2018年翻譯資格考試初級(jí)筆譯模擬題:美國(guó)醫(yī)療保健改革
漢譯英
因?yàn)榇嬖谌毕荩悦绹?guó)的醫(yī)療保健在過(guò)去幾十年里進(jìn)行了重大改革。心臟疾病導(dǎo)致的死亡自1970年以來(lái)下降了40%。由于較先進(jìn)的監(jiān)測(cè)和治療,癌癥死亡率自1990年以來(lái)一直處于下降趨勢(shì)。總的來(lái)看,醫(yī)療進(jìn)步使美國(guó)人均壽命從1950的68歲提高到現(xiàn)在的77歲。
美國(guó)人不僅提高了壽命,而且還提高了生活質(zhì)量。65歲以上患有至少一種長(zhǎng)期殘疾——如在無(wú)人幫助下不能獨(dú)立行走,或不能自己穿衣——的比例從1982年的20%以上下降到1990年的20%以下。視力矯正手術(shù)的發(fā)展,以及其他藥品和治療程序的發(fā)展,使得許多美國(guó)人歷史性地延長(zhǎng)了與年輕有關(guān)的生活樂(lè)趣。
當(dāng)然,并不是美國(guó)人健康和長(zhǎng)壽方面取得的所有進(jìn)步都直接歸功于我們的醫(yī)療保健系統(tǒng)。有些是養(yǎng)成健康習(xí)慣(鍛煉身體、合理飲食)或戒除不健康習(xí)慣(吸煙、過(guò)量飲酒)的直接結(jié)果。然而,良好的醫(yī)療保健依舊是過(guò)去50多年來(lái)產(chǎn)美國(guó)人健康改善和生命延長(zhǎng)的主要因素。
但問(wèn)題是,自1960年以來(lái),醫(yī)療保健費(fèi)用的增長(zhǎng)速度遠(yuǎn)遠(yuǎn)超過(guò)了經(jīng)濟(jì)增長(zhǎng)速度,這意味著我們的收入中用于醫(yī)療保健上的比例越來(lái)越大。1960年醫(yī)療保健費(fèi)用占美國(guó)經(jīng)濟(jì)的5.1%;到1980年的時(shí)候,就升高到了8.8%;而現(xiàn)在已達(dá)到13.3%了。與此同時(shí),私人健康保險(xiǎn)費(fèi)用——僅去年一年就上升了14%——讓越來(lái)越多的美國(guó)人感到難以承受。我們?yōu)榻】刀扇〈胧┑臄?shù)量已經(jīng)超過(guò)了美國(guó)人的承受能力。目前有4100萬(wàn)人口還沒(méi)有上醫(yī)療保險(xiǎn)。因此,關(guān)鍵問(wèn)題不是在于美國(guó)醫(yī)療保健是否應(yīng)該定量配給,因?yàn)槲覀円呀?jīng)實(shí)現(xiàn)了這個(gè)目標(biāo),而是在于醫(yī)療保健怎樣定量配給。美國(guó)人民在痛苦減少、生活質(zhì)量改善或壽命延長(zhǎng)等方面所獲得的潛在益處,怎樣才能抵消伴隨而來(lái)的藥品或就醫(yī)高消費(fèi)呢?誰(shuí)來(lái)負(fù)責(zé)平衡呢?沒(méi)有很高的道德責(zé)任,這些問(wèn)題是難以解決的。但是,我們還是希望醫(yī)療保健系統(tǒng)能夠涵蓋更多的人。
參考譯文
For all it flaws, medical care in the United States has been reformed gigantically over the past several decades. Deaths from heart disease have fallen by 40 percent since 1970. thanks to better detection and treatment, cancer advances have helped to raise U.S. life expectancy from an average of 68 years in 1950 to 77 years today.
Not only have American lives grown longer, but their quality has improved. The proportion of people over 65 with one or more chronic disabilities—such as the inability to walk, or to get dressed, without aid—declined from greater than 25 percent in 1982 to less than 20 percent in 1999. and the development of vision-correction surgery, among many other drugs and procedures, has allowed many Americans to prolong pleasures historically with youth.
Of course, not all the recent improvements in American health and longevity can be directly attributed to our health-care system; some are as much the result of adopting healthier habits( exercise, better diet) or of dropping unhealthy ones (smoking, too much alcohol-drinking). Still, better medical care is the principal cause of improvements in American health and life span over the past 50 years.
But the problem is that since 1960 health-care spending has grown significantly faster than the economy, meaning that we’re spending an ever larger portion of our incomes on medical core. In 1960 health care constituted 5.1 percent of the U.S. economy; in 1980 it constituted 8.8 percent; today it constitutes 13.3 percent. Meanwhile, private health-insurance premiums—which rose by 14 percent last year alone —are becoming unaffordable for ever Americans. The number of things we can do to pay for them. 41 millions of our citizens are now uninsured. So the key question is not whether health care should be rationed in the United States; it already is. Rather the question is how health care should be rationed. How should the potential benefits of reduced pain, improved quality of life, or extended life be weighted against the high costs of the medications or procedures involved? And who should weigh them? These are hard questions with high moral stakes. But we do hope that the health-care system will cover more people.
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