1、大学英语四级改革适用（阅读）模拟试卷 68及答案与解析 Section B 0 The Case for Killing My Mother A)My mother wanted to die,but the doctors wouldnt let her. At least thats the way it seemed to me as I stood by her bed in an intensive-care unit, at a hospital in Hilton Head,S. C,five years ago. My mother was 79, a longtime smo
2、ker who was dying of emphysema(肺气肿 ). She knew that her quality of life was increasingly tied to an oxygen tank. That she was losing her ability to get about, and that she was slowly drowning,The doctors at her bedside were continuing various tests and procedures to keep her alive, but my mother, wi
3、th a certain firmness I recognized, said no. She seemed puzzled and a bit frustrated that she had to be so insistent on her own death. B)The hospital at my mothers assisted-living facility was sustained by Medicare, which pays by the procedure. I dont think the doctors were trying to be greedy by pu
4、shing more treatments on my mother. That s just the way the system works. The doctors were responding to the expectations of almost all patients. As a doctor friend of mine puts it. “Americans want the best they want the latest, and they want it now.“ We expect doctors to make heroic efforts especia
5、lly to save our lives and the fives of our loved ones. C)The idea that we might ration health care to seniors or lonely else is political curse. Politicians do not dare breathe the word, lest they be accused however wrongly of trying to pull the plug on mother. But the need to spend less money on th
6、e elderly at the end-of-life is the elephant in the room in the health, reform debate. Everyone sees it but no one wants to talk about it. At a more basic level, Americans are afraid not just of dying, but of talking and thinking about death. Until Americans learn to regard death as more than a scie
7、ntific challenge to be overcoat, our health-care system will remain unfixable. D)Compared with other Western countries, the United States has more health care, but, generally speaking,not better health care. There is no way we can get control of costs, which have grown by nearly 50 percent in the pa
8、st decade, without finding a way to stop over eating patients. In his address to Congress, President Obama spoke airily about reducing inefficiency, but he slid past the hard choices that will have to be made to stop health care from devouring ever-larger slices of the economy and tax dollar. A sign
9、ificant portion of the savings will have to come from the money we spend on seniors at the end-of-life because, as Willie Sutton explained about why he rubbed banks, that s where the money is. E)As President Obama said, most of the uncontrolled growth in federal spending and the deficit comes from M
10、edicare, nothing else comes close. Almost a third of the money spent by Medicare about $66.8 billion a year goes to chronically ill patients in the last two years of life. This might seem obvious of smartarse the Costs come at the end, when patients are the sickest. But that cant explain what resear
11、chers at Dartmouth have discovered:Medicare spends twice as much on similar patients in sonic parts of the country as in others. The average cost of a Medicare patient in Miami is $16,351: the average in Honolulu is $5,311. F)And this treatment does not necessarily buy better care. In fact, the Dart
12、mouth studies have found worse outcomes in many states and cities where there is more health care. Why? Because just going into the hospital has risks of infection, or error. Some studies estimate that Americas are over treated by roughly 30 percent Its not about rationing care, thats always the bog
13、eyman(魔鬼 )people use to block reform,“ says Dr. Elliott Fisher, a professor at Dartmouth Medical School. “The real problem is unnecessary and unwanted care.“ G)But how do you decide which treatments to cut out? How do you choose between the necessary and the unnecessary? There has been talk among ex
14、perts and lawmakers of giving more power to a panel of government experts to decide Britain has one, called the National Institute for Health and Clinical Excellence(known by the somewhat ironic acronym NICE). But no one wants the horror stories of denied care and long waits that are said to plague
15、state run national health care systems. After the summer of angry town halls, no politician is going to get anywhere near something that could be called a “death panel“. H)Ever rising health-care spending now consumes about 17 percent of the economy. At the current rate of increase, it will devour a
16、 fifth of GDP by 2018. We cannot afford to sustain a productive economy with so much money going to health care. Economic reality may force us to adopt a national health care system like Britains or Canadas. But before that day arrives, there are stops we can take to reduce costs without totally tur
17、ning the system inside out. I)Other initiatives ensure that the elderly get counseling about end-of-life issues. Although demagogue(蛊惑民心的政客 )as a “death panel“, a program in Wisconsin to get patients to talk to their doctors about how they want to deal win death was actually an outstanding success.
18、A study by the Archives of Intermale Medicine shows that such conversations between doctors and patients call decrease costs by about 35 percent while improving the quality of life at the end. J)Patients should be encouraged to draft living wills to make their end-of-life desires known. Unfortunatel
19、y, such paper can be useless if there is a family member at the bedside demanding heroic measures. “A lot of the little guilt is playing a role,“ says Dr. David Tokharian, a surgeon and CEO of the Massachusetts General Physicians Organization. Doctors can feel guilty, too about over treating Patient
20、s Diana, recalls his unease over operating to treat a severe heart infection in a woman with two forms of metastatic(转移 )cancer who was already comatose(昏迷的 ). The family insisted. K)Studies show that about 70 percent of people want to die at home but that about half die in hospitals. There has been
21、 an important increase in hospice(临终关怀病房 )palliative(缓解的 )care keeping patients with incurable diseases as comfortable as possible while they live out the remainder of their lives. Hospice services are generally intended for the terminally ill in the last six months of life, but as a practical matte
22、r, many people receive hospice care for only a few weeks. L)Thats what my mother wanted. After convincing the doctors that she meant it that she really was ready to die she was transferred from the ICU to a hospice, where, five days later, she passed away. In the ICU, as they removed all the monitor
23、s and pulled out all the tubes and wires, she made a shaking motion with her hands. She seemed to be signaling goodbye to all that I m free to go in peace. 1 Doctors are generally expected to make their utmost effort when it comes to the lives of our own and our beloved ones. 2 70% of people want to
24、 die at home, but only a half can do that. 3 According to the study by the Archives of Intermale Medicine, conversations between doctors and patients decrease costs while improving the quality of the end. 4 The rising health-care cost can t sustain a productive economy. 5 President Obama said, nothi
25、ng else could compare with Medicare when it came to federal spending and the deficit. 6 A huge portion of the savings is spending on seniors at the end-of-life. 7 To some extent, Americans are afraid of talking and thinking about death. 8 8.The United States has more, but not better health care than
26、 other Western countries. 9 According to Dartmouth studies, more health care does not necessarily buy better care. 10 Even patients have draft living wills, it will be useless if a family member insists on medical care. 10 Haiti s Tourism A)Like many of its Caribbean neighbors, Haiti once drew many
27、tourists. But decades of political instability, repression and poverty, as well as natural disasters, led to the decay of the tourism infrastructure, and almost no visitors come now. Officials would like to change that. The arts town of Jacmel is one place they think could be a start. B)A couple of
28、untidy aid workers were sucking down Sunday morning beers at the Hotel Florida here when the minister of tourism rolled up to the roadside, followed by the interior minister with body guards and then the star of the show, New York fashion designer Donna Karan of DKNY. The notables were in Jacmel, th
29、e funky(含有黑人韵味的爵士 )art and carnival capital of Haiti, to plot the transformation of the earthquake-rattled port from a faded flower of the Caribbean to a resort destination for celebrities. C)“Were trying to rebrand Haiti, and so were bringing Donna here to help us with our vision,“ Tourism Minister
30、 Stephanie Balrmir Villedrouin said in an interview. “Were trying to raise the bar a little bit,“ Said Karma, as she swept through the abandoned Hotel Jacmeliernne its seaside swimming pool green with grass, its overgrown gardens littered with broken glass Oh, We can definitely work with this!“ D)As
31、 hard as it may be for young Haitians to believe, their country was once a tourist destination. Even during the bad old days of the Duvaiier dictatorships(独裁 ), tourists came. Or at least a few: see Graham Greenes 1966 novel The Comedians, set incidentally at a hotel and based on a real-life mansion
32、(大厦 ), the Hotel Oloffson in the capital; the hotel is still in operation but is now run by Richard Morse, front man for the rock band RAM and the new governments special political envoy(大使 )to the Americas. Today, nobody visits Haiti for fun, except Haitians returning from the abroad. The arrivals
33、at the Port-au-Prince airport are filled with Baptist missionaries, UN officials and American nurses not a real tourist in sight. E)Yet across the Caribbean, revenue from tourism represents about 16 percent of gross domestic product, and many island nations, such as the Bahamas, Barbados and Antigua
34、, generate at least a third of their GDP from visitors. For most of the Caribbean, tourists dollars, euros and pesos(比索 )are the No.l source of foreign investment. F)Haiti let its tourism infrastructure degrade over three decades of political instability, hurricanes, earth quakes and deadly disease.
35、 But the poorest country in the Western hemisphere has a lot to offer the adventuresome visitor, according to international planners and Haitian officials. The Creole French cuisine(美食 )here is some of the best in the Caribbean; its artisans are of world renown, its blend of African and Spanish musi
36、c unique. All this, and rock music, too. G)The still-evolving plans for Haiti forecast Jacmel as a stand-alone destination, meaning tourists would not land in the disordered, dangerous, poor capital, Port-au-Prince, but arrive directly here via air or boat. H)With development aid from banks and dono
37、r nations, the government of former carnival singer and current President Michel Martelly is planning to extend the airport runway at Jacmel so it can accomodate small jets that would shuttle from Miami and Fort Lauderdale, Fla. Puerto Rico; and Guadaloupe. The deserted port is also scheduled for re
38、storation to allow big cruise ships to dock. I)In the late 1800s, Jacmel was an important Caribbean crossroads in Haiti then called the “Pearl of the Antilles“ and its downtown still harbors the Creole architecture of iron balconies and shuttered ware houses for coffee and orange peel. The town remi
39、nds many visitors of the French Quarter in New Orleans, and it hosts one of the best carnivals in the Caribbean, as well as a music festival and a film festival, now struggling to gain promotion again after the 2010 earthquake, seeing potential in ruin. J)Donna Karan knows Jacmel well; she shot her
40、fall catalog at the Hotel Florida. The New Yorker gamely jumped into the bed of a small track for a tour of town. It stopped at the Manoir Alexandre, once the most prominent building in the city and now a rain that is slowly being restored by Leon Paul, a Haitian American orthopedic surgeon from New
41、 York. K)“We want to restore the mansion to its former glory, but as you can see, that is a big job, “Paul said as he walked Karan through the property, with its peeling wallpaper, holes in the roof, missing stair sand tilting balcony. L)He said Jacmel, his home town, will rise from the ruins, and h
42、e promised that someday soon, Haitian said visitors will be sitting in his restored mansion, listening to a band, drinking rum and celebrating. As Karan crawled through the ruins, she saw not despair, but hope: “Wow! Look at this. These are my colors. The rust, yellow and blue. Take a picture. This
43、is perfect!“ 11 Stephanie Balrmir Villedrouin says, theyre trying to rebrand Haiti, and they are bringing Donna to help them. 12 Paul said restoring the mansion to its former glory will be a big job. 13 Even in the days of Duvaiier dictatorships, tourists came to Haiti. 14 An airport runway at Jacme
44、l is being planned so small jets can shuttle from Miami and Fort Lauderdale. 15 Tourists will arrive directly in Jacmel via air of boat, without landing in dangerous capital Port-au-Prince. 16 Haiti s tourism infrastructure degrades with political instability, hurricanes, earth quakes and deadly dis
45、ease. 17 Officials would like to make the arts town of Jacmel as the first place to change the poverty. 18 Tourists dollars, euro and pesos are most of the Caribbean s main source of foreign investment. 19 Jacmel reminds many visitors of the best carnivals in the Caribbean. 20 Karan saw hope in the
46、color of rust, yellow and blue. 20 British Cuisine: The Best of Old and New British cuisine(烹饪 )has come of age in recent years as chefs(厨师 )combine the best of old and new. A)Why does British food have a reputation for being so bad? Because it is bad! Those are not the most encouraging words to hea
47、r just before eating lunch at one of Hong Kong s smartest British restaurants, Alfie s by KEE, but head chef Neil Tomes has more to say. B)“The past 15 years or so have been a noticeable period of improvement for food in England,“ the English chef says, citing the trend in British cuisine for better
48、 ingredients, preparation and cooking methods, and more appealing presentation. Chefs such as Delia Smith, Nigel Slater, Jamie Oliver and Gordon Ramsay made the public realise that cooking and eating didnt have to be a boring thing. And now, most of the British public is familiar even with the extre
49、mes of Heston Blumenthaps molecular gastronomy, a form of cooking that employs scientific methods to create the perfect dish. C)“Its no longer the case that the common man in England is embarrassed to show he knows about food,“ Tomes says. D)There was plenty of room for improvement. The problems with the nations cuisine can be traced back to the Second World War. Before the War, much of Britain s food was imported and when German U-boats began attacking ships bringing food to the country, Britain went on ratio
