填空题

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, to reduce health-care costs.
They’re all groaning about soaring health budgets, the fastest-growing components of which are pharmaceutical costs.
66. ______.
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.
67. ______.
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 tile 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.
68. ______.
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.
69. ______.
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."
70. ______.
So when the premiers gather in Niagara Falls to assemble their usual complaint lists, 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] 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.
[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 treatment. 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 cost, prevent one province from being played off against another, and bargain for better drug prices.

【参考答案】

[C]
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The word deforestation in paragraph 3 means [A] forest damage caused by pollution. [B] moving population from forest to cities. [C] the threat of climate change. [D] cutting large areas of trees.
Almost obscured by this torpor is the fact that there has been some remarkable progress over the past five years—real changes in the attitude of ordinary people in the Third World toward family size and a dawning realisation that environmental degradation and their own well-being are intimately, and inversely, linked. Almost none of this, however, has anything to do with what the bureaucrats accomplished in Rio.
Or it didn’t accomplish. One item on the agenda at Rio, for example, was a renewed effort to save tropical forests. (A previous UN-sponsored initiative had fallen apart when it became clear that it actually hastened deforestation.) After Rio, a UN working group came up with more than 100 recommendations that have so far gone nowhere. One proposed forestry pact would do little more than immunizing wood-exporting nations against trade sanctions.An effort to draft an agreement on what to do about the climate changes caused by CO2 and other greenhouse gases has fared even worse. Blocked by the Bush Administration from setting mandatory limits, the UN in 1992 called on nations to voluntarily reduce emissions to 1990 levels. Several years later, it’s as if Rio had never happened. A new climate treaty is scheduled to be signed this December in Kyoto, Japan, but governments still cannot agree on these limits. Meanwhile, the U.S. produces 7% more CO2 than it did in 1990, and emissions in the developing world have risen even more sharply. No one would confuse the "Rio process" with progress.
While governments have dithered at a pace that could make drifting continents impatient, people have acted. Birth-rates are dropping faster than expected, not because of Rio but because poor people are deciding on their own to reduce family size. Another positive development has been a growing environmental consciousness among the poor. From slum dwellers in Karachi, Pakistan, to colonists in Rondonia, Brazil, urban poor and rural peasants alike seem to realize that they pay the biggest price for pollution and deforestation. There is cause for hope as well in the growing recognition among business people that it is net in their long-term interest to fight environmental reforms. John Browne, chief executive of British Petroleum, boldly asserted in a major speech in May that the threat of climate change could no longer be ignored.