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http://www.sina.com.cn 2006/06/05 16:12  新东方


  Behind the brewing war over protecting patients' records in an age of HMOs and online medicine.

  Technology is a two-edged sword. Rarely is this as clear as it is in the r
ealm of health care. Technology allows doctors to test their patients for genetic defects--and then to turn around and spread the results throughout the world via the Internet. For someone in need of treatment, that's good news. But for someone in search of a job or an insurance policy, the tidings can be all bad.

  Last week President Bill Clinton proposed a corollary to the patients' bill of rights now before Congress: a right to medical privacy. Beginning in 2002, under rules set to become law in February, patients would be able to stipulate the conditions under which their personal medical data could be divulged. They would be able to examine their records and make corrections. They could learn who else had seen the information. Improper use of records by a caregiver or insurer could result in both civil and criminal penalties. The plan was, said Clinton, "an unprecedented step toward putting Americans back in control of their own medical records."

  While the administration billed the rules as an attempt to strike a balance between the needs of consumers and those of the health-care industry, neither doctors nor insurance companies were happy. The doctors said the rules could actually erode privacy, pointing to a provision allowing managed-care plans to use personal information without consent if the purpose was "health-care operations." That, physicians said, was a loophole through which HMOs and other insurers could pry into the doctor-patient relationship, in the name of assessing the quality of care. Meanwhile, the insurers protested that the rules would make them vulnerable to lawsuits. They were especially disturbed by a provision holding them liable for privacy breaches by "business partners" such as lawyers and accountants. Both groups agreed that privacy protections would drive up the cost of health care by at least an additional $3.8 billion, and maybe much more, over the next five years. They also complained about the increased level of federal scrutiny required by the new rules' enforcement provisions.

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


  By EVAN THOMAS Newsweek; 11/08/99, Vol. 134 Issue 19, p67, 1/2p, 1c

  注(1):本文选自By EVAN THOMAS Newsweek; 11/08/99, Vol. 134 Issue 19, p67, 1/2p, 1c

  注(2):本文习题命题模仿对象2003年真题text 2

  1.The author begins his article with “technology is a two-edged sword” to _____________.

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

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

  [C] warn of the harm patients are prone to suffer

  [D] show the advantages and disadvantages of technology

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

  [A] enjoy more rights to their medical records

  [B] be open with their doctors

  [C] decide how to use their medical information

  [D] sue their insurers for improper use of their medical records

  3.Doctors tend to think that the rules _____________.

  [A] may ruin doctor-patient relationship

  [B] can do more harm than good

  [C] will prevent doctors from doing medical research

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

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

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

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

  [C] concealing medical information is widespread in the U.S.

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

  5.From the article we can learn that ________________.

  [A] American government will tighten its control over the use of patients’ personal information.

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

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

  [D] the new rules put insurers in a very disadvantageous position





  brewing [ `brU:IN ] adj. 酝酿中的;逐渐形成的;即将发生的

  HMO: Health Maintenance Organization 医疗保健机构

  tidings [5taIdINz] n. 消息

  corollary [kE5rRlErI]n. 必然的结果;推论

  stipulate [5stIpjJleIt] v. 规定,保证

  divulge [daI5vQldV]v. 泄露, 暴露

  bill [bIl]v. 宣布,宣告

  managed-care plan: n. 管理式医疗保健计划

  loophole [5lu:phEJl]n. 漏洞

  pry [praI]v. 探查,侦查,窥探

  provision [prE5vIV(E)n]n. 规定

  liable [5laIEb(E)l]adj. 有责任的

  breach [bri:tF]n. 违背;不履行


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

  主体句式:The doctors said …

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

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



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

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

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

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






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


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