passage4注解：标题为赤色，翻译为蓝色，分析为绿色。?????????it is said that in england death is pressing难以忘却的，紧迫的（这篇文章意思）, in canada inevitable and in california optional. small wonder【small wonder这缺乏为奇】. americans life expectancy【life expectancy预期寿数】 has nearly doubled over the past century. failing坏了的 hips髋骨?can be replaced, clinical临床的（这篇文章意思），冷酷的?depression抑郁症 controlled, cataracts白内障 removed in a 30-minute surgical procedure. such advances offer the aging population【aging population老龄化人员】 a quality of life that was unimaginable when i entered medicine【entered medicine从医】 50 years ago. but not even a great health-care system can cure death-and our failure to【failure to未能去】?confront that reality now threatens this greatness of ours.
????????death is normal; we are genetically在基因上地?programmed依照特定的方法行事?to disintegrate割裂 and perish消除，消除, even under ideal conditions. we all understand that at some level, yet as medical consumers we treat death as a problem to be solved. shielded维护 by third-party payers【third-party payers第三方付出】 from the cost of our care, we demand everything that can possibly be done for us, even if its useless. the most obvious example is late-stage晚期的 cancer care医治. physicians-frustrated by their inability to cure the disease and fearing loss of hope in the patient-too often offer aggressive斗胆的 treatment far beyond what is scientifically justified.
????????in 1950, the us spent $12.7 billion on health care. in 2002, the cost will be $1,540 billion. anyone can see this tre

nd趋势 is unsustainable. yet few seem willing to try to reverse改变?it. some scholars conclude that a government with finite有限的?resources should simply stop paying for medical care that sustains life beyond a certain age-say 83 or so. former colorado governor richard lamm has been quoted as saying that the old and infirm体弱的 have a duty责任 to die and get out of the way【get out of the way让位】, so that younger, healthier people can realize their potential潜能.
????????i would not go that far【go that far极点】. energetic精力充分的?people now routinely work through their 60s and beyond, and remain dazzlingly非常地（这篇文章意思），耀眼地?productive. at 78, viacom chairman sumner redstonejokingly claims to be 53. supreme court justice sandra day o connor is in her 70s, and former surgeon general c. everett koop chairs担任主席?an internet start-up新式公司?in his 80s. these leaders are living proof【living proof活生生的比方】 that prevention避免 works有用 and that we can manage the health problems that come naturally with age. as a mere 68-year-old,i wish to age as productively as they have.
????????yet there are limits to what a society can spend（资金）花费?in this pursuit. as a physician, i know the most costly and dramatic measures may be ineffective and painful.i also know that people in japan and sweden瑞典,?countries that spend far less on medical care, have achieved longer, healthier lives than we have. as a nation, we may be overfunding the quest for unlikely cures while underfunding research on humbler不起眼的 therapies疗法，医治 that could improve peoples lives.
一、文章规划分析?
这是一篇谈论医疗上花费许多财力去推迟天然去世是不是值得的文章。作者首要从去世的不可以避免性下手，指出耗费许多财力去推迟天然去世是不可以取的，但一起作者亦指出轻视和扔掉对老人的照看也是不对的。最终他经过与其他国家的比照得出了一个处置办法：更多地研讨前进我们日子质量的一般办法。
第一、二段：提出即便有再巨大的医疗清洁体系，去世也是无法打败的。可是咱们如今却不能面临这个实际，其体现就是我们把正常的去世当作疑问来处置，在医疗方面不择办法。
第三、四段：指出因为政府用于医疗清洁的资金日积月累，有人呼吁中止某一年纪以上人群的医疗费用。
最终，作者先经过举例阐明晚年人仍然可以坚持创造力，对上面的观念进行争辩反驳；接着呼吁社会大约把资金更多地投入到研讨前进我们日子质量的往常办法上。
36.what is implied in the first sentence?
[a]americans are better prepared for death than other people.
[b]americans enjoy a higher life quality than ever before.
[c]americans are over-confident of their medical technology.
[d]americans take a vain pride in their long life expectancy.
36.文章第一句话暗示了啥？
【a】美国人在去世面前比其别人更有预备。
【b】美国人享受的日子质量比早年更高。
【c】美国人对他们的医疗技能过于自傲。
【d】美国人对他们较长的寿数感到洋洋满足。
37.the author uses the example of caner patients to show that.
[a]medical resources are often wasted
[b] doctors are helpless against fatal diseases
[c]some treatments are too aggressive
[d] medical costs are becoming unaffordable
37.作者运用“癌症患者”的比方是为了标明。
【a】医疗本钱常常被浪费
【b】医生对丧命疾病束手无策
【c】有些医治方案过于大
【d】医疗费正变得付出不起
38. the authors remark is one of.
[a] strong disapproval
[b] reserved consent
[c] slight contempt
[d] enthusiastic support
38.作者对理查德·拉姆的言辞持有的情绪是。
【a】激烈对立。
【b】有保存地附和
【c】稍有鄙视
【d】火热撑持
39. in contras to the us, japan and sweden are funding their medical care.
[a] more flexibly
[b] more extravagantly
[c] more cautiously
[d] more reasonably
39.与美国比较，日本和瑞典对医疗清洁作业的赞助。
【a】更活络
【b】更奢华
【c】更稳重
【d】更合理
40. the text intends to express the idea that.
[a] medicine will further prolong peoples lives
[b] life beyond a certain limit is not worth living
[c] death should be accepted as a fact of life
[d] excessive demands increase the cost of health care
40.文章所要表达的观念是
【a】医学将进一步延伸我们的生命
【b】跨越了必定极限，生命就不值得连续
【c】去世大约作为生命实际被我们承受
【d】过多的需求添加了医疗清洁的开支
二、中心词汇与超纲词汇?
（1）life expectancy=expectation of life 预期寿数
（2）failing（a.）有缺陷的；失利的；
如：failing health 安康虚弱，failing kidneys肾衰退，a failing business生意失利
（n.）失利，缺陷，缺陷，过期
（3）surgical（a.）外科的，外科医生的，手术上的（n.）外科病房，外科手术；
surgeon（n.）外科医生；
surgery（n.）外科，外科学；手术室，医治室
（4）disintegrate（v.）（使）分化；（使）碎裂；
integrate（v.）使成全体，联系
（5）shield（v.）（from）维护，防护（n.）维护物，护罩；盾，盾状物
（6）unsustainable（a.）不能证明的/撑持的/树立的；
sustainable（a.）可以忍耐的/支撑的；养得起的；
sustain（v.）支撑，坚持，持续，饱尝，忍耐
（7）infirm（a.）弱的，不巩固的，脆弱的；firm（a.）健壮的，坚固的，坚决的，稳
固的
（8）overfunding（a.）对…供给资金过多；
underfunding（a.）对…供给资金缺乏；
前缀over-意为“太甚，过度”，
under-意为“少，缺乏”，
如：overpay多付（钱款），underpay不付满足的款
三、阅览答案：c a b d c
四、全文翻译：?
????????传闻，在英国去世迫在眼前，在加拿大去世不可以避免，在加利福尼亚去世可以选择。这种说法并不新鲜。在曩昔的一个世纪里，美国人的寿数几乎延伸了一倍。髋骨不可了可以替换，临床的郁闷症得到了控制，白内障在30分钟手术中便可以切除。这些前进给晚年人员带来的高质量日子在50年前我刚从事医学时是不可以愿望的。可是即便有一个巨大的医疗清洁体系，去世也是无法打败的一—而咱们不能面临这个实际却正危及着咱们这个年代的巨大。
????????去世是正常表象；咱们的基因抉择咱们即便在最抱负的环境里也会溃散和消亡。咱们一切人在某种程度上都懂得这一点，可是作为医疗花费者，咱们却常将去世视为一个疑问来处置。因为医疗费用由第三方付出，咱们常常需求用尽一切的医疗办法，即便它们不会有任何作用。最显着的比方是晚期癌症的医治。医生因为不能治好疾病，一起又忧虑患者失掉期望，所以常常选用极点斗胆的医治办法，这些办法远远超出了科学可以认同的鸿沟。
????????1950年，美国在医疗清洁方面的开支是127亿美元。2002年这项开支将抵达15400亿。
任何人都理解这个趋势不可以持续下去，可是很稀有情面愿去改变它。有些专家总结说，资金有限的政府大约中止付出医疗费用来推迟某一个年纪以上人群的寿数一—比方83岁支配。传闻，科罗拉多州前州长理查德·拉姆早年说，晚年多病者“有责任死去和让位”，以让更年青、更安康的我们去发扬他们的潜能。
????????我不会说得这么必定，究竟如今精力充分的我们一般能作业到60岁，甚至更久，并仍然具有惊人的创造力。78岁的viacom公司总裁萨姆勒·雷斯顿开玩笑说他只需53岁。最高法院法官桑德拉·欧康奈70有余，前清洁局医务主任c·库普80来岁还出任了一个互联网公司的总裁。这些领导人就是活生生的根据，证明对疾病的防治是有意义的，证明咱们可以抵挡年纪带来的安康疑问。作为一名年仅68岁的人，我期望像他们相同在老龄期间坚持创造力。
????????可是在这样的寻求中，一个社会可以承担的费用是有限的。作为一名医生，我深知最名贵和最急进的办法也可所以无效的和苦楚的。我也深知在医疗开支少得多的日本和瑞典，我们获得了比咱们更长的、更安康的寿数。作为一个国家，咱们可以在寻求不可以能收效的医治办法上花钱太多，而在研讨能前进我们日子质量的更往常的办法上花钱太少。