一、Part Ⅱ Listening Comprehension
1、Question 1 is based on the conversation you have just heard.
A、She can devote all her life to pursuing her passion.
B、Her accumulated expertise helps her to achieve her goals.
C、She can spread her academic ideas on a weekly TV show.
D、Her research findings are widely acclaimed in the world.
2、Question 2 is based on the conversation you have just heard.
A、Provision of guidance for nuclear labs in Europe.
B、Touring the globe to attend science TV shows.
C、Overseeing two research groups at Oxford.
D、Science education and scientific research.
3、Question 3 is based on the conversation you have just heard.
A、A better understanding of a subject.
B、A stronger will to meet challenges.
C、A broader knowledge of related fields.
D、A closer relationship with young people.
4、Question 4 is based on the conversation you have just heard.
A、By applying the latest research methods.
B、By making full use of the existing data.
C、By building upon previous discoveries.
D、By utilizing more powerful computers.
5、Question 5 is based on the conversation you have just heard.
A、They can predict future events.
B、They have no special meanings.
C、They have cultural connotations.
D、They cannot be easily explained.
6、Question 6 is based on the conversation you have just heard.
A、It was canceled due to bad weather.
B、She overslept and missed the flight.
C、She dreamed of a plane crash.
D、It was postponed to the following day.
7、Question 7 is based on the conversation you have just heard.
A、They can be affected by people’s childhood experiences.
B、They may sometimes seem ridiculous to a rational mind.
C、They usually result from people’s unpleasant memories.
D、They can have an impact as great as rational thinking.
8、Question 8 is based on the conversation you have just heard.
A、They call for scientific methods to interpret.
B、They mirror their long-cherished wishes.
C、They reflect their complicated emotions.
D、They are often related to irrational feelings.
9、Question 9 is based on the passage you have just heard.
A、Radio waves.
B、Sound waves.
C、Robots.
D、Satellites.
10、Question 10 is based on the passage you have just heard.
A、It may be freezing fast beneath the glacier.
B、It may have micro-organisms living in it.
C、It may have certain rare minerals in it.
D、It may be as deep as four kilometres.
11、Question 11 is based on the passage you have just heard.
A、Help understand life in freezing conditions.
B、Help find new sources of fresh water.
C、Provide information about other planets.
D、Shed light on possible life in outer space.
12、Question 12 is based on the passage you have just heard.
A、He found there had been little research on their language.
B、He was trying to preserve the languages of the Indian tribes.
C、His contact with a social worker had greatly aroused his interest in the tribe.
D、His meeting with Gonzalez had made him eager to learn more about the tribe.
13、Question 13 is based on the passage you have just heard.
A、He taught Copeland to speak the Tarahumaras language.
B、He persuaded the Tarahumaras to accept Copeland’s gifts.
C、He recommended one of his best friends as an interpreter.
D、He acted as an intermediary between Copeland and the villagers.
14、Question 14 is based on the passage you have just heard.
A、Unpredictable.
B、Unjustifiable.
C、Laborious.
D、Tedious.
15、Question 15 is based on the passage you have just heard.
A、Their appreciation of help from the outsiders.
B、Their sense of sharing and caring.
C、Their readiness to adapt to technology.
D、Their belief in creating wealth for themselves.
16、Question 16 is based on the recording you have just heard.
A、They tend to be silenced into submission.
B、They find it hard to defend themselves.
C、They will feel proud of being pioneers.
D、They will feel somewhat encouraged.
17、Question 17 is based on the recording you have just heard.
A、One who advocates violence in effecting change.
B、One who craves for relentless transformations.
C、One who acts in the interests of the oppressed.
D、One who rebels against the existing social order.
18、Question 18 is based on the recording you have just heard.
A、They tried to effect social change by force.
B、They disrupted the nation’s social stability.
C、They served as a driving force for progress.
D、They did more harm than good to humanity.
19、Question 19 is based on the recording you have just heard.
A、Few of us can ignore changes in our immediate environment.
B、It is impossible for us to be immune from outside influence.
C、Few of us can remain unaware of what happens around us.
D、It is important for us to keep in touch with our own world.
20、Question 20 is based on the recording you have just heard.
A、Make up his mind to start all over again.
B、Stop making unfair judgments of others.
C、Try to find a more exciting job somewhere else.
D、Recognise the negative impact of his coworkers.
21、Question 21 is based on the recording you have just heard.
A、They are quite susceptible to suicide.
B、They improve people’s quality of life.
C、They suffer a great deal from ill health.
D、They help people solve mental problems.
22、Question 22 is based on the recording you have just heard.
A、Few people can identify its texture.
B、Few people can describe it precisely.
C、Its real value is open to interpretation.
D、Its importance is often overestimated.
23、Question 23 is based on the recording you have just heard.
A、It has never seen any change.
B、It has much to do with color.
C、It is a well-protected government secret.
D、It is a subject of study by many forgers.
24、Question 24 is based on the recording you have just heard.
A、People had little faith in paper money.
B、They could last longer in circulation.
C、It predicted their value would increase.
D、They were more difficult to counterfeit.
25、Question 25 is based on the recording you have just heard.
A、The stabilization of the dollar value.
B、The issuing of government securities.
C、A gold standard for American currency.
D、A steady appreciation of the U.S. dollar.
二、Part III Reading Comprehension
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
26、(1)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
27、(2)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
28、(3)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
29、(4)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
30、(5)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
31、(6)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
32、(7)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
33、(8)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
34、(9)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
It was perhaps when my parents—who also happen to be my housemates—left to go travelling for a couple months recently that it (26)_____on me why I had not yet left the family home.
It wasn’t that I relied on them for (27) _____ reasons, or to keep my life in order, or to ease the chaos of the home. These days, I rely on them for their company.
I missed coming home and talking about my day at work, and I missed being able to read their faces and sense how their day was. I missed having unique (28)_____ into the tiny details that make a life.
While the conversation about young adults staying longer at home is (29)_____by talk of laziness, of dependence, of an inability for young people to pull themselves together, (30)_____do we talk of the way, in my case at least, my relationship with my parents has (31)_____strengthened the longer we have lived together.
Over the years the power dynamic has changed and is no longer defined by one being the giver and another, the taker. So, what does this say for our relationships within the family home?
According to psychologist Sabina Read, there are “some very positive possible (32)_____when adult children share the family home”, noting the “parent-child relationship may indeed strengthen and mature” in the process.
But, she notes, a strong (33)_____doesn’t simply come with time. “The many changing factors of the relationship need to be acknowledged, rather than hoping that the mere passage of time will (34)_____connect parents to their adult children. It’s important to acknowledge that the relationship parameters have changed to avoid falling back into (35)_____from the teen years.”
35、(10)
A、patterns
B、stereotypes
C、undoubtedly
D、magically
E、hierarchy
F、contemplated
G、bond
H、leverage
I、logistical
J、rarely
K、legislative
L、insight
M、outcomes
N、saturated
O、dawned
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
36、36. An overwhelming majority of family physicians are willing to use telemedicine if they are duly paid.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
37、37. Many employers are eager to provide telemedicine service as a benefit to their employees because of its convenience.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
38、38. Different states have markedly different regulations for telemedicine.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
39、39. With telemedicine, patients in regions short of professional medical service are able to receive better medical care.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
40、40. Unlike employers and health plans, insurers have been rather reluctant to pay for some telemedicine services.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
41、41. Some supporters of telemedicine hope states will accept each other’s medical practice licenses as valid.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
42、42. The fastest growing area for telemedicine services is for lesser health problems.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
43、43. As telemedicine spreads quickly, some of its opponents doubt whether its service quality can be guaranteed.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
44、44. The results obtained by researchers who pretended to be patients seeking help from telemedicine providers are disturbing.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
How Telemedicine Is Transforming Healthcare
【A】After years of big promises, telemedicine is finally living up to its potential. Driven by faster Internet connections, ubiquitous (无处不在的) smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s dramatically changing the delivery of healthcare.
【B】Doctors are linking up with patients by phone, email and webcam (网络摄像头). They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by. Five to 10 times a day, Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan and elsewhere to its network of 280 experts around the world, and back again via the Internet.
【C】As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.【D】None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy (精通技术的) consumers found that 39% hadn’t heard of telemedicine, and of those who haven’t used it, 42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians, only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed (补偿).
【E】What’s more, for all the rapid growth, significant questions and challenges remain. Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
【F】Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicine. And there’s the question of what services physicians should be paid for: Insurance coverage varies from health plan to health plan, and a big federal plan covers only a narrow range of services. Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges. Here’s a closer look at some of these issues:
【G】Do patients trade quality for convenience? The fastest-growing services in telemedicine connect consumers with clinicians they’ve never met for a phone, video or email visit—on-demand, 24/7. Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and they cost around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.
【H】Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.
【I】But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory (上呼吸道的) infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart or feel your swollen glands. In a recent study, researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters, fewer than one-third disclosed clinicians’ credential or let patients choose; only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed serious conditions, largely because they failed to ask basic follow-up questions, the researchers said. “Telemedicine holds enormous promise, but these sites are just not ready for prime time,” says Jack Resneck, the study’s lead author.
【J】The American Telemedicine Association and other organizations have started accreditation (鉴定) programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
【K】Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or video to consult with existing patients about continuing issues. “It’s very hard to get paid unless you physically see the patient,” says Peter Rasmussen, medical director of distance health at the Cleveland Clinic. Some 32 states have passed “parity” (等同的) laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Medicare lags further behind. The federal health plan for the elderly covers a small number of telemedicine services—only for beneficiaries in rural areas and only when the services are received in a hospital, doctor’s office or clinic.
【L】Bills to expand Medicare coverage of telemedicine have bipartisan (两党的) support in Congress. Opponents worry that such expansion would be costly for taxpayers, but advocates say it would save money in the long run.
【M】Experts say more hospitals are likely to invest in telemedicine systems as move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
【N】Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules, licensing fees and even definitions of “medical practice” makes less sense in the era of telemedicine and is hampering its growth. Currently, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. It also causes administrative hassles (麻烦) for world-class medical centers that attract patients from across the country. At the Mayo Clinic, doctors who treat out-of-state patients can follow up with them via phone, email or web chats when they return home, but they can only discuss conditions they treated in person. “If the patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it. If not, the patient should talk to his primary-care physician about it,” says Steve Ommen, who runs Mayo’s Connected Care program.
【O】To date, 17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine advocates would prefer states to automatically honor one another’s licenses, as they do with drivers’ licenses. But states aren’t likely to surrender control of medical practice, and most are considering new regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring. “A lot of states are still trying to define telemedicine,” says Lisa Robbin, chief advocacy officer for the Federation of State Medical Boards.
45、45. Some people argue that the fact that different states have different regulations concerning medical services hinders the development of telemedicine.
A、A
B、B
C、C
D、D
E、E
F、F
G、G
H、H
I、I
J、J
K、K
L、L
M、M
N、N
O、O
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179 books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her “exhausting” process in the past: “I start the book and don’t leave my desk until the first draft is finished.” She goes from bed, to desk, to bath, to bed, avoiding all contact aside from phone calls with her nine children. “I don’t comb my hair for weeks,” she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all followed her “actually extremely liberating” example of industrious sleeplessness, we would be quick to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on productivity, doubt has been voiced about the accuracy of Steel’s self-assessment. Her output may be undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters (代笔人) at worst, gross exaggeration at best.
Steel says working 20 hours a day is “pretty brutal physically”. But is it even possible? “No, ” says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night, she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the sleep improvement programme Sleepstation. “It’s akin to being drunk.”
It’s possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness has “become a bit of a status symbol”, says Taylor, a misguided measure to prove how powerful and productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health. “People are starting to realise that sleep should not be something that you fit in between everything else,” says Taylor.
But it is possible—if statistically extremely unlikely—that Steel could be a “short sleeper” with an unusual body clock, says sleep expert Dr. Sophie Bostock. “It’s probably present in fewer than 1% of the population.”
Even if Steel does happen to be among that tiny minority, says Bostock, it’s “pretty irresponsible” to suggest that 20-hour days are simply a question of discipline for the rest of us.
46、46. What do we learn about the passage about Glamour magazine readers?
A、They are intrigued by the exotic romance in Danielle Steel’s novels.
B、They are amazed by the number of books written by Danielle Steel.
C、They are deeply impressed by Danielle Steel’s daily work schedule.
D、They are highly motivated by Danielle Steel’s unusual productivity.
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179 books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her “exhausting” process in the past: “I start the book and don’t leave my desk until the first draft is finished.” She goes from bed, to desk, to bath, to bed, avoiding all contact aside from phone calls with her nine children. “I don’t comb my hair for weeks,” she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all followed her “actually extremely liberating” example of industrious sleeplessness, we would be quick to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on productivity, doubt has been voiced about the accuracy of Steel’s self-assessment. Her output may be undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters (代笔人) at worst, gross exaggeration at best.
Steel says working 20 hours a day is “pretty brutal physically”. But is it even possible? “No, ” says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night, she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the sleep improvement programme Sleepstation. “It’s akin to being drunk.”
It’s possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness has “become a bit of a status symbol”, says Taylor, a misguided measure to prove how powerful and productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health. “People are starting to realise that sleep should not be something that you fit in between everything else,” says Taylor.
But it is possible—if statistically extremely unlikely—that Steel could be a “short sleeper” with an unusual body clock, says sleep expert Dr. Sophie Bostock. “It’s probably present in fewer than 1% of the population.”
Even if Steel does happen to be among that tiny minority, says Bostock, it’s “pretty irresponsible” to suggest that 20-hour days are simply a question of discipline for the rest of us.
47、47. What did the business news website Quartz say about Danielle Steel?
A、She could serve as an example of industriousness.
B、She proved we could liberate ourselves from sleep.
C、She could be an inspiration to novelists all over the world.
D、She showed we could get all our work done without sleep.
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179 books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her “exhausting” process in the past: “I start the book and don’t leave my desk until the first draft is finished.” She goes from bed, to desk, to bath, to bed, avoiding all contact aside from phone calls with her nine children. “I don’t comb my hair for weeks,” she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all followed her “actually extremely liberating” example of industrious sleeplessness, we would be quick to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on productivity, doubt has been voiced about the accuracy of Steel’s self-assessment. Her output may be undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters (代笔人) at worst, gross exaggeration at best.
Steel says working 20 hours a day is “pretty brutal physically”. But is it even possible? “No, ” says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night, she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the sleep improvement programme Sleepstation. “It’s akin to being drunk.”
It’s possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness has “become a bit of a status symbol”, says Taylor, a misguided measure to prove how powerful and productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health. “People are starting to realise that sleep should not be something that you fit in between everything else,” says Taylor.
But it is possible—if statistically extremely unlikely—that Steel could be a “short sleeper” with an unusual body clock, says sleep expert Dr. Sophie Bostock. “It’s probably present in fewer than 1% of the population.”
Even if Steel does happen to be among that tiny minority, says Bostock, it’s “pretty irresponsible” to suggest that 20-hour days are simply a question of discipline for the rest of us.
48、48. What do sceptics think of Danielle Steel’s work schedule claims?
A、They are questionable.
B、They are alterable.
C、They are irresistible.
D、They are verifiable.
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179 books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her “exhausting” process in the past: “I start the book and don’t leave my desk until the first draft is finished.” She goes from bed, to desk, to bath, to bed, avoiding all contact aside from phone calls with her nine children. “I don’t comb my hair for weeks,” she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all followed her “actually extremely liberating” example of industrious sleeplessness, we would be quick to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on productivity, doubt has been voiced about the accuracy of Steel’s self-assessment. Her output may be undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters (代笔人) at worst, gross exaggeration at best.
Steel says working 20 hours a day is “pretty brutal physically”. But is it even possible? “No, ” says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night, she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the sleep improvement programme Sleepstation. “It’s akin to being drunk.”
It’s possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness has “become a bit of a status symbol”, says Taylor, a misguided measure to prove how powerful and productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health. “People are starting to realise that sleep should not be something that you fit in between everything else,” says Taylor.
But it is possible—if statistically extremely unlikely—that Steel could be a “short sleeper” with an unusual body clock, says sleep expert Dr. Sophie Bostock. “It’s probably present in fewer than 1% of the population.”
Even if Steel does happen to be among that tiny minority, says Bostock, it’s “pretty irresponsible” to suggest that 20-hour days are simply a question of discipline for the rest of us.
49、49. What does Maryanne Taylor think of self-imposed sleeplessness?
A、It may turn out to be key to a successful career.
B、It may be practiced only by certain tech heads.
C、It may symbolise one’s importance and success.
D、It may well serve as a measure of self-discipline.
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179 books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her “exhausting” process in the past: “I start the book and don’t leave my desk until the first draft is finished.” She goes from bed, to desk, to bath, to bed, avoiding all contact aside from phone calls with her nine children. “I don’t comb my hair for weeks,” she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all followed her “actually extremely liberating” example of industrious sleeplessness, we would be quick to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on productivity, doubt has been voiced about the accuracy of Steel’s self-assessment. Her output may be undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters (代笔人) at worst, gross exaggeration at best.
Steel says working 20 hours a day is “pretty brutal physically”. But is it even possible? “No, ” says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night, she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the sleep improvement programme Sleepstation. “It’s akin to being drunk.”
It’s possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness has “become a bit of a status symbol”, says Taylor, a misguided measure to prove how powerful and productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health. “People are starting to realise that sleep should not be something that you fit in between everything else,” says Taylor.
But it is possible—if statistically extremely unlikely—that Steel could be a “short sleeper” with an unusual body clock, says sleep expert Dr. Sophie Bostock. “It’s probably present in fewer than 1% of the population.”
Even if Steel does happen to be among that tiny minority, says Bostock, it’s “pretty irresponsible” to suggest that 20-hour days are simply a question of discipline for the rest of us.
50、50. How does Dr. Sophie Bostock look at the 20-hour daily work schedule?
A、One should not adopt it without consulting a sleep expert.
B、The general public should not be encouraged to follow it.
C、One must be duly self-disciplined to adhere to it.
D、The majority must adjust their body clock for it.
Organic agriculture is a relatively untapped resource for feeding the Earth’s population, especially in the face of climate change and other global challenges. That’s the conclusion I reached in reviewing 40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, “Organic Agriculture in the 21st Century,” is featured as the cover story for the February issue of the journal Nature Plants. It is the first to compare organic and conventional agriculture across the main goals of sustainability identified by the National Academy of Sciences: productivity, economics, and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the same amount of food. It’s true that organic farming produces lower yields, averaging 10 to 20 percent less than conventional. Advocates contend that the environmental advantages of organic agriculture far outweigh the lower yields, and that increasing research and breeding resources for organic systems would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already produce enough food to more than feed the world’s 7.4 billion people but do not provide adequate access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought conditions, which are expected to increase with climate change in many areas, organic farms can produce as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment. Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only accompanied conventional farming systems but have often extended well beyond their field boundaries. With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality, and reduce soil erosion compared to their conventional counterparts. Organic agriculture also creates less soil and water pollution and lower greenhouse gas emissions. And it’s more energy-efficient because it doesn’t rely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate farmers for providing ecosystem services and avoiding environmental damage or external costs.
51、51. What do we learn from the conclusion of the author’s review study?
A、More resources should be tapped for feeding the world’s population.
B、Organic farming may be exploited to solve the global food problem.
C、The long-term prospects of organic farming are yet to be explored.
D、Organic farming is at least as promising as conventional farming.
Organic agriculture is a relatively untapped resource for feeding the Earth’s population, especially in the face of climate change and other global challenges. That’s the conclusion I reached in reviewing 40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, “Organic Agriculture in the 21st Century,” is featured as the cover story for the February issue of the journal Nature Plants. It is the first to compare organic and conventional agriculture across the main goals of sustainability identified by the National Academy of Sciences: productivity, economics, and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the same amount of food. It’s true that organic farming produces lower yields, averaging 10 to 20 percent less than conventional. Advocates contend that the environmental advantages of organic agriculture far outweigh the lower yields, and that increasing research and breeding resources for organic systems would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already produce enough food to more than feed the world’s 7.4 billion people but do not provide adequate access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought conditions, which are expected to increase with climate change in many areas, organic farms can produce as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment. Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only accompanied conventional farming systems but have often extended well beyond their field boundaries. With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality, and reduce soil erosion compared to their conventional counterparts. Organic agriculture also creates less soil and water pollution and lower greenhouse gas emissions. And it’s more energy-efficient because it doesn’t rely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate farmers for providing ecosystem services and avoiding environmental damage or external costs.
52、52. What is the critics’ argument against organic farming?
A、It cannot meet the need for food.
B、It cannot increase farm yields.
C、It is not really practical.
D、It is not that productive.
Organic agriculture is a relatively untapped resource for feeding the Earth’s population, especially in the face of climate change and other global challenges. That’s the conclusion I reached in reviewing 40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, “Organic Agriculture in the 21st Century,” is featured as the cover story for the February issue of the journal Nature Plants. It is the first to compare organic and conventional agriculture across the main goals of sustainability identified by the National Academy of Sciences: productivity, economics, and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the same amount of food. It’s true that organic farming produces lower yields, averaging 10 to 20 percent less than conventional. Advocates contend that the environmental advantages of organic agriculture far outweigh the lower yields, and that increasing research and breeding resources for organic systems would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already produce enough food to more than feed the world’s 7.4 billion people but do not provide adequate access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought conditions, which are expected to increase with climate change in many areas, organic farms can produce as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment. Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only accompanied conventional farming systems but have often extended well beyond their field boundaries. With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality, and reduce soil erosion compared to their conventional counterparts. Organic agriculture also creates less soil and water pollution and lower greenhouse gas emissions. And it’s more energy-efficient because it doesn’t rely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate farmers for providing ecosystem services and avoiding environmental damage or external costs.
53、53. What does the author think should be taken into account in arguing about organic farming?
A、Growth in world population.
B、Deterioration in soil fertility.
C、Inequality in food distribution.
D、Advance in farming technology.
Organic agriculture is a relatively untapped resource for feeding the Earth’s population, especially in the face of climate change and other global challenges. That’s the conclusion I reached in reviewing 40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, “Organic Agriculture in the 21st Century,” is featured as the cover story for the February issue of the journal Nature Plants. It is the first to compare organic and conventional agriculture across the main goals of sustainability identified by the National Academy of Sciences: productivity, economics, and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the same amount of food. It’s true that organic farming produces lower yields, averaging 10 to 20 percent less than conventional. Advocates contend that the environmental advantages of organic agriculture far outweigh the lower yields, and that increasing research and breeding resources for organic systems would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already produce enough food to more than feed the world’s 7.4 billion people but do not provide adequate access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought conditions, which are expected to increase with climate change in many areas, organic farms can produce as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment. Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only accompanied conventional farming systems but have often extended well beyond their field boundaries. With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality, and reduce soil erosion compared to their conventional counterparts. Organic agriculture also creates less soil and water pollution and lower greenhouse gas emissions. And it’s more energy-efficient because it doesn’t rely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate farmers for providing ecosystem services and avoiding environmental damage or external costs.
54、54. What does science tell us about conventional farming?
A、It will not be able to meet global food demand.
B、It is not conducive to sustainable development.
C、It will eventually give way to organic farming.
D、It is going mainstream throughout the world.
Organic agriculture is a relatively untapped resource for feeding the Earth’s population, especially in the face of climate change and other global challenges. That’s the conclusion I reached in reviewing 40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, “Organic Agriculture in the 21st Century,” is featured as the cover story for the February issue of the journal Nature Plants. It is the first to compare organic and conventional agriculture across the main goals of sustainability identified by the National Academy of Sciences: productivity, economics, and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the same amount of food. It’s true that organic farming produces lower yields, averaging 10 to 20 percent less than conventional. Advocates contend that the environmental advantages of organic agriculture far outweigh the lower yields, and that increasing research and breeding resources for organic systems would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already produce enough food to more than feed the world’s 7.4 billion people but do not provide adequate access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought conditions, which are expected to increase with climate change in many areas, organic farms can produce as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment. Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only accompanied conventional farming systems but have often extended well beyond their field boundaries. With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality, and reduce soil erosion compared to their conventional counterparts. Organic agriculture also creates less soil and water pollution and lower greenhouse gas emissions. And it’s more energy-efficient because it doesn’t rely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate farmers for providing ecosystem services and avoiding environmental damage or external costs.
55、55. Why does the author think higher prices of organic farm produce are justifiable?
A、They give farmers going organic a big competitive edge.
B、They motivate farmers to upgrade farming technology.
C、Organic farming costs more than conventional farming.
D、Organic farming does long-term good to the ecosystem.
三、Part IV Translation
56、 《红楼梦》（Dream of the Red Chamber）是18世纪曹雪芹创作的一部小说。曹雪芹基于自己痛苦的个人经历，讲述了贾宝玉和林黛玉之间的悲剧性爱情故事。书中有大约30个主要人物和400多个次要人物，每个人物都刻画得栩栩如生，具有鲜明的个性。小说详尽地描述了四个贵族世家兴衰的历程，反映了封建社会隐藏的种种危机和错综复杂的社会冲突。
《红楼梦》融合了现实主义和浪漫主义，具有很强的艺术感染力。它被普遍认为是中国最伟大的小说，也是世界上最伟大的文学创作之一。
参考答案：
参考译文
Dream of the Red Chamber is a novel written by Cao Xueqin in the 18th century. Based on his own painful experience, Cao Xueqin tells a tragic love story between Jia Baoyu and Lin Daiyu. There are about 30 main characters and more than 400 minor characters in the book, each of whom is vividly depicted and with a distinct personality. The novel describes the rise and fall of four noble families in detail, reflecting various hidden crises and the complex social conflicts in feudal society.
With a strong artistic appeal, Dream of the Red Chamber combines realism and romanticism. It is generally regarded as the greatest novel of China, as well as one of the greatest literary works in the world.
四、Part I Writing
57、Directions: For this part, you are allowed 30 minutes to write an essay on the saying “Wealth of the mind is the only true wealth.” You should write at least 150 words but no more than 200 words.
参考答案：
参考范文
As a saying goes, “Wealth of the mind is the only true wealth.” The saying emphasizes the importance of spiritual wealth. However, a host of people are now paying more attention to their material wealth but less to the enrichment of their mind. From my perspective, spiritual wealth plays a crucial part in one’s truly happy and meaningful life.
There are two reasons accounting for my view. One can hardly gain inner peace merely by earning a big fortune. People who live without experiencing spiritual pleasure and only pursue sensory stimulation are more likely to feel lost and hollow inside. On the contrary, one’s wealth of mind will make him optimistic and strong-minded to face up to the challenges ahead. There are chances that money could be stolen or lost, but a strong and wise mind would never fail in the face of adversity.
To summarize, we could never overemphasize the importance of spiritual wealth in our life. The more we cherish spiritual wealth, the more benefits we will get in the long run.
参考译文
有句格言是这样说的：“心灵的财富是唯一真正的财富”。这句格言强调了精神财富的重要性。然而，现在许多人更多地是在关注他们的物质财富，而不注重精神的丰富。在我看来，精神财富对一个人能否过上真正幸福而有价值的生活起着至关重要的作用。
以下两方面原因可以解释我的观点。一个人仅仅靠赚大钱很难获得内心的平静。在生活中从不体验精神愉悦、只追求感官刺激的人更容易感到迷茫和空虚。相比之下，一个人在精神上的富足会使他变得乐观、坚强，足以面对未来的挑战。金钱有可能被偷走或遗失，但坚强而富有智慧的头脑在逆境面前决不会被打垮。
总而言之，精神财富在我们生活中的重要性再怎么强调都不为过。从长远来看，我们越是珍视精神财富，我们将从中获得越多的好处。
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