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考研
Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their
Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their
admin
2018-01-08
57
问题
Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, together, to reduce healthcare costs.
They’re all groaning about soaring health budgets, the fastest-growing component of which is pharmaceutical costs.
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 treatments. Part of it arises from new drugs costing more than older kinds. Part of it is higher prices.
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.
What does "national" mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council.
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.
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.
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.
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.
选项
答案
B
解析
根据题干确定答案位置,第四、五段都有出现Romanow和Kirby。第四段是说:Romanow委员会和Kirby保健委员会建议成立一个全国性药物机构;接着第五段更进一步指出:Roy Romanow和Michael Kirby参议员建议成立一个联邦政府和省政府之间的机构,就像刚刚成立不久的“国家健康委员会”一样。因此,B选项为正确答案。
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0
考研英语一
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