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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
54
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.
【B1】
选项
答案
E
解析
本题可以运用复现结构定位法。根据上下文的紧密衔接关系,第1题所在段落和上文必然有很大的关联性和相近性。先去上一段信息板块中定位重要信息点,发现上一段中的关键信息词是pharmaceutical costs,直接提出了“他们(各省省长)关注的医疗支出中,增长最快的部分就是pharmaceutical costs”,但对pharmaceutical costs的论述显然是没有完成的,只是刚提出问题,这样根据上下文的就近和衔接原则,作为下一段的第1题中的信息需要继续围绕此主题展开。也必然会提到pharmaceutical costs这个概念。可以通过查找pharmaceutical costs的复现结构去定位7个选项,只有选项E)中出现了这个复现信息点drug costs,而且选项E)中的信息就是在阐述drug costs快速增长的问题,所以选项E)与第1题上一段落的信息具有相近性和衔接性,为正确答案。
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0
考研英语一
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