1、Part BDirections:In the following text, some sentences have been removed. For Questions 41-45, choose the most suitable one from the list A-G to fit into each of the numbered blanks. There are two extra choices, which do not fit in any of the gaps. Mark your answers on ANSWER SHEET 1. (10 points)Can
2、adas 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.Theyre all groaning about soaring health budgets, the fastest-growing comp
3、onent of which are pharmaceutical costs.41. _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 i
4、t 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
5、own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.42. _C What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created
6、 National Health Council._But “national” doesnt 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
7、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
8、 of 31 million people. Basic economics suggests the greater the potential consumers, the higher the likelihood of a better price.43. _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 prov
9、ince 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 wouldnt 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
10、 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
11、any federal-provincial deal-making. They (particularly Quebec and Alberta) just want Ottawa to fork over additional billions with few, if any, strings attached. Thats one reason why the idea of a national list hasnt gone anywhere while drug costs keep rising fast.44. _F So, if the provinces want to
12、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._Premiers love to quote Mr. Romanows report
13、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 constrain the ever-increasing cost of drugs.”45. _B Or they could read Mr. Kir
14、bys 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.”_So when the premiers gather in Niagara Falls to assemble their usual complaint list, they should also get c
15、racking about something in their jurisdiction that would help their budgets and patients.A Quebecs resistance to a national agency is provincialist ideology. One of the first advocates for a national list was a researcher at Laval University. Quebecs Drug Insurance Fund has seen its costs skyrocket
16、with annual increases from 14.3 per cent to 26.8 per cent!B Or they could read Mr. Kirbys 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”
17、 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 Ins
18、titute 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
19、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 c
20、ourse 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. Th
21、ey wouldnt like a national agency, but self-interest would lead them to deal with it.2006On the north bank of the Ohio River sits Evansville, Ind., home of David Williams, 52, and of a riverboat casino where gambling games are played. During several years of gambling in that casino, Williams, a stat
22、e auditor earning $35,000 a year, lost approximately $175,000. He had never gambled before the casino sent him a coupon for $20 worth of gambling.He visited the casino, lost the $20 and left. On his second visit he lost $800. The casino issued to him, as a good customer, a Fun Card, which when used
23、in the casino earns points for meals and drinks, and enables the casino to track the users gambling activities. For Williams, these activities become what he calls electronic morphine.(41) _. In 1997 he lost $21,000 to one slot machine in two days. In March 1997 he lost $72,186. He sometimes played
24、two slot machines at a time, all night, until the boat locked at 5 a.m., then went back aboard when the casino opened at 9 a.m. Now he is suing the casino, charging that it should have refused his patronage because it knew he was addicted. It did know he had a problem.In March 1998, a friend of Will
25、iamss got him involuntarily confined to a treatment center for addictions, and wrote to inform the casino of Williamss gambling problems. The casino included a photo of Williams among those of banned gamblers, and wrote to him a “cease admissions” letter. Noting the medical/psychological nature of p
26、roblem gambling behaviors, the letter said that before being readmitted to the casino he would have to present medical/psychological information demonstrating that patronizing the casino would pose no threat to his safety or well-being.(42) _.The Wall Street Journal reports that the casino has 20 si
27、gns warning: “Enjoy the fun. and always bet with your head, not over it.” Every entrance ticket lists a toll-free number for counseling from the Indiana Department of Mental Health. Nevertheless, Williamss suit charges that the casino, knowing he was “helplessly addicted to gambling,” intentionally
28、worked to “lure” him to “engage in conduct against his will.” Well.(43) _.The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) says “pathological gambling” involves persistent, recurring and uncontrollable pursuit less of money than of thrill of taking risks in qu
29、est of a windfall.(44) _. Pushed by science, or what claims to be science, society is reclassifying what once were considered character flaws or moral failings as personality disorders akin to physical disabilities.(45) _.Forty-four states have lotteries, 29 have casinos, and most of these states ar
30、e to varying degrees dependent on - you might say addicted to - revenues from wagering. And since the first Internet gambling site was created in 1995, competition for gamblers dollars has become intense. The Oct. 28 issue of Newsweek reported that 2 million gamblers patronize 1,800 virtual casinos
31、every week. With $3.5 billion being lost on Internet wagers this year, gambling has passed pornography as the Webs most profitable business.A Although no such evidence was presented, the casinos marketing department continued to pepper him with mailings. And he entered the casino and used his Fun Card without being detected.B It is unclear what luring was required, given his compulsive behavior. And in what s
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