I. Match each paragraph to its main idea. Write the letter of the correct answer.

HEALTH CARE COSTS AND ACCESS IN THE WEALTHIER COUNTRIES

1. Although the health care available in the wealthy countries is the best in the world, their health care systems are
experiencing serious problems. By far the most urgent, complex difficulty is financial. Medical costs are already
enormously high. For example, in Germany in 1995, total health care spending stood at $210 billion. In the United
States, total spending in 2000 was more than $910 billion. Even more problematic, health care costs increased very
rapidly. In the United States, for example, the rate of increase for 2001 was a troubling 11 percent.

2. Responses to rising costs caused access to health care to be reduced rather than maintained or increased. For
example, in Britain, a country which provides publically funded health care to all its citizens, the government was
reluctant, for political reasons, to increase the tax burden on the population and so had no additional money to
invest in the country’s health care system. As costs rose and funding did not, it become necessary to reduce services.
The number of hospital beds fell; less high-tech equipment was bought; and fewer doctors and nurses were hired.
As a result, there were waits of six months or longer for modern diagnostic procedures like MRIs and colonoscopies,
and the most up-to-date treatments were not available to every seriously ill patient who needed them. For some
types of nonemergency procedures, such as cataract and hip-replacement surgery, patients had to wait for up to
three years.
3. In the United States, where most health insurance is provided by employers, access to quality health care has also
been reduced. In response to rising health care costs, the cost of insurance has increased. As a result, employers
have found it difficult to maintain earlier levels of health care benefits. Many employers have had to reduce health
care coverage for their employees, while others no longer can afford to provide any health insurance and have
eliminated it completely. As a result, from 1987, the number of Americans without health insurance increased
steadily; by 2002, an estimated 43 million people were uninsured. The changes affected almost everyone in the
some way, but clearly hit lower-income families harder.

4. The continuing rise in the costs of health care is attributable to a number of factors. One of these, according to
critics of our health care systems is our emphasis on crisis care, the treatment of disease after it has become serious.
According to the critics, however, such an approach to health care tends to ignore a basic fact: crisis care is usually
more expensive and often less effective than prevention or treatment after an early diagnosis. For today’s killers,
such as cardiovascular disease, breast cancer, and colon cancer, early diagnosis can greatly increase recovery rates
and reduce the need for expensive crisis care later.

5. A second factor behind rising health care costs is that people are living considerably longer than they used to.
Average life expectancy in industrial countries rose through most of the 1900s and reach 77 years of age by the end
of the century. Many people are surviving into their eighties and nineties. Because older people tend to require the
services of the health care system more often than younger people, health care spending has increased.

A. In a system of publicly funded health care, responses to increasing costs have reduced
people’s access to health care.
B. In a system of employer-provided health insurance, responses to increasing costs have
reduced people’s access to health care.
C. The high cost of health care is a major problem for the industrial countries.
D. Health care costs are high partly because an increasing number of people are living
longer.
E. In the health care systems of industrial countries, an emphasis on crisis care is one reason
why the costs are high and continue to increase.
II. Match each summary to its original sentence. Write the letter of the correct answer.

6. It is certainly true to say that one of the most serious difficulties a. Colored immigrants came to
confronting the immigrant community concerns the standard of their Britain to taken up a surplus
accommodation which typically is not very high. jobs.
b. Schools have not responded
7. In the first instance, colored people arriving from countries of the effectively to the needs of
commonwealth to live in Britain left their native countries to fill minorities.
employment vacancies which would otherwise have remained unfilled. c. Britain is a multi-racial society.
d. Poor quality housing is a major
8. It is regretably a fact that many educational establishments for the problem to ethnic minorities.
young have failed to respond adequately to the requirements of that e. Britain is a tolerant society.
proportion of the population which is covered. f. Many colored immigrants
suffer from social and
9. One of the most significant changes in Britain over the last fifty years has economic disadvantages.
been its evolution into a society in which people of variety of ethnic
origins live together.

10. It is a sad reflection on British society that a large number of the black
and brown people who came from the Commonwealth to live in this
country are obliged to endure conditions which favour them neither
financially nor socially.

III. Paraphrase the sentences in numbers 6-10.