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Most people would be impressed by the high quality of medicine available to most Americans. There is a lot of specialization, a great deal of attention to the individual, a vast amount of advanced technical equipment, and intense effort not to make mistakes because of the financial risk which doctors and hospitals must face in the courts if they handle things badly. But the Americans are in a mess. The problem is the way in which health care is organized and financed. Contrary to public belief, it is not just a free competition system. To the private system has been joined a large public system, because private care was simply not looking after the less fortunate and the elderly. But even with this huge public part of the system, which this year will eat up 84.5 billion dollars—more than 10 percent of the U.S. budget—large numbers of Americans are left out. These include about half the 11 million unemployed and those who fail to meet the strict limits on income fixed by a government trying to make savings where it can. The basic problem, however, is that there is no central control over the health system. There is no limit to what doctors and hospitals charge for their services, other than what the public is able to pay. The number of doctors has shot up and prices have climbed. When faced with toothache, a sick child, or a heart attack, all the unfortunate person concerned can do is pay up. Two-thirds of the population are covered by medical insurance. Doctors charge as much as they want knowing that the insurance company will pay the bill. The medical profession has as a result become America’s new big businessmen. The average income of doctors has now reached $100,000 a year. With such vast incomes the talk in the doctor’s surgery is as likely to be about the doctor’s latest financial deal, as about whether the minor operation he is recommending at several thousand dollars is entirely necessary. The rising cost of medicine in the U.S.A. is among the most worrying problem facing the country. In 1981 the country’s health cost climbed 15.9 percent—about twice as fast as prices in general. According to the author, what is the key factor in the rise of health cost in the U.S.
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Although interior design has existed since the beginning of architecture, its development into a specialized field is really quite recent. Interior designers have become important partly because of the many functions that might be (61) in a single large building. The importance of interior design becomes (62) when we realize how much time we (63) surrounded by four walls. Whenever we need to be indoors, we want our surroundings to be (64) attractive and comfortable as possible. We also expect (65) place to be appropriate to its use. You would be (66) if the inside of your bedroom were suddenly changed to look (67) the inside of a restaurant. And you wouldn’t feel (68) in a business office that has the appearance of a school. It soon becomes clear that the interior designer’s most important (69) is the function of the particular (70) . For example, a theater with poor sight lines, poor sound-shaping qualities, and (71) few entries and exits will not work for (72) purpose, no matter how beautifully it might be (73) . Nevertheless, it is not easy to make suitable (74) for different kinds of space, lighting and decoration of everything from ceiling to floor. (75) addition, the designer must usually select furniture or design built-in furniture according to the functions that need to be served.
There is no question that the old style of air pollution could kill people. In one week following the infamous "peasouper" fog in December 1952,4,700 people died in London. Most of these people were elderly and already had heart or lung diseases. A series of these killer fogs eventually led to the British Parliament passing the Clean Air Act which restricted the burning of coal. Fortunately the effect of smog on the lungs is not so dramatic. Scientists have now conducted a number of laboratory experiments in which volunteers are exposed to ozone inside a steel chamber for a few hours. Even at quite low concentrations there is a reversible fall in lung function, an increase in the irritability of the lungs and evidence of airway inflammation. Although irritable and inflamed lungs are particularly seen in people with asthma (哮喘) and other lung diseases, these effects of ozone also occur in healthy subjects. Similar changes are also seen after exposure to nitrogen dioxide, although there is some disagreement about the concentration at which they occur. Other studies have found that people living in areas with high levels of pollution have more symptoms and worse lung function than those living in areas with clean air. Groups of children attending school camps show falls in lung function even at quite low concentrations of ozone. There is also a relationship between ozone levels and hospital admissions for asthma, both in North America and Australia. It is suspected that long-term exposure to smog may result in chronic bronchitis (支气管炎) and emphysema (肺气肿), but this has yet to be proven. Recently an association has been found between the levels of particles in the air and death rates in North American cities. The reason for this association is not understood and as yet there is no evidence this occurs in Australia. However, we do know that hazy days are associated with more asthma attacks in children. Which of the following is NOT mentioned as a possible cause of lung diseases
We sometimes think humans are uniquely vulnerable to anxiety, but stress seems to affect the immune defenses of lower animals too. In one experiment, for example, behavioral immunologist ( 免疫学家) Mark Laudenslager, at the University of Denver, gave mild electric shocks to 24 rats. Half the animals could switch off the current by turning a wheel in their enclosure, while the other half could not. The rats in the two groups were paired so that each time one rat turned the wheel it protected both itself and its helpless partner from the shock. Laudenslager found that the immune response was depressed below normal in the helpless rats but not in those that could turn off the electricity. What he has demonstrated, he believes, is that lack of control over an event, not the experience itself, is what wakens the immune system. Other researchers agree. Jay Weiss, a psychologist at Duke University School of Medicine, has shown that animals who are allowed to control unpleasant stimuli don’t develop sleep disturbances or changes in brain chemistry typical of stressed rats. But if the animals are conditioned to confront with situations they have no control over, they later behave passively even when faced with experiences they can control. Such findings reinforce psychologists’ suspicions that the experience or perception of helplessness is one of the most harmful factors in depression. One of the most startling examples of how the mind can alter the immune response was discovered by chance. In 1975 psychologist Robert Ader at the University of Rochester School of Medicine conditioned (使形成条件反射) mice to avoid saccharin (糖精) by simultaneously feeding them the sweetener and injecting them with a drug that while suppressing their immune systems caused stomach upsets. Associating the saccharin with the stomach pains, the mice quickly learned to avoid the sweetener. In order to extinguish this dislike for the sweetener, Ader reexposed the animals to saccharin, this time without the drug, and was astonished to find that those mice that had received the highest amounts of sweetener during their earlier conditioning died. He could only speculate that he had so successfully conditioned the rats that saccharin alone now served to weaken their immune systems enough to kill them. The passage tells us that the most probable reason for the death of the mice in Ader’s experiment was that______.
Most people would be impressed by the high quality of medicine available to most Americans. There is a lot of specialization, a great deal of attention to the individual, a vast amount of advanced technical equipment, and intense effort not to make mistakes because of the financial risk which doctors and hospitals must face in the courts if they handle things badly. But the Americans are in a mess. The problem is the way in which health care is organized and financed. Contrary to public belief, it is not just a free competition system. To the private system has been joined a large public system, because private care was simply not looking after the less fortunate and the elderly. But even with this huge public part of the system, which this year will eat up 84.5 billion dollars—more than 10 percent of the U.S. budget—large numbers of Americans are left out. These include about half the 11 million unemployed and those who fail to meet the strict limits on income fixed by a government trying to make savings where it can. The basic problem, however, is that there is no central control over the health system. There is no limit to what doctors and hospitals charge for their services, other than what the public is able to pay. The number of doctors has shot up and prices have climbed. When faced with toothache, a sick child, or a heart attack, all the unfortunate person concerned can do is pay up. Two-thirds of the population are covered by medical insurance. Doctors charge as much as they want knowing that the insurance company will pay the bill. The medical profession has as a result become America’s new big businessmen. The average income of doctors has now reached $100,000 a year. With such vast incomes the talk in the doctor’s surgery is as likely to be about the doctor’s latest financial deal, as about whether the minor operation he is recommending at several thousand dollars is entirely necessary. The rising cost of medicine in the U.S.A. is among the most worrying problem facing the country. In 1981 the country’s health cost climbed 15.9 percent—about twice as fast as prices in general. In the U.S. patients can expect, in medical treatment, ______.
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