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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
2019-06-11
44
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 health-care costs.
They’re all groaning about soaring health budgets, the fastest-growing component of which are pharmaceutical costs.
【C1】______.
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.
【C2】______.
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.
【C3】______.
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.
【C4】______.
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."
【C5】______.
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 treatments. 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.
【C4】
选项
答案
F
解析
考查顺接关系。空格前面讲到某些省对联邦政府和省政府之间的交易持怀疑态度,空格后 则指出这些省长们应该通过读报告中有关药品的论述来了解成立国家药物机构的好处。可以推 断.空白处内容要么是继续上面的内容,来讨论来自这些省份的阻力;要么是连接下文,建议他 们更多了解成立国家机构的意义。符合条件的有B和F两项,F项虽然把上文的关键词 “premiers”换成了“provinces”,但其内容没有变化,还是建议各省实现全国药物代理机构的功 能,与上下文内容逻辑关系紧密,故选F项。B项开头有并列连词“or”,在语法上和上文无法衔 接,因此不选。
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0
考研英语一
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