If life expectancy were a marathon, you could say that the United States is fading from the pack. Although everyone is living lo

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问题    If life expectancy were a marathon, you could say that the United States is fading from the pack. Although everyone is living longer, the inhabitants of other industrialized nations have made more dramatic strides in life expectancy than Americans have. Australian men gained an extra six years between 1980 and 2001; Japanese women, 6.1% years. The result: Americans, once on a par with countries such as Italy and New Zealand—in the middle of the pack—now rank below Spain and Greece, near the end.
   On the face of it, this should not be happening.
     Healthier nations are usually wealthier nations. The United States is the third richest of the 30 developed nations belonging to the Organization for Economic Cooperation and Development (OECD), after Luxembourg and Norway. But it now ranks 22nd in life expectancy—down from 12th for women and 18th for men in 1980.
     Could the problem be inadequate healthcare spending?
     No. The US spends $1 of every $7 of its gross domestic product on healthcare—far more than any other OECD nation, which typically devotes less than $1 in $10 of GDP to the sector. Per person, that works out to an extra $1,800 compared with the Swiss or $2,300 compared with the Canadians, even though both those groups live longer than Americans.
     So what’s at work?
     One factor could be diet, according to a new study on longevity by Alicia Munnell, director of the Center for Retirement Research at Boston College, and two students, Robert Hatch and James Lee①. Americans have been getting fatter, and physicians maintain that putting on weight often shrinks a person’s life span.
     On the positive side, US alcohol and tobacco consumption is more moderate than th’e OECD average.
     Another factor holding back longevity: poverty. The quarter to a third of Americans with low incomes often have less money than the same low-income groups in several other rich countries, points out Mr. Burt-less.
     A third factor—inequality—worsens the problem. The most prosperous 10 percent of Americans receive 17 times as much income as those in the bottom 10 percent. In countries with high life expectancies among those at 65—such as Japan, Sweden, and Norway—the top 10 percent makes only five times as much income as those in the bottom, Professor Munnell says.
     The US also struggles with inequality in healthcare. While most rich nations have universal coverage, 45 million in the US did not have health insurance last year, according to census statistics—a rise of 5.2 million since the year of 2000②. Millions more have insurance only part of the year.
     Many of those without health insurance tend to postpone medical care for chronic problems, thoush they may go to hospital emergency facilities in a crisis.
     Thus, a better predicator of life expectancy than GDP may be the average GDP for the bottom 40 percent of the population, notes the Boston College study. Here the US falls in the middle of the pack of rich countries, rather than at the top.
Why does the author say inequality makes the problems worse?

选项 A、The poor cannot get the healthcare insurance.
B、The poor pay no attention to their health.
C、Most of US healthcare have been used by the most prosperous 10% of the Americans.
D、Those without healthcare insurance only go to hospital when they have to go.

答案D

解析 推理判断题。文章倒数第二段“Many of those without health insurance tend to postpone medical care for chronic problems,though they may go to hospital emergency facilities in a crisis”说大部分没有健康保险的人在患慢性病时会推迟医疗,只在危急时候才去医院救治,但并未说他们一点不关注自己的身体健康,所以排除B;倒数第三段第二句话“…45 million in the US did not have health insurance last year,…a rise of 5.2 million since the year of 2000”只是说美国不是全民都有医疗保险,去年有520万人没有医保,有的只有部分医保,而并不是说所有穷人都没有医疗保险,所以排除选项A。而选项C文章没有提及;根据文章倒数第二段“they may go to hospital emergency facilities in a crisis”确定答案为选项D。
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