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It is said that in England death is pressing, in Canada inevitable and in California optional. Small wonder. Americans ’’life expectancy has nearly doubled over the past century. Failing hips can be replaced, clinical depression controlled, cataracts removed in a 30-minute surgical procedure. Such advances offer the aging population a quality of life that was unimaginable when I entered medicine 50 years ago. But not even a great health-care system can cure death--and our failure to confront that reality now threatens this greatness of ours. Death is normal; we are genetically programmed to disintegrate and perish, even under ideal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded by third-party payers from the cost of our care, we demand eyed ’’thing that can possibly be done for us, even if it’’s useless. The most obvious example is late-stage cancer care. Physicians--frustrated by their inability to cure the disease and fearing loss of hope in the patient--too often offer aggressive treatment far beyond what is scientifically justified. In 1950, the U.S. spent $12.7 billion on health care. In 2002, the cost will be $ I, 540 billion. Anyone can see this trend is unsustainable. Yet few seem willing to try to reverse it. Some scholars conclude that a government with finite resources should simply stop paying for medical care that sustains life beyond a certain age--say 83 or so. Former Colorado governor Richard Lamm has been quoted as saying that the old and infirm" have a duty to die and get out of the way" so that younger, healthier people can realize their potential. I would not go that far. Energetic people now routinely work through their 60s and beyond, and remain dazzlingly productive. At 78, Viacom chairman Sumner Redstone jokingly claims to be 53. Supreme Court Justice Sandra Day O’’Connor is in her 7Os, and former surgeon general C.Everett Koop chairs an Internet start-up in his 80s. These leaders are living proof that prevention works and that we can manage the health problems that come naturally with age. As a mere 68-year-old, I wish to age as productively as they have. Yet there are limits to what a society can spend in this pursuit. As a physician, I know the most costly amd dramatic measures may be ineffective and painful. I also know that people in Japan and Sweden, countries that spend far less on medical care, have achieved longer, healthier lives than we have. As a nation, we may be overfunding the quest for unlikely cures while underfunding research on humbler therapies that could improve people’’s lives. The author uses the example of cancer patients to show that

A．medical resources are often wasted.
B．doctors are helpless against fatal diseases.
C．some treatments are too aggressive.
D．medical costs are becoming unaffordable.

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At the start of the 20th century, immigrant labor and innovation helped turn the U. S. into a powerful manufacturing nation. Today, foreign-born engineers jam the corridors of Silicon Valley,helping America’’s information-technology boom. And as the 21st century dawns, yet another wave of immigrants will once again help transform the economy.46)During the next decade, excepting a change in government policy, nearly a million immigrants are expected to arrive in the U. S. every year,most of whom,both legal and illegal,will continue to come from Latin America and Southeast Asia, but every foreign land will be represented.As domestic birthrates stagnate, only foreign-born worker will keep the labor pool growing. By 2006, in fact, immigrants will account for half of all new U. S. workers; over the next 30 years, their share will rise to 60%.47) Even at current levels of immigration, according to the Labor Dept. the number of people available to work will increase by a mere 0.8% per year between 1996 and 2006-half the rate of the previous decade. Without immigrants, according to a new study, the U. S. workforce would actually begin to shrink by 2015.48) It’’s not all about sheer numbers, of course:To lift productivity and spur growth, immigrants must provide creativity, entrepreneurial energy, or simple initiative that America couldn’’t find otherwise. If all you did was bring in people who are exactly the same as those we have here, there would be no economic benefit, says Rand Corp. economist James P. Smith, You’’d just have more people. Just as crucial, the array of education and skills immigrants bring could fit neatly with the supply of jobs over the next decade. According to Linda Levine at the Congressional Research Service,60% of the jobs created through 2005 will require some post-secondary education. But, she adds, low-skill jobs will still represent about half of total employment. 49) Yet immigrants also are 50% more likely than Americans to have a graduate degree, and an unbelievable 23% of U. S. residents holding PhDs in science and engineering are foreign-born, according to the National Science Foundation.Indeed, foreign-born workers have shown an extraordinary ability to assimilate and flourish. Certainly, some less skilled workers will remain at the bottom economic rung all their lives. 50) Yet others will catch up quickly, and within a decade of their arrival, the well-educated will go from making barely half that of native-born Americans in comparable work to nearly 90%, according to a recent study.That, of course, will raise immigrants’’ living standards. More important, it will help drive innovation and entrepreneurship,key engines of the 21st Century Economy.