Passage Five
It is said that in England death is pressing, in Canada inevitable and in California optional. Small wonder. American’s life expectancy has nearly doubled over the past century. Failing hips can be replaced, clinical depression controlled, cataracts (白内障) 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 U.S. 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. Ask 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 overfunding the quest for unlikely cures while underfunding research on humbler therapies that could improve people’s lives.
Questions 21-25 are based on Passage Five.
The first sentence of paragraph l implies that ______.
A.Americans enjoy a higher life quality than ever before B.Americans are better prepared for death than other people C.Americans are over-confident of their medical technology D.Americans take a vain pride in their long life expectancyPassage One
The over-60 population is growing faster than any other age group. Between 1950 and 2050 it is expected to increase from 200 million to 2 billion. As the number of older persons increases, so will the need to ensure their [social inclusion], based on an income from decent work or retirement and a chance to participate in community life through employment, volunteer work or other activities. According to the International Labour Organization, “decent work” is work that meets people’s basic aspirations, not only for income, but also for security for themselves and their families, in a working environment that is safe. Decent work treats men and women equally, without discrimination or harassment. Finally, decent work provides social security and is carried out in conditions of freedom and human dignity.
But there are over 1.2 billion people in the world who live on an income of less than $1 a day, and another billion who live on less than $2 a day. They live hand to mouth, day to day, and do not have enough income to support their daily existence — much less put something aside for retirement. In most developing countries retirement is a luxury few older people can afford. Even in developed countries some hard working people will not have enough to live on retirement. Many women — paid less than men, working more at home than men, and working more informally than men — may not be ready or able to rest at 65.
By tradition, at least in developed countries, there is a change in roles as one moves from active middle years into “gentle” and “enjoyable” retirement. This change in roles has been viewed by the public, by government and by business, as a transition from a productive time of life to one that is unproductive and dependent. [But today more than ever, this is not true.] Most older people do not withdraw from society. Instead, they continue to contribute to their households, to their descendants and to their communities, although their contribution may not be paid employment.
Instead of producing goods or services — the traditional economic model “products”-older persons may contribute a “product” that has value to society, such as caring for children, caring for other older persons, caring for the oldest old, providing community leadership, mentoring or being an effective role model. But in spite of their significant human and economic benefits, such contributions have not been figured into an economy’s gross national product. And they have not been appropriately valued.
Over the past several decades, most industrialized countries have experienced a substantial drop in the average age at which individuals retire from the labour market. Longer life expectancy and better health have not been accompanied by longer working lives. As a consequence, these countries are facing serious concerns about the viability of social security systems. A key challenge for these countries is to mitigate the effects of a drop in the working age population by increasing and prolonging the participation of older people in the labour market.
Questions 1-5 are based on Passage One.
The term “social inclusion” (in Para . 1) here means ______.
A.having decent work B.being equal in jobs C.having decent income D.being productive in life