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Politicians want to lower spending, or at least they say they do. But in all the to-and-fro over raising the debt ceiling, littl

admin2015-03-25  248
问题     Politicians want to lower spending, or at least they say they do. But in all the to-and-fro over raising the debt ceiling, little sensible has been said about lowering spending in the long term. Nothing illuminates this more clearly than health care.
    A new report, published in Health Affairs on July 28th, paints a daunting picture. Health spending will rise by 5.8% each year from 2010 to the end of 2020, according to actuaries at the Centres for Medicare and Medicaid Services(CMS). In 2020 health care will account for one-fifth of America’s economy. The federal government will pay for a greater share than ever before.
    Hawks have long warned that it would be impossible to curb government spending without curtailing cutting spending on health. Democrats claimed that their health law would lower costs. Barack Obama assembled grey-haired sages to recommend changes to entitlement programmes. Paul Ryan, the Republican chairman of the House Budget Committee, offered his own reforms. And yet spending on health care continues to climb.
    Last year the actuaries at CMS projected that health reform would not lower spending, as Democrats hoped. From 2009 to 2019 average annual growth for health spending would be 0.2 percentage points higher with Mr. Obama’s health reform than without it. This slight net rise would mask dramatic shifts, the actuaries said. For example, reform’s efforts to contain costs for Medicare, the government programme for the old, would be dwarfed by the expansion of Medicaid , the government programme for the poor.
    The actuaries’ newest study estimates that health spending grew little last year, mostly because of the weak economy. The next decade, however, will bring rapid growth. Government spending will be the main driver. Ageing baby-boomers will enroll in Medicare; Medicaid coverage will swell; Washington will subsidise many of those on the new state exchanges. CMS expects Washington’s share of health spending to grow from 27% in 2009 to 31% by 2020. Together with spending by states and cities, the public sector will pay for nearly half of America’s health care.
    This is a sobering prediction. However, even this may be an underestimate. The actuaries at CMS assume that only 2m people who now have employer-sponsored insurance will lose it, as companies drop coverage and workers move to exchanges or to Medicaid. But more may make the switch. In June McKinsey, a consultancy, found in a survey that 30% of firms would definitely or probably stop offering insurance after 2014, when the exchanges are in place. On July 25th the National Federation of Independent Business, which represents small firms, published its own survey. If some workers begin to move to exchanges, the report found, 57% of companies would consider dropping insurance completely. If these surveys are borne out in firms’ actions, government spending will be even higher than CMS expects. The debt disaster on August 2nd may be averted. The bigger problem remains.
What is the main idea of the passage?
选项 A、The dispute on whether to implement health-care reform is still on.
B、The health-care reform would stimulate federal government’s spending.
C、More companies would stop paying health care for their employees.
D、Raising debt ceiling can solve the health care problem effectively.
答案B
解析 主旨大意题。全文首先以一份报告的数字为例，说明政府用于医疗保健方面的开支将会增加。而后指出政府针对穷人的公共医疗补助费用大幅增加，使得政府为控制老年人医疗保险成本改革所做的努力大打折扣。接着，作者具体分析了政府用于医疗保健开支的原因。因此，全文讨论的主题是医疗改革将会使政府用于医疗保健的开支增大。[B]与之相符，故为答案。全文讨论的重点是政府用于医疗保健的开支增加，而不是医疗改革本身，因此排除[A];[C]只是文章中的部分细节，因此排除。
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