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2010年12月

PassageOne

Intheearly20thcentury,fewthingsweremoreappealingthanthepromise

ofscientificknowledge.Inaworldstrugglingwithrapidindustrialization,sc

ienceandtechnologyseemedtooffersolutionstoalmosteveryproblem.Newlyc

reatedstatecollegesanduniversitiesdevotedthemselvesalmostentirelytosc

ientific,technological,andengineeringfields.ManyAmericanscametobelieve

thatscientificcertaintycouldnotonlysolvescientificproblems,butalsor

eformpolitics,government,andbusiness.TwoworldwarsandaGreatDepression

rockedtheconfidenceofmanypeoplethatscientificexpertisealonecouldere

ateaprosperousandorderedworld.AfterWorldWarII,theacademicworldturn

edwithnewenthusiasmtohumanisticstudies,whichseemedtomanyscholarsthe

bestwaytoensurethesurvivalofdemocracy.Americanscholarsfannedoutacr

ossmuchoftheworld-withsupportfromtheFordFoundation,theFulbrightpro

gram,etc.一topromotetheteachingofliteratureandtheartsinaneffortto

makethecasefordemocraticfreedoms.

IntheAmericaofourowntime,thegreateducationalchallengehasbecome

anefforttostrengthentheteachingofwhatisnowknownastheSTEMdisciplin

es(science,technology,engineering,andmath).Thereisconsiderableandjust

ifiedconcernthattheUnitedStatesisfallingbehindmuchoftherestofthe

developedworldintheseessentialdisciplines.India,China,Japan,andother

regionsseemtobeseizingtechnologicalleadership.

Atthesametime,perhapsinevitably,thehumanities-whilestillpopulari

nelitecollegesanduniversities-haveexperiencedasignificantdecline.Huma

nisticdisciplinesareseriouslyunderfunded,notjustbythegovernmentandth

efoundationsbutbyacademicinstitutionsthemselves.Humanistsareusuallyam

ongthelowest-paidfacultymembersatmostinstitutionsandareoftenlightly

regardedbecausetheydonotgenerategrantincomeandbecausetheyprovideno

obviouscredentials(資質(zhì))formostnonacademiccareers.

UndoubtedlyAmericaneducationshouldtrainmorescientistsandengineers.

MuchoftheconcernamongpoliticiansaboutthestateofAmericanuniversities

todayisfocusedontheabsenceof“realworld“education—whichmeansprepar

ationforprofessionalandscientificcareers.Buttheideathatinstitutionso

rtheirstudentsmustdecidebetweenhumanitiesandscienceisfalse.Oursocie

tycouldnotsurvivewithoutscientificandtechnologicalknowledge.Butwewou

Idbeequallyimpoverished(貧困的)withouthumanisticknowledgeaswell.Scien

ceandtechnologyteachuswhatwecando.Humanisticthinkinghelpsusunderst

andwhatweshoulddo.

Itisalmostimpossibletoimagineoursocietywithoutthinkingoftheextr

aordinaryachievementsofscientistsandengineersinbuildingourcomplicated

world.Buttrytoimagineourworldaswellwithouttheremarkableworksthath

avedefinedourcultureandvalues.Wehavealwaysneeded,andwestillneed,b

oth.

52.Intheearly20thcenturyAmericansbelievedscienceandtechnologycould

[A]solvevirtuallyallexistingproblems[C]helpraisepeople'slivings

tandards

[B]quickenthepaceofindustrialization[D]promotethenation,ssocial

progress

53.WhydidmanyAmericanscholarsbecomeenthusiasticabouthumanisticstu

diesafterWorldWarII?

[A]Theywantedtoimprovetheirownstatuswithinthecurrenteducationsy

stem.

[B]Theybelievedthestabilityofasocietydependedheavilyonhumanistic

studies.

[C]Theycouldgetfinancialsupportfromvariousfoundationsforhumanisti

cstudies.

[D]Theyrealizedscienceandtechnologyalonewerenoguaranteeforabett

erworld.

54.WhyareAmericanscholarsworriedabouteducationtoday?

[A]TheSTEMsubjectsaretoochallengingforstudentstolearn.

[B]SomeAsiancountrieshaveovertakenAmericainbasicsciences.

[C]AmericaislaggingbehindintheSTEMdisciplines.

[D]Therearenotenoughscholarsinhumanisticstudies.

55.Whataccountsforthesignificantdeclineinhumanisticstudiestoday?

[A]Insufficientfunding.[C]Shortageofdevotedfaculty.

[B]Shrinkingenrollment.[D]Dimprospectsforgraduates.

56.Whydoestheauthorattachsomuchimportancetohumanisticstudies?

[A]Theypromotethedevelopmentofscienceandtechnology.

[B]Theyhelppreparestudentsfortheirprofessionalcareers.

[C]Humanisticthinkinghelpsdefineourcultureandvalues.

[D]Humanisticthinkinghelpscultivatestudents'creativity.

PassageTwo

WillthereeverbeanotherEinstein?Thisistheundercurrentofconversati

onatEinsteinmemorialmeetingsthroughouttheyear.AnewEinsteinwillemerg

e,scientistssay.Butitmaytakealongtime.Afterall,morethan200years

separatedEinsteinfromhisnearestrival,IsaacNewton.

ManyphysicistssaythenextEinsteinhasn,tbeenbornyet,orisababyn

ow.That?sbecausethequestforaunifiedtheorythatwouldaccountforallt

heforcesofnaturehaspushedcurrentmathematicstoitslimits.Newmathmust

becreatedbeforetheproblemcanbesolved.

ButresearcherssaytherearemanyotherfactorsworkingagainstanotherEi

nsteinemerginganytimesoon.

Foronething,physicsisamuchdifferentfieldtoday.InEinstein,sday,

therewereonlyafewthousandphysicistsworldwide,andthetheoreticianswho

couldintellectuallyrivalEinsteinprobablywouldfitintoastreetcarwithse

atstospare.

Educationisdifferent,too.OnecrucialaspectofEinstein,strainingtha

tisoverlookedistheyearsofphilosophyhereadasateenager-Kant,Schopen

hauerandSpinoza,amongothers.Ittaughthimhowtothinkindependentlyanda

bstractlyaboutspaceandtime,anditwasn,tlongbeforehebecameaphilosop

herhimself.

“Theindependencecreatedbyphilosophicalinsightis一inmyopinion一the

markofdistinctionbetweenamereartisan(工匠)orspecialistandarealseek

eraftertruth,“Einsteinwrotein1944.

Andhewasanaccomplishedmusician.Theinterplaybetweenmusicandmathi

swellknown.Einsteinwouldfuriouslyplayhisviolinasawaytothinkthroug

haknottyphysicsproblem.

Today,universitieshaveproducedmillionsofphysicists.Therearen,tma

nyjobsinscienceforthem,sotheygotoWallStreetandSiliconValleytoap

plytheiranalyticalskillstomorepractical-andrewarding-efforts.

uMaybethereisanEinsteinouttheretoday,“saidColumbiaUniversityph

ysicistBrianGreene,“butitwouldbealotharderforhimtobeheard.”

EspeciallyconsideringwhatEinsteinwasproposing.

“Theactualfabricofspaceandtimecurving?MyGod,whatanidea!wGree

nesaidatarecentgatheringattheAspenInstitute."Ittakesacertaintype

ofpersonwhowillbanghisheadagainstthewallbecauseyoubelieveyou'11f

indthesolution.”

PerhapsthebestexamplesarethefivescientificpapersEinsteinwrotein

his“miracleyear”of1905.Theseuthoughtexperiments“werepagesofcalcu

lationssignedandsubmittedtotheprestigiousjournalAnnalenderPhysikbya

virtualunknown.Therewerenofootnotesorcitations.

Whatmighthappentosuchasubmissiontoday?

“Weallgetpaperslikethoseinthemail,Greenesaid."Weputthemin

thejunkfile.”

57.Whatdoscientistsseemtoagreeupon,judgingfromthefirsttwop

aragraphs?

[A]Einsteinpushedmathematicsalmosttoitslimits.

[B]ItwilltakeanotherEinsteintobuildaunifiedtheory.

[C]NophysicistislikelytosurpassEinsteininthenext200years.

[D]ItwillbesometimebeforeanewEinsteinemerges.

58.WhatwascriticaltoEinstein'ssuccess?

[A]Histalentasanaccomplishedmusician.

[B]Hisindependentandabstractthinking.

[C]Hisuntiringefforttofulfillhispotential.

[D]Hissolidfoundationinmaththeory.

59.Whatdoestheauthortellusaboutphysiciststoday?

[A]Theytendtoneglecttraininginanalyticalskills.

[B]Theyareverygoodatsolvingpracticalproblems.

[C]Theyattachgreatimportancetopublishingacademicpapers.

[D]Theyoftengointofieldsyieldinggreaterfinancialbenefits.

60.WhatdoesBrianGreeneimplybysaying”.??itwouldbealotharderf

orhimtobeheard”(Lines1-2,Para.9)?

[A]Peoplehavetocompeteinordertogettheirpaperspublished.

[B]Itishardforascientisttohavehispaperspublishedtoday.

[C]PaperslikeEinstein'swouldunlikelygetpublishedtoday.

[D]Nobodywillreadpapersonapparentlyridiculoustheories.

61.Whenhesubmittedhispapersin1905,Einstein.

[A]forgottomakefootnotesandcitations

[B]waslittleknowninacademiccircles

[C]wasknownasayounggeniusinmathcalculations

[D]knewnothingabouttheformatofacademicpapers

答案:52.A)solvevirtuallyallexistingproblems

53.D)Theyrealizedscienceandtechnologyalonewerenoguaranteeforabe

tterworld

54.B)SomeAsiancountrieshaveovertakenAmericainbasicscienes

55.A)Insufficientfunding

56.C)Humanisticthinkinghelpsdefineourcultureandvalues

57.D)ItwillbesometimebeforeanewEinsteinemerges

58.B)Hisindependentandabstractthinking

59.D)Theyoftengointofieldsyieldinggreaterfinancialbenefits

60.C)PaperslikeEinstein,swouldunlikelygetpublishedtoday

61.B)waslittleknowninacademiccircles

2010年6月

PassageOneQuestions51to56arebasedonthefollowingpassage.

Onlytwocountriesintheadvancedworldprovidenoguaranteeforpaidleav

efromworktocareforanewbornchild.Lastspringoneofthetwo,Australia,

gaveupthedubiousdistinctionbyestablishingpaidfamilyleavestartingin

2011.Iwasn'tsurprisedwhenthisdidn'tmakethenewshereintheUnitedStat

es一we'renowtheonlywealthycountrywithoutsuchapolicy.

TheUnitedStatesdoeshaveoneexplicitfamilypolicy,theFamilyandMedi

calLeaveAct,passedin1993.Itentitlesworkerstoasmuchas12weeks,unpa

idleaveforcareofanewbornordealingwithafamilymedicalproblem.Despit

ethemodestyofthebenefit,theChamberofCommerceandotherbusinessgroups

foughtitbitterly,describingitas〃government-runpersonnelmanagement'and

az,dangerousprecedent”.Infact,everystepoftheway,as(usually)Democrat

icleadershavetriedtointroducework-familybalancemeasuresintothelaw,b

usinessgroupshavebeenstronglyopposed.

AsYalelawprofessorAnneAlstottargues,justifyingparentalsupportdepe

ndsondefiningthefamilyasasocialgoodthat,insomesense,societymustp

ayfor.InherbookNoExit:WhatParentsOweTheirChildrenandWhatSociety0

wesParents,shearguesthatparentsareburdenedinmanywaysintheirlives:

thereis〃noexit"whenitcomestochildren."Societyexpects—andneeds—pare

ntstoprovidetheirchildrenwithcontinuityofcare,meaningtheintensive,i

ntimatecarethathumanbeingsneedtodeveloptheirintellectual,emotionalan

dmoralcapabilities.Andsocietyexpects一andneeds一parentstopersistinthe

irrolesfor18years,orlongerifneeded.,z

Whilemostparentsdothisoutoflove,therearepublicpenaltiesfornot

providingcare.Whatparentsdo,inotherwords,isofdeepconcerntothestat

e,fortheobviousreasonthatcaringforchildrenisnotonlymorallyurgentb

utessentialforthefutureofsociety.Thestaterecognizesthisinthelarge

bodyoffamilylawsthatgovernchildren'welfare,yetparentsreceivelittleh

elpinmeetingthelife-changingobligationssocietyimposes.Toclassifyparen

tingasapersonalchoiceforwhichthereisnocollectiveresponsibilityisno

tmerelytoignorethesocialbenefitsofgoodparenting;really,itistostea

1thosebenefitsbecausetheyaccrue(不斷積累)tothewholeofsocietyastoda

y'schildrenbecometomorrow'sproductivecitizenry(公民).Infact,bysomees

timates,thevalueofparentalinvestmentsinchildren,investmentsoftimeand

money(includinglostwages),isequalto20-30%ofgrossdomesticproduct.If

theseinvestmentsgeneratehugesocialbenefits-astheyclearlydo-thebenef

itsofprovidingmoresocialsupportforthefamilyshouldbethatmuchcleare

r.

52.Whatdowelearnaboutpaidfamilyleavefromthefirstparagraph?

A)Americaisnowtheonlydevelopedcountrywithoutthepolicy.

B)IthasnowbecomeahottopicintheUnitedStates.

C)ItcameasasurprisewhenAustraliaadoptedthepolicy.

D)ItsmeaningwasclarifiedwhenitwasestablishedinAustralia.

53.Whathaspreventedthepassingofwork-familybalancelawsintheUnitedSt

ates?

A)TheincompetenceoftheDemocrats.B)TheexistingFamilyandMe

dicalLeaveAct.

C)ThelackofaprecedentinAmericanhistory.D)Theoppositionfromb

usinesscircles.

54.WhatisProfessorAnneAlstott,sargumentforparentalsupport?

A)ThecostofraisingchildrenintheU.S.hasbeengrowing.B)Goodpa

rentingbenefitssociety.

C)TheU.S.shouldkeepupwithotherdevelopedcountries.D)Children

needcontinuouscare.

55.WhatdoestheauthorthinkofAmerica'slargebodyoffamilylawsgoverning

children'swelfare?

A)Theyfailtoensurechildren,shealthygrowthB)Thefailtoprovidee

noughsupportforparents

C)Theyemphasizeparents'legalresponsibilities.D)Theyimposethecar

eofchildrenonparents.

56.Whydoestheauthorobjecttoclassifyingparentingasapersonalchoice?

A)Itisregardedasalegalobligation.B)Itrelieslargelyonsocial

support.

C)Itgenerateshugesocialbenefits.D)Itisbasicallyasocialunder

taking.

PassageTwoQuestions57to62arebasedonthefollowingpassage.

AnewstudyfromtheCenterforInformationandResearchonCivicLearning

andEngagement(CIRCLE)atTuftsUniversityshowsthattoday'syouthvoteinla

rgernumbersthanpreviousgenerations,anda2008studyfromtheCenterforAm

ericanProgressaddsthatincreasingnumbersofyoungvotersandactivistssupp

orttraditionallyliberalcauses.Butthere,snoeasywaytoseewhatthosefig

uresmeaninreallife.Duringthepresidentialcampaign,BarackObamaassemble

daraciallyandideologicallydiversecoalitionwithhismessageofhopeandc

hange;astherealityoflifeunderanewadministrationsettlesin,someofth

osesupportersmightbecomedisillusioned.Asthenationmovesfurtherintothe

Obamapresidency,willpoliticallyengagedyoungpeoplecontinuetosupportth

epresidentandhisagenda,orwilltheygraduallydriftaway?

ThewritersofGeneration0(shortforObama),anewNewsweekblogthatsee

kstochroniclethelivesofagroupofyoungObamasupporters,wanttoanswer

thatquestion.Forthenextthreemonths,MichelleKremerand11otherObamasu

pporters,ages19to34,willblogaboutlifeacrossmainstreamAmerica,witho

netwist:bytyingalloftheirideasandexperiencestothenewpresidentand

hisadministration,thebloggerswilltrytostartaconversationaboutwhatit

meanstobeyoungandpoliticallyactiveinAmericatoday.MalenaAmusa,a24-

year-oldwriteranddancerfromSt.Louisseestheprojectasawaytopreserve

historyasithappens.Amusa,whoistravelingtoIndiathisspringtofinish

abook,thentoSenegaltoteachEnglish,hasongoingconversationswithherfr

lendsabouthowtheObamapresidencyhaschangedtheirdailylivesandhopesto

putsomeofthoseideas,alongwithherglobalperspective,intoherposts.Sh

esexcitedbecause,assheputsit,〃Idon,thavetowait[until]15yearsfro

mnow〃tomakesenseoftheworld.

HenryElores,apolitical-scienceprofessoratSt.Mary'sUniversity,creditst

hisyoungergeneration*spoliticalstrengthtotheirembraceoftechnology.

heInternet]exposesthemtomorethinking,hesays,“andgroupsthatarelike

-mindedindifferentpartsofthecountrystarttocometogether.That'sexact

lywhattheGeneration0bloggersarehopingtodo.Theresultcouldbeagroup

ofyoungpeoplethat,liketheirboomer(二戰(zhàn)后生育高峰期出生的美國(guó)人)parents,

growsupwithastrongsenseofpurposeandshedstheimageofapathy(冷漠)t

hey,veinheritedfromGenerationX(60年代后期和70年代出生的美國(guó)人).It'sno

smallchallengeforablogrunbyagroupofordinary—ifambitious-youngpeo

pie,butthemembersofGeneration0areuptothetask.

57.WhatisthefindingofanewstudybyCIRCLE?

A)Moreyoungvotersaregoingtothepollsthanbefore.

B)Theyounggenerationsupportstraditionallyliberalcauses.

C)YoungvotersplayedadecisiveroleinObama*selection.

D)YoungpeopleinAmericaarenowmorediverseideologically.

58.WhatisamainconcernofthewritersofGeneration0?

A)HowObamaisgoingtoliveuptoyoungpeople,sexpectations.

B)WhetherAmericaisgoingtochangeduring0bama,spresidency.

C)WhetheryoungpeoplewillcontinuetosupportObama'spolicy.

D)HowObama'sagendaisgoingtoaffectthelifeofAmericans.

59.WhatwilltheGeneration0bloggerswriteaboutintheirposts?

A)TheirowninterpretationofAmericanpolitics.

B)PolicychangestotakeplaceinObama'sadministration.

C)Obama/spresidencyviewedfromaglobalperspective.

D)TheirlivesinrelationtoObama'spresidency.

60.Whataccountsfortheyoungergeneration'spoliticalstrengthaccordingto

ProfessorHenryFlores?

A)Theirembraceofradicalideas.B)TheirdesiretochangeAmerica.

C)TheirutilizationoftheInternet.D)Theirstrongsenseofresponsib

ility.

61.WhatcanweinferfromthepassageaboutGenerationX?

A)Theyarepoliticallyconservative.B)Theyrejectconventionalvalues.

C)Theydaretotakeupchallenges.D)Theyareindifferenttopolitics.

答案:52A)53D)54B)55B)56D)57A)58C)59D)60

C)61D)

2009年12月

SectionB

PassageOneQuestions52to56arebasedonthefollowingpassage.

Thereisnothinglikethesuggestionofacancerrisktoscareaparent,especi

allyoneoftheover-educated,eco-conscioustype.Soyoucanimaginethereact

ionwhenarecentUSATodayinvestigationofairqualityaroundthenation'ss

choolssingledoutthoseinthesmugly(自鳴得意的)greenvillageofBerkeley,

Calif.,asbeingamongtheworstinthecountry.Thecity'spublichighschool,

aswellasanumberofdaycarecenters,preschools,elementaryandmiddlescho

ols,fellinthelowest10%.Industrialpollutioninourtownhadsupposedlytu

rnedstudentsintolivingscienceexperimentsbreathinginalaboratoryJswort

hofheavymetalslikemanganese,chromiumandnickeleachday.Thisinacity

thatrequiresschoolcafeteriastoserveorganicmeals.Great,Ithought,organ

iclunch,toxiccampus.

SinceDecember,whenthereportcameout,themayor,neighborhoodactivists(活

躍分子)andvariousparent-teacherassociationshaveengagedinafiercebattle

overitsvalidity:overtheguiltofthesteel-castingfactoryonthewesterne

dgeoftown,overunionjobsversuschildren'shealthandoverwhat,ifanythi

ng,oughttobedone.Withallsidespresentingtheirownexpertsarmedwithco

nflictingscientificstudies,whomshouldparentsbelieve?Istheretrulyathr

eathere,weaskedoneanotheraswedroppedoffourkids,andifso,howgreat

isit?Andhowdoesitcomparewiththeother,seeminglyperpetualhealthscar

esweconfront,likepanicoverleadinsyntheticathleticfields?Ratherthan

justanotherweirdepisodeinthetownthatbroughtyouprotestingenvironmenta

lists,thislatestdramaisatrialforhowtoday'sparentsperceiverisk,how

wetrytokeepourkidssafe-whetherit'spossibletokeepthemsafe—inwhat

feelslikeanincreasinglythreateningworld.Itraisesthequestionofwhat,i

nourtime,“safe"couldevenmean.

“There'snowayaroundtheuncertainty,saysKimberlyThompson,presidento

fKidRisk,anonprofitgroupthatstudieschildren'shealth."Thatmeansyou

rchoicescanmatter,butitalsomeansyouaren,tgoingtoknowiftheydo.”

A2004reportinthejournalPediatricsexplainedthatnervousparentshavemor

etofearfromfire,caraccidentsanddrowningthanfromtoxicchemicalexposu

re.TowhichIsay:Well,obviously.Butsuchconcretehazardsarebesidethep

oint.It'sthedangersparentscan,t—andmaynever—quantifythatoccurall

ofsudden.That'swhyI'veridmycupboardofmicrowavefoodpackedinbagsc

oatedwithapotentialcancer-causingsubstance,butalthoughI'velivedblock

sfromamajorfaultline(地質(zhì)斷層)formorethan12years,IstillhavenJtbo

Itedourbookcasestothelivingroomwall.

52.WhatdoesarecentinvestigationbyUSATodayreveal?

A)Heavymetalsinlabteststhreatenchildren'shealthinBerkeley.

B)Berkeleyresidentsarequitecontentedwiththeirsurroundings.

C)TheairqualityaroundBerkeley,sschoolcampusesispoor.

D)ParentsinBerkeleyareover-sensitivetocancerriskstheirkidsface.

53.WhatresponsedidUSATodayrsreportdraw?

A)Aheateddebate.B)Popularsupport.C)Widespreadpanic.D)Strongcriti

cism.

54.Howdidparentsfeelinthefaceoftheexperts'studies?

A)Theyfeltverymuchrelieved.B)Theywerefrightenedbytheevidence.

C)Theydidn,tknowwhotobelieve.D)Theyweren'tconvincedoftheresults.

55.Whatistheviewofthe2004reportinthejournalPediatrics?

A)Itisimportanttoquantifyvariousconcretehazards.

B)Dailyaccidentsposeamoreseriousthreattochildren.

C)Parentsshouldbeawareofchildren,shealthhazards.

D)Attentionshouldbepaidtotoxicchemicalexposure.

56.Ofthedangersineverydaylife,theauthorthinksthatpeoplehavemostto

fearfrom.

A)theuncertainB)thequantifiableC)anearthquakeD)unhealthyfood

PassageTwoQuestions57to61arebasedonthefollowingpassage.

Cripplinghealthcarebills,longemergency-roomwaitsandtheinabilitytofin

daprimarycarephysicianjustscratchthesurfaceoftheproblemsthatpatien

tsfacedaily.

Primarycareshouldbethebackboneofanyhealthcaresystem.Countrieswitha

ppropriateprimarycareresourcesscorehighlywhenitcomestohealthoutcomes

andcost.TheU.S.takestheoppositeapproachbyemphasizingthespecialistr

atherthantheprimarycarephysician.

ArecentstudyanalyzedtheproviderswhotreatMedicarebeneficiaries(老年醫(yī)保

受惠人).ThestartlingfindingwasthattheaverageMedicarepatientsawatot

alofsevendoctors一twoprimarycarephysiciansandfivespecialists一inagiv

enyear.Contrarytopopularbelief,themorephysicianstakingcareofyoudo

n'tguaranteebettercare.Actually,increasingfragmentationofcareresults

inacorrespondingriseincostandmedicalerrors.

Howdidweletprimarycareslipsofar?Thekeyishowdoctorsarepaid.Most

physiciansarepaidwhenevertheyperformamedicalservice.Themoreaphysici

andoes,regardlessofqualityoroutcome,thebetterhe'sreimbursed(返還費(fèi)

用).Moreover,theamountaphysicianreceivesleansheavilytowardmedicalor

surgicalprocedures.Aspecialistwhoperformsaprocedureina30-minutevisit

canbepaidthreetimesmorethanaprimarycarephysicianusingthatsame30

minutestodiscussapatientsdisease.Combinethisfactwithannualgovernme

ntthreatstoindiscriminatelycutreimbursements,physiciansarefacedwithno

choicebuttoincreasequantitytoboostincome.

Primarycarephysicianswhorefusetocompromisequalityareeitherdrivenout

ofbusinessortocash-onlypractices,furthercontributingtothedeclineofp

rimarycare.

Medicalstudentsarenotblindtothisscenario.Theyseehowheavilythereimb

ursementdeckisstackedagainstprimarycare.Therecentnumbersshowthatsin

ce1997,newlygraduatedU.S.medicalstudentswhochooseprimarycareasacar

eerhavedeclinedby50%.Thistrendresultsinemergencyroomsbeingoverwhelm

edwithpatientswithoutregulardoctors.

Howdowefixthisproblem?

Itstartswithreformingthephysicianreimbursementsystem.Removethepressur

eforprimarycarephysicianstosqueezeinmorepatientsperhour,andreward

themforoptimally(最佳地)managingtheirdiseasesandpracticingevidence-bas

edmedicine.Makeprimarycaremoreattractivetomedicalstudentsbyforgiving

studentloansforthosewhochooseprimarycareasacareerandreconcilingth

emarkeddifferencebetweenspecialistandprimarycarephysiciansalaries

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