考试时间 2014年3月22日星期六 下午2:00-5:00 原创作者qq 347952582
Since Would War II considerable advances have been made in the area of health-care services. These include better access to health care (particularly for the poor and minorities), improvements in physical plants, and increased numbers of physicians and other health personnel. All have played a part in the recent improvement in life expectancy. But there is mounting criticism of the large remaining gaps in access, unbridled cost inflation, the further fragmentation of service, excessive indulgence in wasteful high-technology “gadgeteering,” and a breakdown in doctor-patient relationships. In recent years proposed panaceas and new programs, small and large, have proliferated at a feverish pace and disappointments multiply at almost the same rate. This has led to an increased pessimism—“everything has been tried and nothing works”—which sometimes borders on cynicism or even nihilism.
It is true that the automatic “pass through” of rapidly spiraling costs to government and insurance carriers, which was set in a publicized environment of “the richest nation in the world,” produced for a time a sense of unlimited resources and allowed to develop a mood whereby every practitioner and institution could “do his own thing” without undue concern for the “Medical Commons.” The practice of full-cost reimbursement encouraged capital investment and now the industry is overcapitalized. Many cities have hundreds of excess hospital beds; hospitals have proliferated a superabundance of high-technology equipment; and structural ostentation and luxury were the order of the day. In any given day, one-fourth of all community beds are vacant; expensive equipment is underused or, worse, used unnecessarily. Capital investment brings rapidly rising operating costs.
Yet, in part, this pessimism derives from expecting too much of health care. It must be realized that care is, for most people, a painful experience, often accompanied by fear and unwelcome results. Although there is vast room for improvement, health care will always retain some unpleasantness and frustration. Moreover, the capacities of medical science are limited. Humpty Dumpty cannot always be put back together again. Too many physicians are reluctant to admit their limitations to patients; too many patients and families are unwilling to accept such realities. Nor is it true that everything has been tried and nothing works, as shown by the prepaid group practice plans of the Kaiser Foundation and at Puget Sound. In the main, however, such undertakings have been drowned by a veritable flood of public and private moneys which have supported and encouraged the continuation of conventional practices and subsidized their shortcomings on a massive, almost unrestricted scale. Except for the most idealistic and dedicated, there were no incentives to seek change or to practice self-restraint or frugality. In this atmosphere, it is not fair to condemn as failures all attempted experiments; it may be more accurate to say many never had a fair trial.
1. The author implies that the Kaiser Foundation and Puget Sound plans (lines 47-48) differed
from other plans by
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(A) encouraging capital investment (B) requiring physicians to treat the poor (C) providing incentives for cost control
(D) employing only dedicated and idealistic doctors (E) relying primarily on public funding
2. The author mentions all of the following as consequences of full-cost reimbursement
EXCEPT
(A) rising operating costs (B) underused hospital facilities (C) overcapitalization
(D) overreliance on expensive equipment (E) lack of services for minorities
3. The tone of the passage can best be described as
(A) light-hearted and amused (B) objective but concerned (C) detached and unconcerned (D) cautious but sincere (E) enthusiastic and enlightened
4. According to the author, the “pessimism” mentioned at line 35 is partly attributable to the fact
that
(A) there has been little real improvement in health-care services (B) expectations about health-care services are sometimes unrealistic
(C) large segments of the population find it impossible to get access to health-care services (D) advances in technology have made health care service unaffordable (E) doctors are now less concerned with patient care 5. The author cites the prepaid plans in lines 46-48 as
(A) counterexamples to the claim that nothing has worked (B) examples of health-care plans that were over-funded (C) evidence that health-care services are fragmented (D) proof of the theory that no plan has been successful (E) experiments that yielded disappointing results
6. It can be inferred that the sentence “Humpty Dumpty cannot always be put back together
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again” means that
(A) the cost of health-care services will not decline (B) some people should not become doctors (C) medical care is not really essential to good health (D) illness is often unpleasant and even painful (E) medical science cannot cure every ill
7. With which of the following descriptions of the system for the delivery of health-care services
would the author most likely agree?
(A) It is biased in favor of doctors and against patients. (B) It is highly fragmented and completely ineffective (C) It has not embraced new technology rapidly enough (D) It is generally effective but can be improved (E) It discourages people from seeking medical care
8. Which of the following best describes the logical structure of the selection?
(A) The third paragraph is intended as a refutation of the first and second paragraphs. (B) The second and third paragraphs explain and put into perspective the points made in the
first paragraph.
(C) The second and third paragraphs explain and put into perspective the points made in the
first paragraph.
(D) The first paragraph describes a problem, and the second and third paragraphs present two
horns of a dilemma.
(E) The first paragraph describes a problem, the second its causes, and the third a possible
solution.
9. The author’s primary concern is to
(A) criticize physicians and health-care administrators for investing in technologically
advanced equipment
(B) examine some problems affecting delivery of health-care services and assess their
severity
(C) defend the medical community from charges that health-care has not improved since
World War II
(D) analyze the reasons for the health-care industry’s inability to provide quality care to all
segments of the population
(E) describe the peculiar economic features of the health-care industry that are the causes of
spiraling medical costs
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1. C 6. E
2. E 7. D 3. B 8. C 4. B 9. B 5. A 10. Behavior is one of two general responses available to endothermic (warm-blooded) species for the regulation of body temperature, the other being innate (reflexive) mechanisms of heat production and heat loss. Human beings rely primarily on the first to provide a hospitable thermal microclimate for themselves, in which the transfer of heat between the body and the environment is accomplished with minimal involvement of innate mechanisms of heat production and loss. Thermoregulatory behavior anticipates hyperthermia, and the organism adjusts its behavior to avoid becoming hyperthermic: it removes layers of clothing, it goes for a cool swim, etc. The organism can also respond to changes in the temperature of the body core, as is the case during exercise; but such responses result from the direct stimulation of thermoreceptors distributed widely within the central nervous system, and the ability of these mechanisms to help the organism adjust to gross changes in its environment is limited.
Until recently it was assumed that organisms respond to microwave radiation in the same way that they respond to temperature changes caused by other forms of radiation. After all, the argument runs, microwaves are radiation and heat body tissues. This theory ignores the fact that the stimulus to a behavioral response is normally a temperature change that occurs at the surface of the organism. The thermoreceptors that prompt behavioral changes are located within the first millimeter of the skin’s surface, but the energy of a microwave field may be selectively deposited in deep tissues, effectively bypassing these thermoreceptors, particularly if the field is at near-resonant frequencies. The resulting temperature profile may well be a kind of reverse thermal gradient in which the deep tissues are warmed more than those of the surface. Since the heat is not conducted outward to the surface to stimulate the appropriate receptors, the organism does not “appreciate” this stimulation in the same way that it “appreciates” heating and cooling of the skin. In theory, the internal organs of a human being or an animal could be quite literally cooked well-done before the animal even realizes that the balance of its thermomicroclimate has been disturbed.
Until a few years ago, microwave irradiations at equivalent plane-wave power densities of about 100 mW/cm2 were considered unequivocally to produce “thermal” effects; irradiations within the range of 10 to 100 mW/cm2 might or might not produce “thermal” effects; while effects observed at power densities below 10 mW/cm2 were assumed to be “nonthermal” in nature.
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Experiments have shown this to be an oversimplification, and a recent report suggests that fields as weak as 1 mW/cm2 can be thermogenic. When the heat generated in the tissues by an imposed radio frequency (plus the heat generated by metabolism) exceeds the heat-loss capabilities of the organism, the thermoregulatory system has been compromised. Yet surprisingly, not long ago, an increase in the internal body temperature was regarded merely as “evidence” of a thermal effect. 1. The author is primarily concerned with
(A) showing that behavior is a more effective way of controlling bodily temperature than
innate mechanisms
(B) criticizing researchers who will not discard their theories about the effects of microwave
radiation on organisms
(C) demonstrating that effects of microwave radiation are different from those of other forms
of radiation
(D) analyzing the mechanism by which an organism maintains its bodily temperature in a
changing thermal environment
(E) discussing the importance of thermoreceptors in the control of the internal temperature of
an organism
2. The author makes which of the following points about innate mechanisms for heat
production? I.
They are governed by thermoreceptors inside the body of the organism rather than at the surface.
II. They are a less effective means of compensating for gross changes in temperature than
behavioral strategies.
III. They are not affected by microwave radiation. (A) I only (B) I and II only (C) I and III only (D) II and III only (E) I, II, and III
3. Which of the following would be the most logical topic for the author to take up in the
paragraph following the final paragraph of the selection?
(A) A suggestion for new research to be done on the effects of microwaves on animals and
human beings
(B) An analysis of the differences between microwave radiation
(C) A proposal that the use of microwave radiation be prohibited because it is dangerous
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华中科技大学2014年考博英语-真题-答案
