2009年12月6级阅读理解逐句翻译

2009年12月

一、

There is nothing like the suggestion of a cancer risk to scare a parent, especially one of the over-educated, eco-conscious type.

没有什么事情比有得癌症的迹象更让父母感到害怕的了，尤其对于受到过度教育、对生态环境敏感的那种人来说。

So you can imagine the reaction when a recent USA Today investigation of air quality around the nation’s schools singled out those in the smugly（自鸣得意的）green village of Berkeley, Calif., as being among the worst in the country.

所以当《今日美国》在近期公布的一份全国范围内的学校周边空气质量调查中，把加州伯克利的绿色环保小镇列为全国最差时，你可以想象到那些自鸣得意的人的反应。

The city’s public high school, as well as a number of daycare centers, preschools, elementary and middle schools, fell in the lowest 10%. Industrial pollution in our town had supposedly turned students into living science experiments breathing in a laboratory’s worth of heavy metals like manganese, chromium and nickel each day.

该市的公立高中以及为数众多的日间看护中心、学前教育机构、小学和中学都在最差的10%之列。我们镇上的工业污染大概把学生置于活体科学实验之中，学生们以等值于实验室的剂量每天吸入锰、镉和镍等重金属。

This in a city that requires school cafeterias to serve organic meals. Great, I thought, organic lunch, toxic campus.

这发生在一个要求学校的餐厅提供有机饭菜的城市中。太伟大了，我想，有机午餐，有毒校园。

Since December, when the report came out, the mayor, neighborhood activists（活跃分子）and various parent-teacher associations have engaged in a fierce battle over its validity: over the guilt of the steel-casting factory on the western edge of town, over union jobs versus children’s health and over what, if anything, ought to be done.

自12月份报告公布以来，市长，社区活跃分子和各种家长---教师联合会都参与到一场关于报告的可信度的激烈斗争中：关于位于小镇西北角上的钢铁铸造厂的罪责、有关孩子们的健康VS工会职责，以及应该去做的事，如果还有事能做的话。

With all sides presenting their own experts armed with conflicting scientific studies, whom should parents believe?

每一方都有代表他们的专家，手头上的科学研究结果相互矛盾，父母究竟应该相信谁？

Is there truly a threat here, we asked one another as we dropped off our kids, and if so, how great is it?

我们在让孩子下车时会相互询问，这儿是不是真的存在危险？如果真有危险的话，有多大？And how does it compare with the other, seemingly perpetual health scares we confront, like panic over lead in synthetic athletic fields?

和其他危险相比怎么样？比如像综合运动场上铅含量这样我们似乎要面临的永久性的健康恐慌。

Rather than just another weird episode in the town that brought you protesting environmentalists, this latest drama is a trial for how today’s parents perceive risk, how we try to keep our kids safe —whether it’s possible to keep them safe—in what feels like an increasingly threatening world. It

raises the question of what, in our time, “safe”could even mean.

这不仅仅是发生在城镇中的又一个奇特事件，引来一群游行抗议的环保主义者，这场最新的闹剧是对现在的父母如何看待风险的试金石，我们如何在一个看起来日益危机四起的世界里尽量保证我们孩子的安全----无论能否保证他们的安全。这引起的问题是，在我们的时代“安全”究竟意味着什么。

“There’s no way around the uncertainty,”says Kimberly Thompson, president of Kid Risk, a nonprofit group that studies children’s health. “That means your choices can matter, but it also means you aren’t going to know if they do.”

“没有办法解决不确定的问题，”金伯利汤普森说，她是一个研究儿童健康问题的非盈利性组织“孩子的危险”的主席。“这意味着你的选择很重要，但这也意味着如果你的选择真的很重要的话，你也没有办法知道。”

A 2004 report in the journal Pediatrics explained that nervous parents have more to fear from fire, car accidents and drowning than from toxic chemical exposure.

一份2004年发表在学术期刊《儿科》上的报告解释了不安的父母们对火灾、车祸和溺水的恐慌要更甚于接触有毒化学物质。

To which I say: Well, obviously. But such concrete hazards are beside the point.

对此我认为：“嗯，很明显。但是这些具体的危险并非重点。

It’s the dangers parents can’t—and may never—quantify that occur all of sudden. That’s why I’ve rid my cupboard of microwave food packed in bags coated with a potential cancer-causing substance, but although I’ve lived blocks from a major fault line(地质断层) for more than 12 years, I still haven’t bolted our bookcases to the living room wall.

正式父母们不能----可能永远也不能-----量化危险会突然发生。这正是我已经把所有包装袋上涂有可能致癌物质的微波食品全部扔掉的原因，但是尽管我住在一个距离大地质断层几街区远的地方已经12年了，我仍然没把我们的书架固定在客厅的墙上。

二、

Crippling health care bills, long emergency-room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily.

问题重重的医疗保障费用，急诊室前排起的长队，以及无法找到初级护理医生，这些仅是每天要面对的问题中的一部分。

Primary care should be the backbone of any health care system.

初级护理应该是所有医疗保障体系的支柱。

Countries with appropriate primary care resources score highly when it comes to health outcomes and cost.

有充足的初级护理资源的国家在健康水平和费用支出上都获得甚佳的评价。

The U.S. takes the opposite approach by emphasizing the specialist rather than the primary care physician.

美国却反其道而行之，注重专科医生而非初级护理医生。

A recent study analyzed the providers who treat Medicare beneficiaries（老年医保受惠人）.

最近一项研究分析了负责治疗老年医保受惠人的医生。

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.

这项令人震惊的研究发现，老年医保受惠人平均每天要看七名医生----包括两名初级护理医

生和五名专科医生。与公众的想法刚好相反，更多的医生给你看病并不能保证更好的医疗服务。

Actually, increasing fragmentation of care results in a corresponding rise in cost and medical errors.

实际上，医疗服务的日益分化导致的是费用的上升和误诊数量的增多。

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.

我们怎么会使初级护理如此严重地滑坡呢？关键是医生的收入。大部分医生的收入来源于他们所提供的医疗服务。

The more a physician does, regardless of quality or outcome, the better he’s reimbursed (返还费用).

医生做的越多，不管质量或结果如何，他获得的返还费用就越高。

Moreover, the amount a physician receives leans heavily toward medical or surgical procedures. 此外，医生的收入在很大程度上受到医疗或者外壳手术的影响。

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.

一名专科医生耗时30分钟进行某个手术，其收入要比比一名初级护理医生花同样多的时间去讨论一个病人病情的收入高3倍。

Combine this fact with annual government threats to indiscriminately cut reimbursements, physicians are faced with no choice but to increase quantity to boost income.

再加上政府每年都威胁要一视同仁地降低医疗返还费用，初级护理医生没有选择的余地，只好通过提升数量以增加收入。

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.

对于拒绝牺牲质量的初级护理而言，要么被迫停业，要么就只从事能赚钱的业务，这使得初级护理的质量进一步下滑。

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%.

医学院的学生对此并非一无所知。他们看到了费用返还体制是如何严重地弄虚作假，不利于初级护理。最近的数据表明，自1997年以来，美国医学院的毕业生选择初级护理作为职业的人数下降了50%。

This trend results in emergency rooms being overwhelmed with patients without regular doctors. 这样的趋势导致急诊室里人满为患，挤满了那些无法找到普通医生的病人。

How do we fix this problem?

我们怎么解决这个问题。

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 (最佳地) managing their diseases and practicing evidence-based medicine.

首先需要改革医生费用返还体制。卸下初级护理医生每小时看更多病人的压力，对于优化病患管理和机遇病症用药给予奖励。

Make primary care more attractive to medical students by forgiving student loans for those who choose primary care as a career and reconciling the marked difference between specialist and primary care physician salaries.

通过减免从事初级护理的医学院学生的学费贷款，使初级护理对医学院学生更有吸引力，消除去专科医生和初级护理医生薪水之间的巨大差异。

We’re at a point where primary care is needed more than ever. Within a few years, the first wave of the 76 million Baby Boomers will become eligible for Medicare.

我们对初级护理的需求从未像现在这样迫切过。在几年之内，第一波7600万婴儿潮一代将被纳入老年人医保。在未来的十年期间

Patients older than 85, who need chronic care most, will rise by 50% this decade.

年龄大于85岁的最需要长期看护的病人数量将会增加50%。

Who will be there to treat them?

到时谁去治疗他们？

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