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  3. 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

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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.
【B4】
选项
答案F
解析 本题是有一定难度的，主要是选项A)具有极大的迷惑性。表面上看第4题前一段的信息提到了“一些省对全国性的机构抱有怀疑态度”，令人很容易去考虑选项A)，因为选项A)的信息是谈论Quebec省对national的抵制问题。但是如果严格遵循上下文的就近原则，就会发现第4题前两段的尾部信息中明确提出了predictably and regrettably，Quebec refused to join，因此，选项A)的信息与该段更相近，或者说关于Quebec这个具体省的抵制问题在那个段落中已经阐述了；这样就要找其他的可以与第4题前一段提到的“一些省对全国性的机构抱有怀疑态度”相衔接的信息。选项F)开头出现了标志词so，表明它与上文是因果关系，而且该选项的主要信息就是谈论“如果这些省想管理医疗福利，它们就必须证明自己有完成这个任务的能力。它们必须开一张省际单子以避免重复、节约管理费用、防止一个省和另一个省之间的互相竞争和争取更低廉的药品价格。”选项F)的信息可以和第4题前一段的信息形成因果关系，因为第4题前一段说明了“一些省对全国性的机构抱有怀疑态度，想自己管理药品问题”，所以应该有在选项F)中提到的这些能力；另外，从匹配的角度，第4题前一段的信息涉及的一些省份，并不是仅指Quebec一省，选项A)的信息是只谈论Quebec一个具体的省，而选项F)中涉及的也是一些省，所以选项F)填入第4题与前文段落更具有衔接性。
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