考试时间 2014年3月22日星期六 下午2:00-5:00 原创作者qq 347952582 zn^ v!:[
Passage 72(9/22) cD8Ea(
SinceWould War II considerable advances have been made in the area of health-careservices. These include better access to health care (particularly for the poorand minorities), improvements in physical plants, and increased numbers ofphysicians and other health personnel. All have played a part in the recentimprovement in life expectancy. But there is mounting criticism of the largeremaining gaps in access, unbridled cost inflation, the further fragmentationof service, excessive indulgence in wasteful high-technology “gadgeteering,”and a breakdown in doctor-patient relationships. In recent years, proposed panaceas and new programs,small and large, have proliferated at a feverish pace and disappointmentsmultiply at almost the same rate. This has led to an increasedpessimism—“everything has been tried and nothing works”—which sometimes borderson cynicism or even nihilism. Um'Ro 4
Itis true that the automatic “pass through” of rapidly spiraling costs togovernment and insurance carriers, which was set in a publicized environment of“the richest nation in the world,” produced for a time a sense of unlimitedresources and allowed to develop a mood whereby every practitioner andinstitution could “do his own thing” without undue concern for the “MedicalCommons.” The practice of full-cost reimbursement encouraged capital investmentand now the industry is overcapitalized. Many cities have hundreds of excesshospital beds; hospitals have proliferated a superabundance of high-technologyequipment; and structural ostentation and luxury were the order of the day. Inany given day, one-fourth of all community beds are vacant; expensive equipmentis underused or, worse, used unnecessarily. Capital investment brings rapidlyrising operating costs. Y"oDFo,
Yet,in part, this pessimism derives from expecting too much of health care. It mustbe realized that care is, for most people, a painful experience, oftenaccompanied by fear and unwelcome results. Although there is vast room forimprovement, health care will always retain some unpleasantness andfrustration. Moreover, the capacities of medical science are limited. HumptyDumpty cannot always be put back together again. Too many physicians arereluctant to admit their limitations to patients; too many patients andfamilies are unwilling to accept such realities. Nor is it true that everythinghas been tried and nothing works, as shown by the prepaid group practice plansof the Kaiser Foundation and at Puget Sound. In the main, however, suchundertakings have been drowned by a veritable flood of public and privatemoneys which have supported and encouraged the continuation of conventionalpractices and subsidized their shortcomings on a massive, almost unrestricted scale.Except for the most idealistic and dedicated, there were no incentives to seekchange or to practice self-restraint or frugality. In this atmosphere, it isnot fair to condemn as failures all attempted experiments; it may be moreaccurate to say many never had a fair trial. )-#i8?y3C
1. The author implies that the KaiserFoundation and Puget Sound plans (lines 47-48) differed from other plans by m0C{SBn-M
(A)encouraging capital investment Z>h{`
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(B)requiring physicians to treat the poor 1b+h>.gWar
(C)providing incentives for cost control feN!_-
(D)employing only dedicated and idealistic doctors 1=>2uYKR
(E)relying primarily on public funding ) H+d.Y
2. The author mentions all of the following asconsequences of full-cost reimbursement EXCEPT !"%S#nrL$
(A)rising operating costs `/c@nxh
(B)underused hospital facilities d Q
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(C)overcapitalization ]f5c\\)
(D)overreliance on expensive equipment )WclV~
(E)lack of services for minorities jf 8w7T
3. The tone of the passage can best bedescribed as j^{b^!4~}
(A)light-hearted and amused -`g J
(B)objective but concerned iAgOnk[
(C)detached and unconcerned P]-#wz=S
(D)cautious but sincere w#rVSSXQ3
(E)enthusiastic and enlightened $-e=tWkgv
4. According to the author, the “pessimism”mentioned at line 35 is partly attributable to the fact that xlk5Gob*
(A)there has been little real improvement in health-care services Eny!R@u7q
(B)expectations about health-care services are sometimes unrealistic *cPN\Iu.W
(C)large segments of the population find it impossible to get access tohealth-care services IBDVFA
(D)advances in technology have made health care service unaffordable 0yKhp:^
(E)doctors are now less concerned with patient care Zq^^|[)bA
5. The author cites the prepaid plans in lines46-48 as Eh:yRJ_8
(A)counterexamples to the claim that nothing has worked _=6vW^s
(B)examples of health-care plans that were over-funded PQ i
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(C)evidence that health-care services are fragmented l-XnB
(D)proof of the theory that no plan has been successful !@A|L#*
(E)experiments that yielded disappointing results |MVV +.X
6. It can be inferred that the sentence“Humpty Dumpty cannot always be put back together again” means that +<z7ds{Z
(A)the cost of health-care services will not decline :ET x*c
(B)some people should not become doctors n00z8B1j(l
(C)medical care is not really essential to good health " xlJs93c
(D)illness is often unpleasant and even painful p?}&
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(E)medical science cannot cure every ill vu44 !c@
7. With which of the following descriptions ofthe system for the delivery of health-care services would the author mostlikely agree? ]bf'
(A)It is biased in favor of doctors and against patients. FXcc1X/
(B)It is highly fragmented and completely ineffective % /~os2R
(C)It has not embraced new technology rapidly enough ]Kof sU_{
(D)It is generally effective but can be improved zI(xSX@
(E)It discourages people from seeking medical care SCqu,
8. Which of the following best describes thelogical structure of the selection?
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(A)The third paragraph is intended as a refutation of the first and secondparagraphs. Sb^a dd0dT
(B)The second and third paragraphs explain and put into perspective the pointsmade in the first paragraph. i[mC3ghM6,
(C)The second and third paragraphs explain and put into perspective the pointsmade in the first paragraph. iOKr9%9?Z
(D)The first paragraph describes a problem, and the second and third paragraphs presenttwo horns of a dilemma.
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(E)The first paragraph describes a problem, the second its causes, and the third apossible solution. U<K|jsFo
9. The author’s primary concern is to tWcizj;?wK
(A)criticize physicians and health-care administrators for investing in techno-logicallyadvanced equipment "4KkKi
(B)examine some problems affecting delivery of health-care services and assesstheir severity ?0? x+
(C)defend the medical community from charges that health-care has not improvedsince World War II Q S5dP
(D)analyze the reasons for the health-care industry’s inability to provide qualitycare to all segments of the population B >ms`|q=l
(E)describe the peculiar economic features of the health-care industry that arethe causes of spiraling medical costs 6s> sj7
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Passage 71(8/22) s@/B*r9
Behavioris one of two general responses available to endothermic (warm-blooded) speciesfor the regulation of body temperature, the other being innate (reflexive)mechanisms of heat production and heat loss. Human beings rely primarily on thefirst to provide a hospitable thermal microclimate for themselves, in which thetransfer of heat between the body and the environment is accomplished withminimal involvement of innate mechanisms of heat production and loss.Thermoregulatory behavior anticipates hyperthermia, and the organism adjustsits behavior to avoid becoming hyperthermic: it removes layers of clothing, itgoes for a cool swim, etc. The organism can also respond to changes in thetemperature of the body core, as is the case during exercise; but suchresponses result from the direct stimulation of thermoreceptors distributedwidely within the central nervous system, and the ability of these mechanismsto help the organism adjust to gross changes in its environment is limited. LZgwIMd
Untilrecently it was assumed that organisms respond to microwave radiation in thesame way that they respond to temperature changes caused by other forms ofradiation. After all, the argument runs, microwaves are radiation and heat bodytissues. This theory ignores the fact that the stimulus to a behavioralresponse is normally a temperature change that occurs at the surface of theorganism. The thermoreceptors that prompt behavioral changes are located withinthe first millimeter of the skin’s surface, but the energy of a microwave fieldmay be selectively deposited in deep tissues, effectively bypassing thesethermoreceptors, particularly if the field is at near-resonant frequencies. Theresulting temperature profile may well be a kind of reverse thermal gradient inwhich the deep tissues are warmed more than those of the surface. Since theheat is not conducted outward to the surface to stimulate the appropriatereceptors, the organism does not “appreciate” this stimulation in the same waythat it “appreciates” heating and cooling of the skin. In theory, the internalorgans of a human being or an animal could be quite literally cooked well-donebefore the animal even realizes that the balance of its thermomicroclimate hasbeen disturbed. [Od>NO,n+]
Untila few years ago, microwave irradiations at equivalent plane-wave powerdensities of about 100 mW/cm2 were considered unequivocally toproduce “thermal” effects; irradiations within the range of 10 to 100 mW/cm2might or might not produce “thermal” effects; while effects observed at powerdensities below 10 mW/cm2 were assumed to be “nonthermal” in nature.Experiments have shown this to be an oversimplification, and a recent reportsuggests that fields as weak as 1 mW/cm2 can be thermogenic. Whenthe heat generated in the tissues by an imposed radio frequency (plus the heatgenerated by metabolism) exceeds the heat-loss capabilities of the organism,the thermoregulatory system has been compromised. Yet surprisingly, not longago, an increase in the internal body temperature was regarded merely as“evidence” of a thermal effect. <\B],M1=s=
1. The author is primarily concerned with ,R7=]~<io"
(A)showing that behavior is a more effective way of controlling bodily temperaturethan innate mechanisms +s#S{b
(B)criticizing researchers who will not discard their theories about the effectsof microwave radiation on organisms AGw1Pl8]K
(C)demonstrating that effects of microwave radiation are different from those ofother forms of radiation yg]suU<z]
(D)analyzing the mechanism by which an organism maintains its bodily temperaturein a changing thermal environment nF|#@O`1
(E)discussing the importance of thermoreceptors in the control of the internaltemperature of an organism XLkL#&Ir
2. The author makes which of the followingpoints about innate mechanisms for heat production? ls8olLM>
I. They are governed by thermoreceptorsinside the body of the organism rather than at the surface. ]#vvlM>/
II. They are a less effective means ofcompensating for gross changes in temperature than behavioral strategies.
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III. They are not affected by microwaveradiation. <~IH`
(A)I only S3%.-)ib
(B)I and II only L8,H9T#e
(C)I and III only '6Pu[^x
(D)II and III only .0R/'!e
(E)I, II, and III ^.pE`l%1}
3. Which of the following would be the mostlogical topic for the author to take up in the paragraph following the final paragraph of the selection? |TQe
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(A)A suggestion for new research to be done on the effects of microwaves on animalsand human beings 6xDl=*&%
(B)An analysis of the differences between microwave radiation a"v"n$
(C)A proposal that the use of microwave radiation be prohibited because it isdangerous G#9o?
(D)A survey of the literature on the effects of microwave radiation on humanbeings nzQYn
(E)A discussion of the strategies used by various species to control hyperthermia
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4. The author’s strategy in lines 39-42 is to z[0LU]b<
(A)introduce a hypothetical example to dramatize a point dy8In%
(B)propose an experiment to test a scientific hypothesis 7Ap~7)z[
(C)cite a case study to illustrate a general contention tF;& x
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(D)produce a counterexample to disprove an opponent’s theory u~naVX\3b
(E)speculate about the probable consequences of a scientific phenomenon c'TiWZP~
5. The author implies that the proponents ofthe theory that microwave radiation acts on organisms in the same way as otherforms of radiation based their conclusions primarily on ^
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(A)laboratory research T}b(
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(B)unfounded assumption LS2ek*FJO
(C)control group surveys '5OVs:)"^
(D)deductive reasoning ,
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(E)causal investigation :#Ex3H7
6. The tone of the passage can best bedescribed as f!uA$uLc
(A)genial and conversational <L!~f`nH2
(B)alarmed and disparaging ZB_16&2Ow
(C)facetious and cynical QBPvGnb
(D)scholarly and noncommittal Jegx[*O>b
(E)scholarly and concerned c=jI.=mi3
7. The author is primarily concerned with jV|$?
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(A)pointing out weaknesses in a popular scientific theory
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(B)developing a hypothesis to explain a scientific phenomenon H[_uVv;}6
(C)reporting on new research on the effects of microwave radiation @6i8RmOu}
(D)criticizing the research methods of earlier investigators 7p>-oR"
(E)clarifying ambiguities in the terminology used to describe a phenomenon vA7jZw
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Passage 74(11/22) 84oW
Agriculturalprogress provided the stimulus necessary to set off economic expansion inmedieval France. As long as those who worked the land were barely able toensure their own subsistence and that of their landlords, all other activitieshad to be minimal, but when food surpluses increased, it became possible torelease more people for governmental, commercial, religious and culturalpursuits. s*~jvL
However,not all the funds from the agricultural surplus were actually available forcommercial investment. Much of the surplus, in the form of food increases,probably went to raise the subsistence level; an additional amount, in the formof currency gained from the sale of food, went into the royal treasury to beused in waging war. Although Louis VII of France levied a less crushing taxburden on his subjects than did England’s Henry II, Louis VII did spend greatsums on an unsuccessful crusade, and his vassals—both lay and ecclesiastic—tookover spending where their sovereign stopped. Surplus funds were claimed both bythe Church and by feudal landholders, whereupon cathedrals and castlesmushroomed throughout France. 6<Pg>Bg
Thesimultaneous progress of cathedral building and, for instance, vineyardexpansion in Bordeaux illustrates the very real competition for availablecapital between the Church and commercial interests; the former producedinestimable moral and artistic riches, but the latter had a stronger immediateimpact upon gross national product. Moreover, though all wars by definition aredefensive, the frequent crossings of armies that lived off the land andimpartially burned all the huts and barns on their path consumed considerableresources. <11Tqb
Sincedemands on the agricultural surplus would have varied from year to year, wecannot precisely calculate their impact on the commercial growth of medievalFrance. But we must bear that impact in mind when estimating the assets thatwere likely to have been available for investment. No doubt castle andcathedral building was not totally barren of profit (for the builders, thatis), and it produced intangible dividends of material and moral satisfactionfor the community. Even wars handed back a fragment of what they took, at leastto a few. Still, we cannot place on the same plane a primarily destructiveactivity and a constructive one, nor expect the same results from a new belltower as from a new water mill. Above all, medieval France had little room forinvestment over and above the preservation of life. Granted that war cost muchless than it does today, that the Church rendered all sorts of educational andrecreational services that were unobtainable elsewhere, and that government wasfar less demanding than is the modern state—nevertheless, for medieval men andwomen, supporting commercial development required considerable economicsacrifice. luz%FY:
1. According to the passage, agriculturalrevenues in excess of the amount needed for subsistence were used by medievalkings to s3E~X
(A)patronize the arts Xx<&6
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(B)sponsor public recreation V8U`%/`N
(C)wage war +D-+}&oW
(D)build cathedrals r dG2| Tp
(E)fund public education ?VN]0{JSp
2. According to the passage, which of thefollowing was an important source of revenue in medieval France? }v$=mLy
(A)Cheese io33+/
(B)Wine =UKR<@QrK
(C)Wool $}nUK~$GSv
(D)Olive oil 674oL,
(E)Veal <%#y
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3. The passage suggests that which of thefollowing would have reduced the assets immediately available for commercialinvestment in medieval France? c+i`Zd.m<
I. Renovation of a large cathedral _}9R}
II. A sharp increase in the birth rate Q]g 4gj
III. An invasion of France by Henry II A%w]~ chC9
(A)III only z&vms
(B)I and II only aE cg_es
(C)I and III only |>}0? '/]
(D)II and III only ;pyJ O_R[
(E)I, II, and III XM@i|AK
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4. It can be inferred from the passage thatmore people could enter government and the Church in medieval France because )~mc1U`b
(A)the number of individual landholdings in heavily agricultural areas wasbeginning to increase
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(B)an increase in the volume of international trade had brought an increase in thepopulation of cities g!Yh=kA'N
(C)a decrease in warfare had allowed the king to decrease the size of the army yz$1qEII`q
(D)food producers could grow more food than they and their families needed tosurvive ~)8i5p;P/k
(E)landlords were prospering and thus were demanding a smaller percentage oftenants’ annual yields KeHE\Fq^V
5. The author implies that the reason wecannot expect the same results from a new bell tower as from a new water millis that vrnj}f[h
(A)bell towers yield an intangible dividend N3c)ce7[
(B)bell towers provide material satisfaction nzJi)A./
(C)water mills cost more to build than bell towers Lz{T8yvZ
(D)water mills divert funds from commerce 7Z~szD
(E)water mills might well be destroyed by war kDP^[V
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6. The author of the passage most probablybases his central argument on which of the following theoretical assumptionsoften made by economists? }ZV
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(A)Different people should be taxed in proportion to the benefit they can expectto receive from public activity. 0@x$Cp
(B)Perfect competition exists only in the case where no farmer, merchant, orlaborer controls a large enough share of the total market to influence marketprice. WJ4UJdf'
(C)A population wealthy enough to cut back its rate of consumption can funnel theresulting savings into the creation of capital. rZQHB[^3
(D)A full-employment economy must always, to produce one good, give up producinganother good. YIUmCx0a
(E)There is a universal tendency for population, unless checked by food supply, toincrease in a geometric progression. KP-z
7. The author suggests that commercialexpansion in medieval France “required considerable economic sacrifice” (lines59-60) primarily for which of the following reasons? vk+%#w
(A)Cathedrals cost more to build and rebuild than did castles. oqHm:u^2
(B)The numerous wars fought during the period left the royal treasury bankrupt. .LcE^y[V
(C)Louis VII levied a more crushing tax burden on his subjects than did Henry II. +Qb/:xQu
(D)Although much of the available surplus had been diverted into vineyardexpansion, the vineyards had not yet begun to produce. 9,> Y
(E)Although more food was being produced, the subsistence level was not very farabove the minimum required to sustain life. bK%tQeT
8. The passage implies that which of thefollowing yielded the lowest dividend to medieval men and women relative to itscost? !
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(A)Warfare PlRs-% d
(B)Vineyard expansion H>X1(sh#}
(C)Water mill construction \1'R}B@;
(D)Castle building .V:<