1 . Unhealthy health care bills, long emergency-room waits and inability to find a primary care physician just scratch the surface of the problems that patients face daily.
Primary care should be the backbone of any health care system. Countries with appropriate primary care resources score highly when it comes to health outcomes and costs. The U.S. takes the opposite approach by emphasizing the specialists rather than the primary care physician.
A recent study analyzed the providers who treat Medicare Beneficiaries(老年医保受惠人）. The startling finding was that the average Medicare patient saw a total of seven doctors --- two primary care physicians and five specialists --- in a given year. Contrary to popular belief, the more physicians taking care of you don't guarantee better care. Actually increasing breakup of care results in a corresponding rise in costs and medical errors.
How did we let primary care slip so far? The key is how doctors are paid. Most physicians are paid whenever they perform a medical service. The more a physician does, regardless of quality or outcome, the better he's reimbursed（ 返还费用）. Moreover, the amount of a physician receives leans heavily toward medical or surgical procedures. A specialist who performs a procedure in a 30-minute visit can be paid three times more than a primary care physician using that same 30 minutes to discuss a patient's disease. Combine this fact with annual government threats to indiscriminately cut reimbursements, physicians are faced with no choice but to increase quantity to boost income.
Primary care physicians who refuse to compromise quality are either driven out of business or to cash-only practices, further contributing to the decline of primary care.
Medical students are not blind to this scenario. They see how heavily the reimbursement deck is stacked against primary care. The recent numbers show that since 1997, newly graduated U.S. medical students who choose primary care as a career have declined by 50%. This trend results in emergency rooms being overwhelmed with patients without regular doctors.
How do we fix this problem?
It starts with reforming the physician reimbursement system. Remove the pressure for primary care physicians to squeeze in more patients per hour, and reward them for optimally managing their diseases and practicing evidence-based medicine. Make primary care more attractive food to medical students by forgiving students loans for those who choose primary care as a career and harmonizing the marked difference between specialist and primary care physician salaries.
We’re at the point where primary care is needed more than ever. Within a few years, the first wave of 76 million Baby Boomers will become qualified for Medicare. Patients older than 85, who need chronic care most, will rise by 50% this decade.
Who will be there to treat them？
1. The author’s chief concern about the current U.S. health care system is_____.| A．the inadequate training of physicians | B．the declining number of doctors |
| C．the ever-rising health care costs | D．the shrinking primary care resources |
| A．the more costly the medicine, the more effective the cure |
| B．seeing more doctors may result in more diagnostic errors |
| C．visiting doctors on a regular basis ensures good health |
| D．the more doctors taking care of a patient, the better |
| A．They find the need for primary care declining. |
| B．The current system works against primary care. |
| C．Primary care physicians command less respect. |
| D．They think working in an emergency room tedious. |
| A．Bridge the salary gap between specialists and primary care physicians. |
| B．Extend primary care to patients with chronic diseases. |
| C．Recruit more medical students by offering them loans. |
| D．Reduce the tuition of students who choose primary care as their major. |
Did you know that the Chinese built the largest canal in the world? Its length of 1,104 miles easily compares with a route linking New York and Florida. Connecting five river systems and four provinces, it ends at Beijing in the North and Hangzhou in the south. For this reason, it is officially called the Beijing-Hangzhou Grand Canal.
In 486 B.C., the leader of the State of Wu, to transport goods to the northern areas of China, constructed a man-made channel using already existing waterways to link the Yangtze and Huai rivers. It was this channel that laid the foundation for the future longer Grand Canal. More than 1000 years later, Emperor Yang of Sui Dynasty had the old canals rebuilt and connected to form what we know today as the Grand Canal.
Then in 1403,Emperor Yongle of the Ming Dynasty transferred his capital from Nanjing to Beijing. In order to feed all those moving North, he had to transport grain from the south along the Grand Canal. To restore the Canal, more than 47,000 men were employed.
The canal soon became the economic lifeline of the empire. Grain was not the only trade goods transported North on the waterways. Salt was another, as well as wine and tea. Goods traded from the North included cotton, wool, coal, flour, precious stones, and dried meat. At times, more than 120,000 soldiers and officers were needed to operate the almost 12,000 ships that annually travelled the Grand Canal.
With the expansion of the railway system in the mid-1800s, the Grand Canal became less and less important to traders. Today, few goods are transported along its waterways. Still, the current South-North Water Transfer Project proves that the Chinese government still sees the Grand Canal important to the welfare of China. The aim of this costly project is to divert huge amounts of water every year from the Yangtze River to the drier regions in the north.
1. What is special about the Grand Canal?| A．It can date back to the Sui Dynasty. |
| B．It has a history of less than1, 000 years. |
| C．It runs from New York to Florida. |
| D．It is the longest canal across the world. |
| A．It was first constructed to convey officers. |
| B．It was employed for wars by Emperor Yongle. |
| C．It used to transport goods between south and north. |
| D．It is now carrying more goods than the railway system. |
| A．Transfer. | B．Recycle. | C．Conserve. | D．Clarify. |
| A．A diary. | B．A magazine. | C．A novel. | D．A biography. |
3 . A blow-fly (绿头苍蝇) was looking for an ideal place to lay eggs, like rotting meat, so that when her little maggots (蛆) were born, they could feed on the meat.
As she turned a corner in the grassland, she smelt something stinking in the air. The smell of rotten meat! With great joy she perched on it and laid her eggs. She was happy that her children would have enough food to eat.
The blow-fly did not know she had made a great mistake. What she had sat upon was not meat but a flower, which stinks. It is called a carrion flower (牛尾草). So, when the blow-fly’s eggs hatched and the little maggots came out, they had nothing to eat. They died of starvation.
The carrion flower is one of the many flowers which give out dirty smells to attract flies. The Rafflesia stinks like rotting meat, while the tropical Lords and Ladies flower gives out a smell like rotting fish.
They do it for a special reason. Unlike mating birds, these plants cannot move from their place. But it is important for the male cell of one plant to get in touch with the female cell of another plant. Once that is done , the seed of the plant will bloom and give birth to another plant.
The plant uses its stink to attract flies. As soon as the blow-fly sits on the flower, it is captured by the flower with strong hair. When the hair falls, the fly is free to fly, but it takes some pollen (花粉) with it. And goes and sits on another plant. The male cell of one plant meets the female cell of the other. The seed gets new life.
1. What does the underlined word “stinking” in paragraph 2 refer to?| A．Moving around. |
| B．Shaking in the wind. |
| C．Being in full bloom. |
| D．Giving out bad smell. |
| A．They feed on the flower. |
| B．They die of hunger. |
| C．They become blow-flies again. |
| D．They become food of the flower. |
| A．To get food for itself. |
| B．To kill the flies. |
| C．To get their maggots. |
| D．To let the flies help with its reproduction. |
| A．The blow-fly only lays eggs on a carrion flower. |
| B．The carrion-flower and the blow-fly benefit each other. |
| C．The blow-fly falls victim to the carrion flower in the end. |
| D．The blow-fly helps the carrion flower in an important way. |
4 . Maybe you think the richer the happier. As the richest countries in the world, you’d expect that Qatar and Japanese people would also be the happiest. Seeing as though they have the highest life expectancy (平均寿命).
But clearly wealth and good health do not guarantee happiness after both countries failed to make the top ten most positive countries.
The survey of nearly 150, 000 people around the world found that seven of the world’s 10 countries with the happiest attitudes are in Latin America.
Gallup asked about 1,000 people in each of 148 countries if they were well-rested, had been treated with respect, smiled or laughed a lot, learned or did something interesting and felt feelings of enjoyment the previous day.
In Panama and Paraguay, 85 percent of those surveyed said yes to all five, putting those countries at the top of the list. They were followed closely by El Salvador, Venezuela, Trinidad and Tobago, Thailand. Guatemala, the Philippines, Ecuador and Costa Rica.
The people least likely to report positive emotions lived in Singapore, the wealthy and orderly city-state that ranks among the most developed in the world. Other wealthy countries also sat surprisingly low on the list. Germany and France tied with the poor African state of Somaliland for 47th place.
Many of the seven countries which were most positive do poorly in traditional measures of well-being, like Guatemala, a country torn by decades of civil war followed by waves of gang-driven criminality that give it one of the highest murder rates in the world. “In Guatemala, it’s a culture of friendly people who are always smiling,” said Luz Castillo, a 30-year-old surfing instructor. “Despite all the problems that we’re facing, we’re surrounded by natural beauty that lets us get away from it all.”
The poll (民意测验) shows that wealthy nations can also be deeply unhappy ones. And poverty-stricken ones are often full of positivity, or at least a close approximation of it.
1. Which of the following country is the happiest one according to the passage?| A．Qatar. | B．Panama. | C．Japan. | D．Singapore. |
| A．wealth | B．good order | C．health | D．positive emotions |
| A．The richest countries are in Asia |
| B．People in poor countries are unhappy |
| C．The happiest countries have good social order |
| D．People in Guatemala face the difficulty positively because of its beautiful nature |
| A．The World Countries | B．The World Happiest Region |
| C．The World Happiness Index | D．The Wealthy Countries in the World |
5 . Welcome to Vietnam!
Day 1: Endangered Primates and Stunning Landscape Of Ninh Binh
After breakfast take the electric car to the Endangered Primates Rescue Centre. Here, they focus on the conservation of the gibbons (长臂猿) and langur (叶猴). You will have chance to see how the staff feed them in captivity and semi-wild areas of primary forest. Then you’ll see how their behavior is studied in semi-wild conditions and how they are prepared for full release into the wild.
Day 2: Cruising Halong Bay
A delicious lunch will be served as you slowly sail through this Halong Bay. It was designated a UNESCO World Heritage site in 1994. Mid-afternoon head to the Vung Vieng fishing village by local rowing boats to explore the interesting daily lives of its inhabitants. In the evening you will experience a Vietnamese cooking meal served in the main dining room. Evenings are beautiful on Halong Bay. Relax on the top deck and take in the transformation of the bay.
Day 3: Discover Hue the Authentic Way
Today, you will get a taste of what real life is like in Hue. One of the city’s most famous cooking experiences is the Royal Dinner. You will have a unique experience where you will have a private audience with descendant (后裔) of the last royal family of Vietnam, in her own home. Spend time tasting the real dishes that were once served to royalty.
Day 4: Walk to the Hang Tien Cave
Hang Tien is actually two huge caves, one of which is over 3km long. The wonder lies in unusual rock formations, such as breathtaking rock formations that look like terraced rice fields, giving the caves an otherworldly feel. On your way back, take a dip in the natural jungle swimming pool and have a coffee, a quick swim, before making your return journey.
1. What are tourists scheduled to do on their first day?| A．Tour a bay by boat. |
| B．Watch endangered animals. |
| C．Climb breathtaking rock formations. |
| D．Visit a UNESCO World Heritage site. |
| A．Tasting local foods. |
| B．Exploring huge caves. |
| C．Visiting a small fishing village. |
| D．Enjoying water-related activities. |
| A．Day 1. | B．Day 2. | C．Day 3. | D．Day 4. |
6 . China, the United Arab Emirates (UAE) and the United States plan to launch (发射) unpiloted spaceships in the next few weeks to fly to Mars. The operations are aimed at searching for signs of ancient, tiny life. Each country hopes the research will help them learn if astronauts could someday visit the red planet.
All the spaceships are expected to reach Mars next February after traveling about 485 million kilometers. Scientists want to find out what Mars was like billions of years ago, when it had rivers, lakes and Oceans, It is not by chance that the three launches are taking place soon. Mars and the earth are now in positions that favor such travel , permitting shorter travel time and less fuel use, The positioning happens about every two years.
The UAE spacecraft is named Amal, an Arabic word for hope. It is set to leave from Japan on Friday. The spacecraft will arrive at Mars in the year that the UAE marks the 50th anniversary of its founding: Controlled from Dubai , the spaceship will study the upper atmosphere of Mars and follow changes in its climate.
China will launch a rover (月球车) and an orbiter sometime around July 23. Chinese officials haven' t released much information about the operation, which is called Tianwen,or Questions for Heaven.
The USA plans to launch on July 30 from Florida. Perseverance, the NASA spaceship, will land in Jezero Crater, the site of an ancient river and lake. The area is Tull of large rocks ,cliffs and sand dunes (沙丘) - all possible threats to Perseverance. It will look for rocks that show signs of past life in the area. It will also test some of the technology that will be needed to send humans to the red planet and bring them home safely.
1. Why have the countries chosen to launch spaceships in the same month?| A．They wish of search for signs of ancient life. |
| B．They can make full use of natural conditions. |
| C．They plan to get to Mars before February. |
| D．They want to test some of the high technology. |
| A．In 2020. | B．In 2021. | C．In 2022. | D．In 2023. |
| A．It aims to study changes in climate. | B．It will be sent to Mars on July 23rd. |
| C．It is to be launched in Jezero Crater. | D．It may face difficulty while landing. |
| A．Culture. | B．Education. | C．Technology. | D．Lifestyle. |
7 . Reducing plastic waste isn't easy because the cheap material is found in almost every household item. Now a delicious and nutritious solution has come up to help reduce our dependence on this environmental hazard（危害）.
David Christian, the co-founder of Evoware, says the idea of creating the biodegradable （生物降解的）products came from concern at the country's high pollution rate. Indonesia is home to four of the world's worst polluted river. Since single-use packaging is a large contributor to the problem, Evoware decided to deal with that first.
After investigating various materials, the company settled on seaweed. Unlike corn, commonly used for biodegradable containers, seaweed does not require resources like water or large amounts of space. Since Indonesian farmers already harvest more seaweed than they can sell, it's easy for the company to find the material.
Though they will not reveal their production process, Evoware says the seaweed packaging contains no chemicals and is safe to consume. The company has also invented single-use cups, which can break down 30 days after they're thrown away.
While replacing plastic with the seaweed products may seem appealing to most of us, it is a hard-sell in Indonesia. According to Christian, The awareness to reduce single-use plastic is still very low. This makes our bioplastic unnecessary.” Also a factor is the cost, which is higher than using plastic. Hopefully, Evoware will succeed in convincing Indonesians and people worldwide that switching to their products will be helpful to protecting our beautiful planet.
1. What problem did Evoware decide to deal with first？| A．Ways to clean the four worst polluted rivers. |
| B．How to deal with single-use packaging. |
| C．Means to contribute to the country’s economy. |
| D．What nutritious materials for people to use. |
| A．It could be found everywhere in his country. |
| B．It was most commonly used for packaging. |
| C．It didn't require much space and was easy to get. |
| D．It grew thickly in most of the polluted rivers. |
| A．Sometimes it's hard to get people to reduce the use of plastics. |
| B．Their seaweed products have won government support. |
| C．Their new products have received worldwide popularity. |
| D．The cost of making seaweed products will be lowered soon. |
8 . Every time I passed boys who were playing basketball, I stopped silently to watch them. I really envied them. But as a girl, I once thought that I could never play basketball.
I like playing basketball though I’m not good at it. I’ve had a basketball since I was a child. At first, I could play freely because no one cared when I was just a kid. But as I grew up it seemed harder and harder for me to enjoy basketball.
At school, it was always the boys who played basketball during P.E. classes. The girls were only allowed to play volleyball or badminton.
My parents did not let me play basketball at home. “Basketball is not for girls,” they said. Even when I went to play basketball with my friends, boys stared at me on the court as if I were an alien.
I was feeling down and had hope of playing basketball. Unexpectedly, something changed the first day of high school. I made some friends who also enjoyed playing basketball. They encouraged me to get back on the court.
One of them told me with a smile, “Go your own way, let others talk.” This girl would always play basketball with me. Even the boy who sat next to me in class talked about basketball with me almost every day.
I was inspired by them. Confidence and passion (激情) returned to my heart. I am ready to stand up and play. I will play as well as I can, and for me, even the sky is boundless.
Basketball has become an important part of my life. I am interested in it. I watch and play almost every day. Through basketball, not only do I feel happy and confident, but also learn a lot.
I have heard the NBA star Tracy McGrady say “Nothing is impossible.” It is from an advertisement on TV. I have come to realize that life is just like playing basketball. You should have an aim. After that, just be confident and keep going. Never give up and you will make it sooner or later.
I love the motto of the NBA. It can express my strong feelings for basketball, “I love this game!”
1. The writer often stopped to watch the boys playing basketball because| A．she envied them. |
| B．the boys were top players. |
| C．the boys were her classmates. |
| D．she liked to play basketball. |
| A．P.E. teachers think girls are good at playing volleyball and badminton. |
| B．parents and teachers think basketball is not suitable for girls. |
| C．parents and teachers think girls hate basketball. |
| D．parents and teachers think only basketball is suitable for boys. |
| A．succeed | B．produce it |
| C．make a fortune | D．make a NBA player |
9 . For the brave in the armed forces, being sent away from home for months at a time is just part of the duty. However, it's never an easy one to perform especially for those with children. So when I found out I was going to be stationed in South Korea for a year, I was nervous about how my five children, particularly my eldest daughter Abigail, would take the news since it meant I wouldn't be home to see her graduate from high school.
Incredibly, Abigail told me not to worry and even suggested we live stream the event among family members when I leaked the news. “We've been lucky you haven't had to be sent abroad yet. Anyway we can get connected through the Internet. See me on your phone on my spot,” Abigail said. She stepped into many of my roles when I was gone. I wanted to find a way to thank her and show her how proud I was of her. I started planning the special surprise when my request to return home a few weeks early to attend Abigail's graduation ceremony was approved.
When my time in South Korea finally came to an end, I flew home, rented a car, and stayed in a hotel. And on Abigail's graduation day, I hid in an office behind the stage waiting until I heard my daughter's name called. I just kept thinking “Don't cry. Don't trip in your heels. Don't fall over.” At last！Abigail was up on stage. I slipped up behind her, whispered in her ear, and around she turned! “I was just thinking, like, ‘You aren't supposed to be here. What? What? How？’ It was the biggest shock...I'm pretty sure my dad made people he didn't even know cry. Emotional for everyone,” Abigail cried.
You know what followed: Embraces, kisses, tears, laughs, flowers, wishes...Aren't they what a family has in store?
1. What worried the author most?| A．His duty in South Korea. | B．His five children's safety. |
| C．His eldest daughter's study. | D．His absence from a big event. |
| A．Plan. | B．Celebrate. | C．Prepare. | D．Broadcast. |
| A．Embarrassed. | B．Overjoyed. | C．Nervous. | D．Satisfied. |
| A．A soldier's personal sacrifice. | B．A father's love for his family. |
| C．The meaning of family bond. | D．The way to plan a big surprise. |
10 . Drinking a daily glass of wine for health reasons may not be so healthy after all, a new study from Washington University School of Medicine suggests.
Analyzing data from more than 400,000 people between ages 18 to 85, the researchers found that consuming one to two drinks four or more times per week-an amount considered healthy by current guidelines-increases the risk of early death by 20 percent, compared with drinking three times a week or less. The increased risk of death was consistent across age groups.
＂It used to seem like having one or two drinks per day was no big deal, and there even have been some studies suggesting it can improve health,” said first author Sarah M. Hartz. “But now we know that even the lightest daily drinkers have an increased death risk. ”
Although some earlier studies have linked light drinking to improvements in cardiovascular(心血管的）health, Hartz said the new study shows that those potential gains are outweighed by other risks. Her team evaluated heart disease risk and cancer risk and found that although in some cases, drinking alcohol may reduce risk of heart-related problems, daily drinking increased cancer risk and, as a result, mortality risk.
The new study reviewed data from more than 700 studies around the world and concluded that the safest level of drinking is none. The Washington University team analysis focused on light drinkers: those who consumed only one or two drinks a day. The study focused on two large groups of people in the United States: 340,668 participants, aged 18 to 85, in the National Health Interview Survey, and another 93,653 individuals, aged 40 to 60 who were treated as outpatients(门诊病人）at Veterans Administration clinics.
Hartz thought that some doctors could recommend that people with family histories of heart problems have a drink from time to time, but in families with a history of cancer, physicians had better recommend quitting drinking.
1. What's the new finding of the study on light drinking?| A．It benefits heart health. |
| B．It is potentially unhealthy. |
| C．It is the main cause of cancer. |
| D．It harms only certain age groups. |
| A．By collecting, clinical data. |
| B．By analyzing questionnaires. |
| C．By visiting hospitals personally. |
| D．By making an analysis of other studies. |
| A．Earlier studies are proved totally wrong by Hartz. |
| B．Hartz thought doctors should avoid suggesting drinking. |
| C．Hartz thought doctors should offer personalized suggestions. |
| D．The Washington University team surveyed about 700 people. |
| A．Daily drinking, however much, adds to risk of death |
| B．Risk of drinking wine can't be ignored among youth · |
| C．A sip of wine a day keeps the doctor away |
| D．Light drinking still promises a longer life: |
