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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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2016-08-19
56
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.
【R4】
选项
答案
D
解析
空白前面讲:某些省长不相信任何联邦政府和省政府的合作机构;后文内容主要谈到:这些官员应该读一读报告中有关药品的论述部分,这样能了解成立国家代理机构的益处。由此可知,中间空白处内容可能和“受到这些省份的阻力”相关。D项“因此如果某些省想运营医疗福利事业,它们就必须证明自己有能力运作,还得开一张省际通用列表来终止重复,最后还得节约管理费用,防止省份之间的竞争,并且还能尽量争取低廉的药价”。该内容语义上和后文有连贯性,故选D。
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