单选题 According to legend, Aesculapius bore two daughters, Panacea and Hyegeia, who gave rise to dynasties of healers and hygienists. The schism (分离) remains today, in clinical training and in practice; and, because of the imperative nature of medical care and the subtlety of health care, the former has tended to dominate. Preventive medicine has as its primary objective the maintenance and promotion of health. It accomplishes this by controlling or manipulating environmental factors that affect health and disease. For example, in California presently there is serious suffering and substantial economic loss because of the failure to introduce controlled fluoridation (加氟作用) of public water supplies. Additionally, preventive medicine applies prophylactic (预防性的) measures against disease by such actions as immunization and specific nutritional measures. Third, it attempts to motivate people to adopt healthful lifestyles through education.
For the most part, curative medicine has as its primary objective the removal of disease from the patient. It provides diagnostic techniques to identify the presence and nature of the disease process. While these may be applied on a mass basis in an attempt to "screen" out persons with preclinical disease, they are usually applied after the patient appears with a complaint. Second, it applies treatment to the sick patient. In every case, this is, or should be, individualized according to the particular need of each patient. Third, it utilizes rehabilitation methodologies to return the treated patient to the best possible level of functioning.
While it is true that both preventive medicine and curative medicine require cadres of similarly trained personnel such as planners, administrators, and educators, the underlying delivery systems depend on quite distinctive professional personnel. The requirements for curative medicine call for clinically trained individuals who deal with patients on a one-to-one basis and whose training is based primarily on an understanding of the biological, pathological, and psychological processes that determine an individual's health and disease status. The locus (地方)for this training is the laboratory and clinic. Preventive medicine, on the other hand, calls for a very broad spectrum of professional personnel, few of whom require clinical expertise. Since their actions apply either to environmental situations or to population groups, their training takes place in a different type of laboratory or in a community not necessarily associated with the clinical locus.
The economic differences between preventive medicine and curative medicine have been extensively discussed, perhaps most convincingly by Winslow in the monograph The Cost of Sickness and the Price of Health. Sickness is almost always a negative, nonproductive and harmful state. All resources expended to deal with sickness are therefore fundamentally economically unproductive. Health, on the other hand, has a very high value in our culture. To the extent that healthy members of the population are replaced by sick members, the economy is doubly burdened. Nevertheless, the per capita cost of preventive measures for specific diseases is generally far lower than the per capita cost of curative medicine applied to treatment of the same disease. Prominent examples are dental caries (蛀牙) , poliomyelitis(脊髓灰质炎 ) and phenylketonuria (苯丙酮尿) .
There is an imperative need to provide care for the sick person within a single medical care system, but there is no overriding reason why a linkage is necessary between the two components of a health care system, prevention and treatment. A national health and medical care program composed of semiautonomous systems for personal health care and medical care would have the advantage of clarifying objectives and strategies and of permitting a more equitable division of resources between prevention and cure.

单选题 The author's primary concern is to ______.
A. refute a counterargument B. draw a distinction
C. discuss a dilemma D. isolate causes

单选题 It can be inferred that the author regards a program of controlled fluoridation of public water supplies as ______.
A. an unnecessary government program that wastes economic resources
B. a potentially valuable strategy of preventive medicine
C. a government policy that has relatively little effect on the health of a population
D. an important element of curative medicine

【正确答案】 B

【答案解析】这是推理性问题。第一段中作者讨论了疾病预防的基本策略，然后举例说明加利福尼亚州的 fluoridation(加氟作用)的情况。因为有关权威人士没有实施有控制的fluoridation，让当地老百姓遭受到了不必要的痛苦及经济损失。论点的发展让我们得出结论：作者认为，这种不必要的损失完全是因为权威人士没有实行疾病预防措施而造成的。B的内容解释了这个道理，所以是正确的。A是错误的，因为作者对fluoridation持有肯定的态度。C的内容是错的，因为作者引用加州fluoridation的案例来证明采取预防性措施的重要性。D也是错误的，因为fluoridation是一种预防性措施，而不是治疗措施。

单选题 Which of the following best explains the author's use of the phrase "doubly burdened" in Para. 4?
A. A person who is ill does not contribute to production; treatment consumes economic resources.
B. The per capita cost of preventive measures is only one-half of the per capita cost of treatment.
C. The division between preventive medicine and curative medicine requires duplication of administrative expenses.
D. The individual who is ill must be rehabilitated after the cure has been successful.

【正确答案】 A

【答案解析】这也是一道推理题。在第四段中，作者讲到，治疗所花费的资源财力就是丢失掉的花费，也就是说，这方面投入花费的产出等于零。另外，一个病人生病期间也不能创造任何财富。这样，从经济角度上讲，就导致双重损失—花费社会资源，而这些资源又不能有任何产出。A的内容完全表达了这层意思，是对的。B引用错了作者的观点，作者从未在数量上对疾病预防和治疗的花费进行量化比较，仅是说疾病预防花费的要比治疗的少。C是错的，因为作者认定预防与治疗是完全不同的，他最终希望将它们加以区分，由各自独立的权威部门去管辖。D也是错的，因为rehabilitation和cure都属于curative medicine，这不能解释经济受到doubly burdened。