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Canada’s premiers (the leaders of provincial government), if they have any breath left after complaining about Ottawa at their l
Canada’s premiers (the leaders of provincial government), if they have any breath left after complaining about Ottawa at their l
admin
2022-12-08
24
问题
Canada’s premiers (the leaders of provincial government), if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, to reduce health-care costs.
They’re all groaning about soaring health budgets, the fastest-growing components of which are pharmaceutical costs.
【B1】________
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.
【B2】________
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.
【B3】________
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.
【B4】________
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."
【B5】________
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 percent to 26.8 percent!
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 treatment. 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.
【B2】
选项
答案
C
解析
本题可以组合运用上下文逻辑关系定位法、复现结构定位法和代词指代关系定位法。研究第2题之前的段落信息可发现,该段落利用一个设问句What to do?提出了控制药品支出上涨的办法就是建立national drug agency(全国性的药品机构),根据上下文的就近和衔接原则,下一段第2题中的信息很可能会继续围绕此主题展开,第2题中的信息必然会提到national drug agency这个概念,就可通过查找national drug agency的复现结构去定位7个选项;其次,第2题的下一段落中出现了but “national” doesn’t have to mean that,这里也提到了national,说明第2题这个段落的信息中肯定要有national的复现信息点,同时第2题的段落与下一段落由于but形成了转折关系,可根据上下文逻辑关系定位法去选项中查找哪个选项可以和第2题的下一段形成转折;另外,代词that的出现限定了填入第2题的选项中必须有可以被that所指代的信息。根据以上线索发现只有选项A)和C)中出现了national复现信息点,再根据上下文的转折关系和that的代词指代关系去定位,可以排除选项A),它主要是谈论Quebec省对national的抵制问题,与第2题的前后段落信息没有什么相近比,所以只有选项C)是唯一符合上述全部线索的最佳选项。
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考研英语一
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