I no longer care ____ modern jazz.

听力原文：M: I'm terribly sorry, Anna, I lost the magazine you lent me the other day.

W: It doesn't matter, It was a back number any way.

Q: Why doesn't the woman care about the lost magazine？

(19)

A．She is a generous woman by nature.

B．It doesn't have a back cover.

C．She feels the man's apology is enough.

D．It is no longer of any use to her.

A．During the journey down, many people showed care and concern for others.

B．It took the speaker much longer than the others to escape from the building because he had an artificial leg.

C．The building collapsed immediately after the speaker got out.

D．Many people died because they got trapped in elevators.

Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatment, as they make decisions about patient care.

The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how healthcare dollars are spent.

In practical terms, the new guidelines being developed could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment-at the end of life, for example-is too expensive. In the extreme, some critics have said that making treatment decisions based on cost is a form. of rationing.

Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones are expected to make doctors more conscious of the economic consequences of their decisions, even though there's no obligation to follow them. Medical society guidelines are also used by insurance companies to help determine reimbursement(报销)policies.

Some doctors see a potential conflict in trying to be both providers of patient care and financial overseers.

"There should be forces in society who should be concerned about the budget, but they shouldn't be functioning simultaneously as doctors," said Dr. Martin Samuels at a Boston hospital. He said doctors risked losing the trust of patients if they told patients, "I'm not going to do what I think is best for you because I think it's bad for the healthcare budget in Massachusetts."

Doctors can face some grim trade-offs. Studies have shown, for example, that two drugs are about equally effective in treating macular degeneration, an eye disease. But one costs $50 a dose and the other close to $2,000. Medicare could save hundreds of millions of dollars a year if everyone used the cheaper drug. Avastin, instead of the costlier one, Lucentis.

But the Food and Drug Administration has not approved Avastin for use in the eye, and using it rather than the alternative, Lucentis, might carry an additional, although slight, safety risk. Should doctors consider Medicare's budget in deciding what to use？

"I think ethically(在道德层面上)we are just worried about the patient in front of us and not trying to save money for the insurance industry or society as a whole," said Dr. Donald Jensen.

Still, some analysts say that there's a role for doctors to play in cost analysis because not many others are doing so. "In some ways," said Dr. Daniel Sulmasy, "it represents a failure of wider society to take up the issue."

57.What do some most influential medical groups recommend doctors do？

A.Reflect on the responsibilities they are supposed to take.

B.Pay more attention to the effectiveness of their treatments.

C.Take costs into account when making treatment decisions.

D.Readjust their practice in view of the cuts in health care.

58.What were doctors mainly concerned about in the past？

A.Specific medicines to be used.

B.Professional advancement.

C.Effects of medical treatment.

D.Patients' trust.

59.What may the new guidelines being developed lead to？

A.The redefining of doctors' roles.

B.Conflicts between doctors and patients.

C.Overuse of less effective medicines.

D.The prolonging of patients' suffering.

60.What risk do doctors see in their dual role as patient care providers and financial overseers？

A.They may be involved in a conflict of interest.

B.They may be forced to divide their attention.

C.They may have to use less effective drugs.

D.They may lose the respect of patients.

61.What do some experts say about doctors' involvement in medical cost analysis？

A.It may add to doctors' already heavy workloads.

B.It will help to save money for society as a whole.

C.It results from society's failure to tackle the problem.

D.It raises doctors' awareness of their social responsibilities.

out theirkids‘ well-being．

查看材料

Questions are based on the following passage．

Saying they can no longer ignore the rising prices of health care， some of the most influentialmedical groups in the nation are recommending that doctors weigh the costs， not just the effectiveness of treatments， as they make decisions about patient care．The shift， little noticed outside the medical establishment but already controversial inside it，suggests that doctors are starting to redefine their roles， from being concerned exclusively about individual patients to exerting influence on how healthcare dollars are spent．In practical terms， the new guidelines being developed could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment—at the end of life， for example—is too expensive．In the extreme， some critics have said that making treatment decisionsbased on cost is a form. of rationing．Traditionally， guidelines have heavily influenced the practice of medicine， and the latest ones areexpected to make doctors more conscious of the economic consequences of their decisions， even though there"s no obligation to follow them．Medical society guidelines are also used by insurancecomoanies to help determine reimbursement （报销） policies．Some doctors see a potential conflict in trying to be both providers of patient care and fmancial

Overseers．"There should be forces in society who should be concerned about the budget， but they shouldn"t be functioning simultaneously as doctors，" said Dr．Martin Samuels at a Boston hospital．He said doctors risked losing the trust of patients if they told patients， "I"m not going to do what I think is best for you because I think it"s bad for the healthcare budget in Massachusetts．" Doctors can face some grim trade—offs．Studies have shown， for example， that two drugs are about

equally effective in treating macular degeneration， and eye disease．But one costs $ 50 a dose and the other close to $ 2，000．Medicare could save hundreds of millions of dollars a year if everyone used the cheaper drug， Avastin， instead of the costlier one， Lucentis．But the Food and Drug Administration has not approved Avastin for use in the eye．and using it rather than the alternative， Lucentis， might carry an additional， although slight， safety risk．Should doctors consider Medicare"s budget in deciding what to use？"I think ethically （在道德层面上） we are just worried about the patient in front of us and not trying to save money for the insurance industry or society as a whole，" said Dr．Donald Jensen．Still， some analysts say that there"s a role for doctors to play in cost analysis because not many others are doing so．"In some ways，" said Dr．Daniel Sulmasy， "it represents a failure of wider society

to take up the issue．"

What do some most influential medical groups recommend doctors do？ 查看材料

A.Reflect on the responsibilities they are supposed to take．

B.Pay more attention to the effectiveness of their treatments．

C.Take costs into account when making treatment decisions．

D.Readjust their practice in view of the cuts in health care．

er. Dr. Miller is a professor of Sociology at Washington University and has written numerous articles and books on the issues facing older Americans in our graying society for the past 15 years.

M: Thank you for that introduction.

W: Well, Dr. Miller, as a matter of fact, there are many issues facing aged people. Can you say something about those？

M: Well, first, I want to share a story of my own life. Several years ago when my grandparents were well into their eighties, they were faced with the reality of no longer being able to adequately care for them.

W: Yeah, that is quite a common and natural problem with aged people.

M: My grandfather spoke of his greatest fear, that of leaving the only home they had known for the past 60 years. The prospect of having to sell their home, giving up their independence and moving into a retirement home was an extremely depressing experience for them.

W: That's definitely sure.

M: He was quite sad, exclaiming that he felt he wasn't important anymore.

W: Yeah, that's a quite natural feeling.

M: For them and some older Americans, this period of their lives means the decline of not only one's health but the loss of identity and serf-worth. In many societies, this serf-identity is closely related with our social status, occupation, material possessions, or independence.

W: So is there any way to help the elderly reestablish their serf-identity？

M: Well, I think it is important to find some meaningful roles the elderly can and should play in our societies. By doing something for the society, they will feel they are still useful and important.

(23)

A．The growing crisis of inadequate retirement pensions for the future.

B．The problem of providing adequate medical care for the elderly.

C．An emotional problem facing the elderly and how to overcome it.

D．Helping the elder lead a life in retirement homes.

It can be inferred from the passage that ________.

A) compared with other hospitals nurse at Beth Israel Hospital are more patient

B) in most hospitals patient care is inadequate from the professional point of view

C) in most hospital nurse get low salaries

D) compared with other hospital nurses have to work longer hours at Beth Israel Hospital

The author believes the most effective method to solve the pension crisis is to______.

A．allow people to work longer

B．increase tax revenues

C．cut back on health care provisions

D．start reforms right away

nal. 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 everything 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 US spent ＄12.7 billion on health care. In 2002, the cost will be＄1 540 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 70s, 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 and 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 over funding the quest for unlikely cures while under funding research on humbler therapies that could improve people's lives.

What is implied in the first sentence？

A．Americans are better prepared for death than other people.

B．Americans enjoy a higher life quality than ever before.

C．Americans are overconfident of their medical technology.

D．Americans take a vain pride in their long life expectancy.

Dr. Hilary A. Tindle suggested in his study that______.

A．women are more likely to live a long life compared with men

B．negative thinkers have a healthier way of living than positive thinkers

C．optimistic people care less about their health than pessimistic people

D．people who think positively live longer than those thinking negatively