One aim of the rules is to reassure patients about confidentiality, thereby encouraging them to be open with their doctors. Today various cancers and sexually transmitted diseases can go untreated because patients are afraid of embarrassment or of losing insurance coverage. The fear is real: Clinton aides noted that a January poll by Princeton Survey Research Associates found that one in six U.S. adults had at some time done something unusual to conceal medical information, such as paying cash for services.

注（1）：本文选自Newsweek；

注（2）：本文习题命题模仿对象为2003年真题Text 2。



1. The author begins his article with “technology is a two-edged sword”（Line 1, Paragraph 1） to ______.

A) show that doctor’s improper use of technology can end up in bad results

B) call on people’s attention to the potential danger technology can bring to us

C) warn of the harm patients are prone to suffer

D) show the advantages and disadvantages of technology

2. According to the proposal made by President Clinton, patients will be able to do the following EXCEPT ______.

A) enjoy more rights to their medical records

B) be open with their doctors

C) decide how to use their medical information

D) sue their insurers for improper use of their medical records

3. Doctors tend to think that the rules ______.

A) may ruin doctor-patient relationship

B) can do more harm than good

C) will prevent doctors from doing medical research

D) will end up in more health care cost and poorer medical service

4. The example of the January poll by Princeton Survey Research Associates is used to show that ______.

A) American patients’ concealment of their medical information has become a big concern

B) a large portion of patients would rather leave their diseases untreated

C) concealing medical information is widespread in the U.S.

D) paying cash for medical service is a common practice among American patients

5. From the article we can learn that ______.

A) American government will tighten its control over the use of patients’ personal information

B) doctors and insurers are both against the rules for the same reasons

C) patients are entitled to have complete control of their medical information

D) the new rules put insurers in a very disadvantageous position





篇章剖析


本文主要讲述了病人医疗隐私权立法及其引发的争议，采用的是提出问题——分析问题的模式。作者首先说明了病人医疗隐私泄露可能带来的问题；接着谈了提议中的病人医疗隐私权法案的内容；第三段作者说明了反对该法案一方的观点；最后一段则强调了新法规的宗旨和不立法可能造成的不良后果。





词汇注释


tidings /ˈtaɪdɪŋz/ n. 消息

corollary /kəˈrɒləri/ n. 必然的结果；推论

bill /bɪl/ v. 宣布，宣告

stipulate /ˈstɪpjʊleɪt/ v. 规定，保证

divulge /daɪˈvʌldʒ/ v. 泄露，暴露

managed-care plan 管理式医疗保健计划

loophole /ˈluːphəʊl/ n. 漏洞

HMO 医疗保健机构（Health Maintenance Organization）

pry /praɪ/ v. 探查，侦查，窥探

provision /prəˈvɪʒ(ə)n/ n. 规定

liable /ˈlaɪəb(ə)l/ adj. 有责任的

breach /briːtʃ/ n. 违背；不履行





难句突破


The doctors said the rules could actually erode privacy, pointing to a provision allowing managed-care plans to use personal information without consent if the purpose was “health-care operations.”

主体句式：The doctors said...

结构分析：本句中pointing to这个伴随状语中又包含了一个介词without引出的方式状语和由if引导的条件状语从句，使得句子的结构变得较为复杂。

句子译文：医生认为这些法规实际上是在破坏隐私权，因为其中一条规定允许管理式医疗保健计划（managed-care plan）在“开展医疗保健工作”时可以不经许可使用个人信息。





题目分析


1. A 语义题。文章以医生利用先进的互联网技术传播病人医疗信息会有助于治疗某些病人的疾病，但同时又给一些病人在就业和购买保险方面带来困难为例说明保护病人医疗信息的重要性，以及不当使用技术可能带来的不良后果。

2. B 细节题。“be open with their doctors”只是这项法规试图达到的效果，并不是该法规赋予病人的权利。因此答案应该是B。

3. B 细节题。文章引用医生的观点认为新法规不但不利于保护病人的隐私，反而会actually erode privacy，由此可见答案应该是B。

4. A 推理题。前文讲到了病人因为羞于启齿或者担心失去保险赔付而隐瞒病情，使疾病得不到治疗；然后说“The fear is real”，继而引用普利斯顿调查研究协会的调查结果，意在说明这一问题的严重性。

5. D 推理题。文章中提到保险公司的反对意见时，引用了保险公司的说法：“the rules would make them vulnerable to lawsuits”，由此可见答案应该是D。A项中提出的政府加强对病人私人信息的控制的说法是不正确的，因为保险公司抗议的是政府要加强对法规实施情况的审查（the increased level of federal scrutiny required by the new rules’ enforcement provisions）。





参考译文


技术是一把双刃剑。这一点在医疗保健领域尤为明显。借助技术，医生可以测试病人的遗传缺陷——并通过互联网很快将结果传遍全世界。对于那些需要治疗的人来说，这是好消息；但对于那些正在找工作，或者想要买一份保险的人来说，这样的消息可能非常糟糕。

上周，比尔·克林顿总统向国会提交了一份病人权利法案的推论：医疗隐私权。从2002年开始，根据2月即将生效的法规，病人将有权规定透露其个人医疗资料的条件。他们可以检查自己的病历并进行更正，也可以了解哪些人曾看过他们的信息。医护人员或者保险公司对病历使用不当将会导致民事或者刑事处罚。克林顿说，这一提案“在促使美国人重新获得对自己的病历控制权方面迈出了极其重要的一步。”

虽然政府称这些法规旨在平衡消费者和医疗保健行业的需求，但医生和保险公司对此都颇有微词。医生认为这些法规实际上是在破坏隐私权，因为其中一条规定允许管理式医疗保健计划（managed-care plan）在“开展医疗保健工作”时可以不经许可使用个人信息。医生们称其为一个漏洞，它使得医疗保健机构（HMO）和其他保险公司可以打着评估医疗保健质量的旗号窥探医患关系。同时，保险公司也对这些法规持反对意见，他们认为这些法规很容易让他们惹上官司。其中一条法规令他们尤为不满，该法规规定：保险公司对律师和会计这样的“商业伙伴”的侵犯隐私行为负责。这两个群体都一致认为，保护隐私会使医疗保健成本至少增加38亿美元，在接下来的五年里也许还会增加更多。根据新法规的执行条例，联邦政府将加大对医疗保健行业的审查力度，他们对此也表示不满。

新法规的目标之一就是要让病人不再担心自己的隐私被泄漏，从而鼓励他们对医生坦诚相告。今天各种各样的癌症和性病可能会因为病人羞于启齿或者担心失去保险赔付而得不到治疗。这种担心并非无中生有：克林顿的助手补充说，由普林斯顿调查研究协会在一月份进行的一项民意测试显示：在美国，每六个成年人中就有一个曾经做过刻意隐瞒医疗信息的事情，比如用现金支付服务费。





Unit 69


When Gina Garro and Brian Duplisea adopted 4-month-old Andres from Colombia last month, they were determined to take time off from work to care for him. Six years ago, after their daughter, Melina, was born, the family scraped by on Duplisea’s $36,000 salary as a construction worker so Garro, a special-education teacher, could stay home. Now, since Garro’s job furnishes the family health insurance, she’ll head back to work this fall while Duplisea juggles diapers and baby bottles. His boss agreed to the time off—but he will have to forgo his $18-an-hour pay. It won’t be easy. Though Garro’s $40,000 salary will cover their mortgage, the couple will have to freeze their retirement accounts, scale back on Melina’s after-school activities—and pray that nothing goes wrong with the car. “It takes away from your cushion and your security,” says Garro. “Things will be tight.”

The 1993 Family and Medical Leave Act was supposed to help families like Garro’s, offering a safety net to employees who want to take time off to nurture newborns, tend to their own major illnesses or care for sick relatives. But while the law guarantees that workers won’t lose their jobs, it doesn’t cover their paychecks. One survey last year showed that while 24 million Americans had taken leaves since 1999, 2.7 million more wanted to, but couldn’t afford it. That may change soon. In response to increasing demands from voters, at least 25 states are now exploring new ways to offer paid leave. One possibility: tapping state disability funds. A handful of states—New York, New Jersey, California, Rhode Island and Hawaii—already dip into disability money to offer partial pay for women on maternity leave. But that doesn’t help dads or people caring for elderly parents. New Jersey and New York may soon expand disability programs to cover leave for fathers and other caretakers. Thirteen states, including Arizona, Illinois and Florida, have proposed using unemployment funds to pay for leave.

Massachusetts has been especially creative. When the state’s acting governor, Jane Swift, gave birth to twin daughters in May, she drew attention to the issue with her own “working maternity leave”: she telecommuted part-time but earned her usual full-time salary. Even before Swift returned to work last week, the state Senate unanimously passed a pilot plan that would use surplus funds from a health-insurance program for the unemployed to give new parents 12 weeks off at half pay. Another plan, proposed in the House, would require employers to kick in $20 per worker to set up a “New Families Trust Fund.” Businesses would get tax credits in return. This week Swift is expected to announce her own paid-leave plan for lower-income mothers and fathers. Polls show widespread public support—another reason Swift and other politicians across the country have embraced the issue.

Still, not everyone’s wild about the idea. People without children question why new parents—the first group to get paid leave under many of the proposed plans—should get more government perks than they do. Business groups are resistant to proposals that would raid unemployment funds; several have already filed suit to block them. As the economy slows, many companies say they can’t afford to contribute to proposed new benefit funds either. Business lobbyists say too many employees already abuse existing federal family-leave laws by taking time off for dubious reasons or in tiny time increments. The proposed laws, they say, would only make matters worse.

For Garro and Duplisea, though, the new laws could make all the difference. As Melina fixes a peanut-butter-and-jelly sandwich, Duplisea hugs a snoozing Andres against his T T-shirt. “We’re trying to do the right thing by two kids, and we have to sacrifice,” Duplisea says. In Massachusetts and plenty of other states, help may be on the way.

注（1）：本文选自Newsweek；

注（2）：本文习题命题模仿对象：第1、2、4、5、3题分别模仿2013年真题Text 2第1、3、2、5题和Text 3第1题。



1. From the first paragraph, we learn that ______.

A) Garro and Duplisea used to live a comfortable and easy life

B) Duplisea’s boss is so considerate as to allow him to keep his job

C) Garro can earn more money so she should go back to work

D) the couple have made a lot of sacrifices to take care of their children

2. When Garro says “It takes away from your cushion and your security”（Lines 8~9, Paragraph 1）, she means ______.

A) it exhausts her family savings

B) it plunges her family into financial trouble

C) it deprives her children of health insurance

D) it makes her feel insecure

3. If Garro lives in Massachusetts, she will ______.

A) have 12 weeks off at half pay

B) telecommute part-time but earn full-time salary

C) leave her job without pay to take care of her kids

D) get $20 from her employer for her leave

4. The word “perk”（Line 2, Paragraph 4）most probably means ______.

A) grant

B) policy

C) encouragement

D) reward

5. The author’s attitude towards paid leave seems to be that of ______.

A) opposition

B) suspicion

C) approval

D) indifference





篇章剖析


本文为说明文，主要介绍带薪请假政策的起因、制定过程和实施情况，以及所面临的问题和反对意见。文章首先以加罗一家的经历说明停薪请假的人所面临的经济困难；然后在第二、三段介绍了各州针对这一问题的解决方案。第四段介绍了反对者的态度和看法，最后一段再次以加罗一家的情况来说明带薪请假政策可能带来的积极变化，并且呼应了文章开头部分，以此作为结尾，使得全文层次分明，结构完整。





词汇注释


scrape /skreɪp/ v. （常与along, by, through连用）勉强维持生计；勉强通过

furnish /ˈfəːnɪʃ/ v. 供应，提供

juggle /ˈdʒʌg(ə)l/ v. 耍，弄

diaper /ˈdaɪəpə(r)/ n. 尿布

forgo /fɔːˈgəʊ/ v. 抛弃；放弃

cushion /kuʃən/ n. 缓冲，缓和不利后果的东西

tap /tæp/ v. 开发；利用

maternity /məˈtəːnɪti/ adj. 母性的，孕妇的；适合于孕妇的

telecommute /ˌtelɪkəˈmjuːt/ v. （在家里通过使用与工作单位连接的计算机终端）远距离工作

pilot plan 试点方案

kick in 参与提供资金和其他帮助的活动

tax credit 税金免除

perk /pɜːk/ n. （= perquisite）额外津贴

raid /reɪd/ v. 侵吞

lobbyist /ˈlɒbiɪst/ n. 院外活动集团成员；说客

increment /ˈɪnkrɪmənt/ n. 增加，增量





难句突破


The 1993 Family and Medical Leave Act was supposed to help families like Garro’s, offering a safety net to employees who want to take time off to nurture newborns, tend to their own major illnesses or care for sick relatives.

主体句式：The Act was supposed to help...

结构分析：本句是一个复杂句，既包括从句，也包括分词结构。Be supposed to do something表示“应该做某事”，通常强调义务、责任等。Safety net原意是防止坠落受伤的“安全网”，在此引申为“安全保障”。

句子译文：1993年颁布的《家庭医疗休假法》本来应该帮助像加罗这样的家庭，为那些请假照顾新生儿、治疗重病或者照顾患病亲人的员工提供一个安全保障。





题目分析


1. D 推理题。从第一段的内容来看，为了照顾两个孩子，这一对夫妇做出了许多选择。这些选择大都意味着做出一定牺牲，比如请假在家照顾孩子，收入减少，冻结退休金账户，减少孩子课外活动开支等。

2. B 语义题。从第一段列举的事实来看，加罗夫妇不得不冻结退休金账户，减少梅丽娜的课后活动开支——还要祷告汽车别出问题。可见请假照顾孩子给他们带来了严重的经济问题。答案B正确。

3. A 细节题。内容涉及马萨诸塞州最近通过的一项议案。原文参照第三段第五行。

4. A 语义题。从第二、三段的内容来看，各州政府试图动用各种基金对请假照料新生婴儿的父母进行经济上的帮助，因此A项在意义上最符合。

5. C 情感态度题。本文重点说明了停薪请假人所面临的经济困难，以及各州的解决方案，并在最后一段说明带薪请假政策可能带来的积极变化。从材料的选择来看，作者对于带薪请假政策持积极的态度，所以答案为C。





参考译文


上个月，吉纳·加罗和布莱恩·杜普里希从哥伦比亚收养了四个月大的安德烈时，这对夫妇决定请假照顾他。六年前，他们的女儿梅丽娜出生后，这家人靠着杜普里希做建筑工人每年36000美元的薪水勉强度日，这样，从事特殊教育教学的加罗就可以待在家里照顾孩子。如今，因为加罗的工作能够为家庭提供医疗健康保险，她将在今年秋季回去工作，而让杜普里希摆弄那些尿片和婴儿奶瓶。他的老板同意他请假——但他必须为此放弃时薪为18美元的报酬。这可有些让这个家庭犯难了。虽然加罗40000美元的年薪可以支付他们的抵押贷款，但夫妇俩却不得不冻结他们的退休金账户，减少梅丽娜的课后活动开支——还要祷告汽车别出问题。“我们不再后顾无忧，”加罗说道，“生活会变得很拮据。”

1993年颁布的《家庭医疗休假法》本来应该帮助像加罗这样的家庭，为那些请假照顾新生儿、治疗重病或者照顾患病亲人的员工提供一个安全保障。可是，法律虽然可以保证这些员工不至于丢掉工作，却不能支付他们的薪水。去年的一项调查显示，虽然从1999年以来有2400万美国人请假，但还有270万人想要请假，却承受不起请假带来的损失。要不了多久这种情况就会改变。目前至少有25个州正在探索提供带薪休假的新途径，以回应选民日益增加的要求。一种可能性就是利用州伤病基金。一些州——纽约、新泽西、加利福尼亚、罗德岛和夏威夷——已经动用伤病基金为请孕产假的妇女提供部分工资。但这种举措并不能帮助那些做父亲的人和照料年迈父母的人。新泽西州和纽约州也许不久就会扩大伤病基金计划的覆盖面，让那些请假照料孩子的父亲们和其他照料伤病亲属的人都能从中受益。包括亚利桑那州、伊利诺伊州和佛罗里达州在内的13个州已经提议动用失业基金来支付请假工资。

马萨诸塞州的举措尤具创意。当该州的代理州长，简·斯威夫特于5月生下一对双胞胎女儿的时候，她以自己“请产假”的方式引起人们对这一问题的关注。她在家通过电脑终端远程工作，做的是兼职工作，拿的却是全职的薪水。在她上周重返工作岗位之前，州参议院就一致通过了一项试点方案，允许动用失业人员医疗保险计划的剩余基金，让刚生了孩子的父母可以拿一半工资，请假12周。众议院提议的另外一项计划则要求雇主为每个员工增加20美元工资，以便设立一个“新家庭信托基金”。作为回报，商业企业可以获得税金免除。这一周，预计斯威夫特将宣布她本人针对低收入母亲和父亲提出的带薪请假计划。民意测验显示了广泛的公众支持——这是斯威夫特和其他国内政治家乐意解决这一问题的另外一个原因。

不过，并不是所有人都热衷这种想法。一些没有子女的人质疑为什么刚生了孩子的父母——他们是许多提案当中第一批获得带薪请假待遇的人——得到的政府补贴比他们的多。商业机构抵制动用失业基金的提案；一些机构甚至已经提起诉讼，以阻止这些提案获得通过。随着经济发展的减速，许多公司也说他们无力为提议中的福利基金提供资金。商业企业的院外游说成员说有太多的员工已经滥用现有的联邦家庭医疗休假法，以许多可疑的借口请假，或者拖延一点请假时间。他们认为该法律提案只会使情况变得更糟。

不过，对于加罗和杜普里希来说，新的法律会使他们的境况大为不同。梅丽娜准备一块花生黄油果冻三明治的时候，杜普里希把怀中打盹的安德烈抱在胸前。“我们正在努力为两个孩子创造好的条件，所以不得不做出牺牲。”杜普里希说。在马塞诸塞州和其他许多州，也许很快人们就会得到这样的帮助。





Unit 70


Few lawyers did more to help George W. Bush become president than Barry Richard. As Bush’s quarterback in the Florida courts during last fall’s bruising recount, the white-maned Tallahassee, Fla., litigator became a familiar figure to TV audiences. He got the GOP equivalent of rock-star treatment when he came to Washington last January for Bush’s Inauguration. At one ball, recalls law partner Fred Baggett, a heavyset Texas woman lifted Richard off the floor and planted a big kiss on his cheek, exclaiming, “I love you for giving us our president!”