2. 考研
  3. A. Or they could read Mr. Kirby’s report: "The substantial buying power of such an agency would strengthen the public prescripti

A. Or they could read Mr. Kirby’s report: "The substantial buying power of such an agency would strengthen the public prescripti

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问题 A. 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. "
B. What does "national" mean? Roy Romanow and Senator Michael Kirby recommended federal provincial body much like the recently created National Health Council.
C. 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.
D. So, if the provinces want to run the health-care show, they should prove they can run it, start-ing 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.
E. 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.
    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.
【R1】______
    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.
【R2】______
    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.
【R3】______
    A small step has been taken in the direction of a national agency with the creation of the Canadian Coordinating 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.
【R4】______
    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. "
【R5】______
    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.
【R3】
选项
答案E
解析 空白前面介绍成立国家机构的各种好处；空格后文则介绍在建立国家代理机构方面取得的小进展。根据文章上下文衔接，可推测空白处内容和国家代理机构有关。E项“医药公司就会大喊大叫表示不满了”和“但是，在利益的去驱使下，他们不得不硬着头皮去应对”。表明确实遭遇阻力，但还是有些微进展，这一点语义上与后文相符，故选E。
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