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)


Canadas 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 component of which are pharmaceutical costs.

(41) ____________


What to do? Both the Romanow commission and the Kirby committee on health careto say nothing of reports from other expertsrecommended 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.

(42) _____________


But nationaldoesnt have to mean that. Nationalcould mean interprovincialprovinces combining efforts to create one body.


Either way, one benefit of a nationalorganization would be to negotiate better prices, if possible, with drug manufacturers. Instead of having one provinceor a series of hospitals within a provincenegotiate 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 of 31 million people. Basic economics suggests the greater the potential consumers, the higher the likelihood of a better price.

(43) _____________


A small step has been taken in the direction of a national agency with the creation of the Canadian Co-ordinating 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. Thats one reason why the idea of a national list hasnt gone anywhere, while drug costs keep rising fast.

(44) _____________


Premiers love to quote Mr. Romanows 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 constrain the ever-increasing cost of drugs.

(45) _____________


So when the premiers gather in Niagara Falls to assemble their usual complaint list, they should also get cracking 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 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 nationalmean? 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 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 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 costs, prevent one province from being played off against another, and bargain for better drug prices.


[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 province to another. They can hope that, if one province includes a drug on its list, the pressure will cause others toinclude it on theirs. They wouldnt like a national agency, but self-interest would lead them to deal with it.



【答案】 E
【解析】空所在的位置是介于两段之间,那么解题的关键是看前后给出的关键信息。文章第一段由加拿大省级官员的会议引出文章谈论的主题——加拿大的保健费用上升。第二段,也就是空的上一段,进一步指出保健费用上升的原因是由于医疗费用上升。空的下一段谈到解决这个问题的措施——建立一个全国性的机构。空前提到问题,空后谈到解决办法,空居于中间,必然要起到承上启下的作用,而从第四段的开头“What to do?”问句,显然这里才开始涉及到方法,故就只能含有承上的内容,也就是继续谈到医疗费用高涨的情况,查看选项,只有E满足这一条件,故答案为E

【答案】 C

【答案】 G

【答案】 F

【答案】 B