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The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just

admin2014-12-26  81
问题     The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just and most efficient way, is not a new one. Every health system in an economically developed society is faced with the need to decide(either formally or informally)what proportion of the community’s total resources should be spent on health-care; how resources are to be apportioned; what diseases and disabilities and which forms of treatment are to be given priority; which members of the community are to be given special consideration in respect of their health needs; and which forms of treatment are the most cost-effective.
    What is new is that, from the 1950s onwards, there have been certain general changes in outlook about the finitude of resources as a whole and of health-care resources in particular, as well as more specific changes regarding the clientele of health-care resources and the cost to the community of those resources. Thus, in the 1950s and 1960s, there emerged awareness in Western societies that resources for the provision of fossil fuel energy were finite and exhaustible and that the capacity of nature or the environment to sustain economic development and population was also finite. In other words, we became aware of the obvious fact that there were "limits to growth". The new consciousness that there were also severe limits to health-care resources was part of this general revelation of the obvious. Looking back, it now seems quite incredible that in the national health systems that emerged in many countries in the years immediately after the 1939-1945 World War, it was assumed without question that all the basic health needs of any community could be satisfied, at least in principle; the "invisible hand" of economic progress would provide.
    However, at exactly the same time as this new realization of the finite character of health-care resources was sinking in, an awareness of a contrary kind was developing in Western societies: that people have a basic right to health-care as a necessary condition of a proper human life. Like education, political and legal processes and institutions, public order, communication, transport and money supply, health-care came to be seen as one of the fundamental social facilities necessary for people to exercise their other rights as autonomous human beings. People are not in a position to exercise personal liberty and to be self-determining if they are poverty-stricken, or deprived of basic education, or do not live within a context of law and order. In the same way, basic health-care is a condition of the exercise of autonomy.
With hindsight, what is inconceivable about national health systems in the years after the end of WWII?
选项 A、It was taken for granted that such systems catered to all of people’ s basic health needs.
B、It was taken for granted that such systems were perfectly established.
C、It was taken for granted that such systems were just and fair.
D、It was taken for granted that such systems were up-to-date.
答案A
解析 细节题。根据WWII定位到第二段Looking back，it now seems quiteincredible that in the national health systems that emerged in many countries in the yearsimmediately after the 1939—1945 World War，it was assumed without question that allthe basic health needs of any community could be satisfied，at least in principle；the“invisible hand”of economic progress would provide．“回溯起来．有一个观点现在看来不可思议：在1939年到1945年的世界大战结束后的几年内，很多国家建立了国民卫生体系，人们认为这样的国民卫生体系至少在理论上能够满足任何人群的所有基础卫生需求，经济增长中‘看不见的手’将提供一切所需。”题干中的Withhindsight和原文的Looking back．inconceivable和incredible，catered to和satisfied互为对应点，所以选A。
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