In the following article, some sentences have been removed. For Questions 41--45, choose the most suitable one from the list A--G to fit into each of the numbered blank. There are two extra choices, which do not fit in any of the gaps. Mark your answers on ANSWER SHEET 1. (10 points)
Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, together, to reduce health-care costs.
They’re all groaning about soaring health budgets, the fastest-growing component of which are pharmaceutical costs.
41.
What to do? Both the Romanow commission and the Kirby committee on health care—to say nothing of reports from other experts—recommended the creation of a national drug agency. Instead of each province having its own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.
42.
But “national” doesn’t have to mean that. “National” could mean interprovincial—provinces combining efforts to create one body.
Either way, one benefit of a “national” organization would be to negotiate better prices, if possible, with drug manufacturers. Instead of having one province—or a series of hospitals within a province—negotiate a price for a given drug on the provincial list, the national agency would negotiate on behalf of all provinces.
Rather than, say, Quebec, negotiating on behalf of seven million people, the national agency would negotiate on behalf of 31 million people. Basic economics suggests the greater the potential consumers, the higher the likelihood of a better price.
43.
A small step has been taken in the direction of a national agency with the creation of the Canadian Co-ordinating Office for Health Technology Assessment, funded by Ottawa and the provinces. Under it, a Common Drug Review recommends to provincial lists which new drugs should be included. Predictably, and regrettably, Quebec refused to join.
A few premiers are suspicious of any federal-provincial deal-making. They (particularly Quebec and Alberta) just want Ottawa to fork over additional billions with few, if any, strings attached. That’s one reason why the idea of a national list hasn’t gone anywhere, while drug costs keep rising fast.
44.
Premiers love to quote Mr. Romanow’s report selectively, especially the parts about more federal money. Perhaps they should read what he had to say about drugs.
“A national drug agency would provide governments more influence on pharmaceutical companies in order to try to constrain the ever-increasing cost of drugs.”
45.
So when the premiers gather in Niagara Falls to assemble their usual complaint list, they should also get cracking about something in their jurisdiction that would help their budgets and patients.
A. Quebec’s resistance to a national agency is provincialist ideology. One of the first advocates for a national list was a researcher at Laval University. Quebec’s Drug Insurance Fund has seen its costs skyrocket with annual increases from 14.3 per cent to 26.8 per cent!
B. Or they could read Mr. Kirby’s report: ‘The substantial buying power of such an agency would strengthen the public prescription-drug insurance plans to negotiate the lowest possible purchase prices from drug companies.”
C. What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council.
D. The problem is simple and stark: health-care costs have been, are, and will continue to increase faster than government revenues.
E. According to the Canadian Institute for Health Information, prescription drug costs have risen since 1997 at twice the rate of overall health-care spending. Part of the increase comes from drugs being used to replace other kinds of treatments. Part of it arises from new drugs costing more than older kinds. Part of it is higher prices.
F. So, if the provinces want to run the health-care show, they should prove they can run it, starting with an interprovincial health list that would end duplication, save administrative costs, prevent one province from being played off against another, and bargain for better drug prices.
G. Of course, the pharmaceutical companies will scream. They like divided buyers, they can lobby better that way. They can use the threat of removing jobs from one province to another. They can hope that, if one province includes a drug on its list, the pressure will cause others to include it on theirs. They wouldn’t like a national agency, but self-interest would lead them to deal with it.
41. ［Ｅ］ According to the Canadian Institute for Health Information, prescription drug costs have risen since 1997 at twice the rate of overall health-care spending. Part of the increase comes from drugs being used to replace other kinds of treatment. Part of it arises from new drugs costing more than older kinds. Part of it is higher prices. (本題可從三個(gè)角度來(lái)推測(cè)。其一，從篇章重要話題的一致性角度來(lái)看，只有把本選項(xiàng)填入全文的第3語(yǔ)段，才能與原文第1語(yǔ)段的“costs”構(gòu)成一致性。其二，從第2語(yǔ)段與第3語(yǔ)段的一致性看，第2語(yǔ)段最后談?wù)摿怂幤烦杀荆╬harmaceutical costs），而第3語(yǔ)段（選項(xiàng)E）話題為藥品的成本增加，符合一致性的原則。其三，選項(xiàng)中的“drug costs”、“spending”、“increase”、“prices”等概念與語(yǔ)段2的“budgets”、“growing”、“pharmaceutical”、“costs”構(gòu)成了較佳的一致性與連貫性。至少?gòu)囊陨先齻�(gè)角度來(lái)看，本選項(xiàng)為第3語(yǔ)段的最佳選擇。)
42. ［Ｃ］ What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council. (本語(yǔ)段的選擇是相對(duì)容易的題目。本題可從三個(gè)角度來(lái)推測(cè)。其一，從語(yǔ)段4和語(yǔ)段6的上下文一致性來(lái)看。這些語(yǔ)段之間主要談?wù)摰脑掝}是關(guān)于國(guó)家機(jī)構(gòu)（national institution），將本選項(xiàng)填入此空，能夠取得最佳的一致性。其二，從語(yǔ)段5和語(yǔ)段6之間邏輯的連貫性來(lái)看，兩個(gè)語(yǔ)段分別對(duì)比性的從兩個(gè)側(cè)面說(shuō)明“national”一詞的含義。取得邏輯的連貫性。其三，從更高的篇章層次來(lái)看，本選項(xiàng)中包括的概念“provinces”和“interprovincial”與第1語(yǔ)段的“premiers”等概念構(gòu)成了一致性。至少?gòu)囊陨先齻�(gè)角度來(lái)看，本選項(xiàng)為第5語(yǔ)段的最佳選擇。)
43. ［G］ Of course, the pharmaceutical companies will scream. They like divided buyers; they can lobby better that way. They can use the threat of removing jobs from one province to another. They can hope that, if one province includes a drug on its list, the pressure will cause others to include it on theirs. They wouldn’t like a national agency, but self-interest would lead them to deal with it. (本題可從三個(gè)角度來(lái)推測(cè)。其一，根據(jù)整篇文章的一致性來(lái)看，整篇文章以各個(gè)方面就醫(yī)療保健費(fèi)用的劇增問(wèn)題發(fā)表觀點(diǎn)，本選項(xiàng)談?wù)摰氖撬幤饭镜目捶�。其二，從上文�?、第7語(yǔ)段來(lái)看，談?wù)摰氖桥c藥品制造商協(xié)商的話題，而本選項(xiàng)的主要話題正是藥品公司的反應(yīng)。吻合于上下文的一致性。其三，從下文第10語(yǔ)段來(lái)看，討論的是如何解決國(guó)家機(jī)構(gòu)的問(wèn)題，而本選項(xiàng)的最后一個(gè)小句出現(xiàn)了解決的信息（to deal with it），可以構(gòu)成語(yǔ)段之間的銜接。至少?gòu)囊陨先齻�(gè)角度來(lái)看，本選項(xiàng)為第9語(yǔ)段最佳選擇。)
44. ［F］ So, if the provinces want to run the health-care show, they should prove they can run it, starting with an interprovincial health list that would end duplication, save administrative costs, prevent one province from being played off against another, and bargain for better drug prices. (可從三個(gè)角度來(lái)推測(cè)。其一，從上下文的篇章邏輯發(fā)展來(lái)看，上文語(yǔ)段11中出現(xiàn)了關(guān)于原因的問(wèn)題，而此選項(xiàng)中的“So”，能夠與上文構(gòu)成因果邏輯發(fā)展關(guān)系。其二，從上下文的概念一致性來(lái)看，選項(xiàng)中的“provinces”、“health-care”、“interprovincial”、“costs”、“better drug prices”在原文上下文中反復(fù)出現(xiàn)，可構(gòu)成較佳的一致性。其三，本選項(xiàng)與第1自然段在情感、邏輯、概念上構(gòu)成了最好的一致性，與下文語(yǔ)段13構(gòu)成了很好的連貫性。至少?gòu)囊陨先齻�(gè)角度來(lái)看，本選項(xiàng)為第12語(yǔ)段的最佳選擇。)
45. ［B］ Or they could read Mr. Kirby’s report: “The substantial buying power of such an agency would strengthen the public prescription-drug insurance plans to negotiate the lowest possible purchase prices from drug companies.” (本題可從三個(gè)角度來(lái)推測(cè)。其一，根據(jù)整篇文章的一致性來(lái)看，整篇文章從各個(gè)方面就醫(yī)療保健費(fèi)用的劇增問(wèn)題發(fā)表觀點(diǎn)，本選項(xiàng)談?wù)摰氖荕r. Kirby’s的看法。其二，上下文話題的一致性來(lái)看，本選項(xiàng)中的許多重要概念“agency”、“drug”、“insurance”、“prices”等在語(yǔ)境中多次出現(xiàn)，構(gòu)成了一致性。其三，從第13語(yǔ)段和第14語(yǔ)段的邏輯來(lái)看，本選項(xiàng)中的“or”構(gòu)成了一種選擇性的邏輯。至少?gòu)囊陨先齻�(gè)角度來(lái)看，本選項(xiàng)為第14自然段的最佳選擇。)
【干擾分析】
�。跘］Quebec's resistance to a national agency is provincialist ideology. One of the first advocates for a national list was a researcher at Laval University. Quebec's Drug Insurance Fund has seen its costs skyrocket with annual increases from 14.3 percent to 26.8 per cent! (本選項(xiàng)構(gòu)成的干擾因素在于幾個(gè)方面。其一，本選項(xiàng)中的“Quebec”、“national”、“l(fā)ist”、“costs”在原文中反復(fù)出現(xiàn)，似乎可構(gòu)成較大的一致性。其二，本語(yǔ)段的話題為“Quebec”省的情況，顯然本選項(xiàng)在更高的層次上無(wú)法構(gòu)成一致性。就所缺語(yǔ)段的上下文來(lái)看，本選項(xiàng)無(wú)法在所缺段落中構(gòu)成一致性或連貫性。)
�。跠］ The problem is simple and stark: health-care costs have been, are, and will continue to increase faster than government revenues. (本選項(xiàng)構(gòu)成的干擾因素在于幾個(gè)方面。其一，本選項(xiàng)中的“health-care costs”這一表達(dá)具有極大的干擾性，因?yàn)樵恼麄�(gè)篇章談?wù)撫t(yī)療費(fèi)用的問(wèn)題。其二，本選項(xiàng)中出現(xiàn)了原文的重要話題詞匯，如“government”、“revenues”等，但是選項(xiàng)中的“problem”填入原文所缺語(yǔ)段無(wú)法構(gòu)成較佳的連貫和銜接。其三，很明顯，整篇文章的寫(xiě)作模式為“一般 - 特殊”，而不是“問(wèn)題 - 解決型”。就所缺語(yǔ)段的上下文來(lái)看，本選項(xiàng)無(wú)法在所缺段落中構(gòu)成一致性或連貫性。)
