the rate of senior middle school students who suffer from myopia is the highest
2.Which of the following is not the reason associated with the high rate of myopia in China?
A.Time of reading books. B.Lack of adequate sleep.
C.Lack of outdoor physical activity. D.Excessive use of electronics products.
3.The author writes the passage to __________.
A.introduce some methods to protect our eyes
B.tell us why so many people have an eye problem
C.compare the myopia figures of different countries
D.call on everyone to pay attention to the myopia among the young people
4.Where is the passage most probably from?
A.A literary essay. B.A historical novel.
C.A science report. D.A travel magazine.
Many people want to travel around the world and enjoy new cultures, especially the different festivals. There are festivals going on somewhere in the world every day of the year. These range from very large events which involve whole cities to local celebrations in tiny villages or neighborhoods of towns or cities. We have selected a few of the more unusual, colorful festivals from around the world. You can choose anyone you like best!
The Million Ringgit Charity Duck Race: Kuala Lumpur, Malaysia
Thirteen years ago, Eric Schechter and his friends were brainstorming to find new ways of raising money for local charities when they came up with the idea of rubber duck races. The event, crazy as it may sound, involves racing "cool" rubber ducks down a local waterway and having members of the community "adopt" the ducks for a chance to win valuable donated prizes, possibly even $1 million bucks.
La Tomatina: Bunol, Spain
"The tomato battle is in honor of Saint Luis Beltran, the patron saint of Bunol. Residents and visitors take part in a tomato-throwing battle that decimates more than 88,000 pounds of tomatoes. This crazy event began with a serious aim as a symbolic protest against Franco. But the Tomatina is now celebrated as an amusing way to end the summer."
Mighty Mud Mania: Scottsdale, Arizona, USA
"Children's dreams really do come true in the City of Scottsdale. Children aged 1 to 13, get to participate in a mud race to end all mud races. During the running of the Mighty Mud Obstacle(泥坑) course, several mud pits strategically placed, provide wet and really dirty obstacles as kids compete for the fastest time in each heat. There are also mud puddle pools for the tiny tots, and a mini mud course for those six and younger. In addition, Mighty Mudway features water and mud games. There are also water slides, sandcastle buildings and fun for all ages. Moms and dads, remember to send your kids out with old clothes and shoes. And have no fear, Rural Metro Fire Department is on hand to offer plenty of water for the muddy children."
Canberra Sled Dog Classic: Canberra, Australian Capital Territory, Australia
Dog sledding is one of the fastest growing sports on the east coast of Australia. As there's no snow (the trail is earth and sand and is smooth and wide with a few hills and turns), the sleds have wheels instead of runners, but the excitement is the same.
1.Which of the following means the summer is over?
A.Mighty Mud Mania. B.La Tomatina.
C.Canberra Sled Dog Classic. D.The Million Ringgit Charity Duck Race.
2.What can you enjoy in all the four festivals mentioned?
A.Fantastic activities. B.Beautiful beaches.
C.Delicious food. D.Amazing sceneries.
3.The main purpose of the passage is to _______.
A.share personal experiences B.compare cultures in different countries
C.introduce favorable festivals D.offer practical tips on choosing activities
On Friday afternoon Class Seven had an Art lesson. It was their favourite lesson of the week. Everyone ______ Trudy Hubble looked forward to it. Trudy had arms that stuck out and always knocked things over.
When Trudy came into the classroom, Rob Mason said, “Look out, here comes Trouble!” All the kids ______. Trudy had to smile and pretended she didn’t mind. How she wished she could be more like Lisa Gibbs, who had small hands and feet and never ______ things over!
That day, they were going to paint animals. Again, Trudy knocked over the jam jar. Dirty water spread in a pool across the table and ______ Lisa’s dragon. Every time Trudy tried to do Art, it was always a ______.
“I hate Art,” Trudy thought as she went home on the bus, wishing never to go to school again.
As soon as she got home, Mum asked her to take a ______ to Mrs. Willow.
Trudy knocked on the door and the door opened. There stood an old lady, so tall and elegant, like her house, which was full of ______ china.
“My mum’s your home help. She won’t be able to come tomorrow. She’s got a cold.”
“I’m sorry to hear that. What she needs is my special cold ______. Come inside and I’ll give you some. ” Mrs. Willow opened the door wider.
Keeping her arms pressed to her sides, Trudy stood ______, much like a statue, afraid to move in.
“Why?”
“I am the clumsiest person in our school! I know something will get broken when I’m ______.”
“I used to be clumsy too, a real ugly little duck,” Mrs. Willow smiled. “But I grew up to be a swan(白天鹅).”
“But I don't think I shall,” Trudy doubted. “I’ll just grow up to be an ugly ______.”
“Not if you do as I did. You have to keep telling yourself that inside, where it matters, you’re really a swan.”
“I’m a swan,” Trudy ______ her throat and took the medicine, heading for home.
Next morning Mum’s cold was much better. “If Mrs. Willow’s cold cure is a kind of ______, then her swan cure must work as well.” Trudy couldn’t wait to try it out.
In the school playground some children stood looking up into the chestnut tree. Lisa was in tears.
“What’s the matter?” asked Trudy.
“It’s my kite,” Lisa said, wiping her eyes. “Rob let go and it’s got ______ up the tree.”
“I’ll get it down for you,” Trudy said kindly.
“No, you’ll tear it!” Lisa looked ______. “It’s a special Chinese kite! I got it for my birthday.”
For a moment Trudy felt like her old ______ self. But then she remembered what Mrs. Willow had said. It didn't matter how she looked outside. Inside, she was really a swan.
She jumped up and grabbed the lowest ______ and began to climb. “Swans never rush,” she told herself. It took her ages, but she didn't rush. At last she managed to ______ the kite. But now she had to climb down again using only one hand. Very, very ______ she swung herself down to the ground. The kite was safe!
“Thanks, Trudy.” Lisa showed it to the others. “Look, it’s all right!”
Trudy felt very, very proud and different. Smiling at everyone, she walked swan-like across the playground and into school, so tall and ______.
1.A.except B.besides C.including D.behind
2.A.danced B.sang C.laughed D.jumped
3.A.took B.turned C.rolled D.tripped
4.A.drew B.drowned C.marked D.colored
5.A.success B.masterpiece C.failure D.disaster
6.A.gift B.textbook C.message D.letter
7.A.delicate B.ugly C.cheap D.messy
8.A.care B.leave C.concern D.cure
9.A.straight B.still C.by D.tall
10.A.around B.apart C.ahead D.away
11.A.dragon B.swan C.tiger D.duck
12.A.touched B.cleaned C.cleared D.wiped
13.A.imagination B.magic C.cheating D.creation
14.A.stuck B.crashed C.torn D.damped
15.A.satisfied B.disappointed C.frightened D.delighted
16.A.beautiful B.clumsy C.dishonest D.smart
17.A.root B.trunk C.branch D.leaf
18.A.fly B.design C.make D.free
19.A.carefully B.doubtfully C.confidently D.anxiously
20.A.eager B.elegant C.enthusiastic D.energetic
阅读下列短文，根据短文内容填空。在未给提示词的空白处仅填写一个适当的词，在给出提示词的空白处用括号内所给词的正确形式填空。
A week before Earth Day, posters1. (put) up around our school, calling upon us to join in the actions for a greener earth.
Our class came up with the idea2. (make) better use of used materials. We brought to our classroom worn-out clothes, pieces of cardboard and empty plastic bottles and turned those into dolls, handbags, tissue boxes and small vases. That weekend, we went to a nearby neighbourhood and gave them away to the people there. All were very happy with those 3. (expect) gifts, especially little kids and elderly people. We did so well that we were invited to share our ideas and experience with all the students of our school.
We are very proud of 4. (we) and believe we can do more for a better world.
