剑桥雅思4 Test 4阅读Passage 3原文翻译 医疗资源稀缺的问题 the problem of scare resource
剑桥雅思4第四套题目阅读第三篇文章介绍了医疗资源稀缺的问题。文章分为五个部分，分别说明医疗资源是发达国家共同面对的问题，可持续经济发展的重要性，医疗和人权之间的联系，政府在医疗中的角色，以及医疗资源近期的发展状况等。下面是具体每一部分的翻译。
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雅思真题阅读词汇 剑桥雅思4 test 4 passage 3 医疗资源
剑桥雅思4 Test 4阅读Passage 3答案解析 医疗资源不足的问题
剑4 Test 4 Passage 3阅读原文翻译
A部分
The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just and most efficient way, is not a new one. Every health system in an economically developed society is faced with the need to decide (either formally or informally) what proportion of the community’s total resources should be spent on health-care; how resources are to be apportioned; what diseases and disabilities and which forms of treatment are to be given priority; which members of the community are to be given special consideration in respect of their health needs; and which forms of treatment are the most cost-effective.
应该如何分配医疗资源，以便它们能够以最公正和最有效的方式分配，这不是一个新问题。经济发达社会中的每个卫生系统都必须决定（正式或非正式地）将社区总资源的多少用于医疗保健；如何分配资源；应优先考虑哪些疾病和残疾以及哪种治疗形式；社区哪些成员的健康需求应给予特别考虑；以及哪种治疗方式最具成本效益。
B部分
What is new is that, from the 195 Os onwards, there have been certain general changes in outlook about the finitude of resources as a whole and of health-care resources in particular, as well as more specific changes regarding the clientele of health-care resources and the cost to the community of those resources. Thus, in the 1950s and 1960s, there emerged an awareness in Western societies that resources for the provision of fossil fuel energy were finite and exhaustible and that the capacity of nature or the environment to sustain economic development and population was also finite. In other words, we became aware of the obvious fact that there were ‘limits to growth’. The new consciousness that there were also severe limits to health-care resources was part of this general revelation of the obvious. Looking back, it now seems quite incredible that in the national health systems that emerged in many countries in the years immediately after the 1939-45 World War, it was assumed without question that all the basic health needs of any community could be satisfied, at least in principle; the ‘invisible hand’ of economic progress would provide.
全新的是，从20世纪50年代起关于整体资源的有限性，尤其是医疗资源的局限性，前景发生了某些整体变化，同时在医疗资源用户和这些资源的社区成本上也有了具体的变化。因此，在20世纪50年代和20世纪60年代，西方社会文章来自老烤鸭雅思开始意识到提供化石燃料能源的资源是有限的和可耗尽的，自然或环境维持经济发展和人口的能力也是有限的。换句话说，我们意识到了一个明显的事实，即“增长存在限制”。医疗资源也存在严重限制，这种新的认识是这一普遍启示的一部分。现在回想起来，令人难以置信的是，在1939-45年世界大战之后的许多年里不少国家出现的全国卫生系统至少原则上毫无疑问地假定，任何社区的所有基本医疗需求都可以得到满足。 经济进步的“看不见的手”将提供这些资源。
C部分
However, at exactly the same time as this new realisation of the finite character of health-care resources was sinking in, an awareness of a contrary kind was developing in Western societies: that people have a basic right to health-care as a necessary condition of a proper human life. Like education, political and legal processes and institutions, public order, communication, transport and money supply, health-care came to be seen as one of the fundamental social facilities necessary for people to exercise their other rights as autonomous human beings. People are not in a position to exercise personal liberty and to be self-determining if they are poverty-stricken, or deprived of basic education, or do not live within a context of law and order. In the same way, basic health-care is a condition of the exercise of autonomy.
但是，正在人们逐渐意识到医疗资源有限这一特点的时候，西方社会正在形成一种相反的认识：人们拥有基本的医疗权利是进行正常人类生活的基本条件。 就像教育，政治和法律程序机构，公共秩序，通讯，运输和货币供应一样，医疗保健已被视为人们作为独立人行使其他权利所必需的基本社会设施之一。如果人们陷入贫困，被剥夺了基础教育或没有生活在法律和秩序的环境中，他们将无权行使人身自由和自决权。同样，基本医疗保健是行使自主权的条件。
D部分
Although the language of ‘rights’ sometimes leads to confusion, by the late 1970s it was recognised in most societies that people have a right to health-care (though there has been considerable resistance in the United States to the idea that there is a formal right to health-care). It is also accepted that this right generates an obligation or duty for the state to ensure that adequate health-care resources are provided out of the public purse. The state has no obligation to provide a health-care system itself, but to ensure that such a system is provided. Put another way, basic health-care is now recognised as a ‘public good’, rather than a ‘private good’ that one is expected to buy for oneself. As the 1976 declaration of the World Health Organisation put it: ‘The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.’ As has just been remarked, in a liberal society basic health is seen as one of the indispensable conditions for the exercise of personal autonomy.
尽管“权利”一词有时会引起混淆，但到20世纪70年代后期，大多数社会已经认识到人们享有医疗保健的权利（尽管在美国，人们对拥有医疗服务正式权利的观念持相当抵制的态度）。人们也接受这项权利对国家产生了义务，以确保从公共财政中提供足够的医疗资源。国家没有义务自行提供医疗保健系统，但有义务确保这种系统的存在。换句话说，基本医疗保健现在被认为是一种“公共物品”，而不是人们期望自己购买的“私人物品”。正如世界卫生组织1976年的宣言所指出的那样：“享受可获得的最高健康标准是每个人的基本权利之一，不分种族，宗教，政治信仰，经济或社会条件。” 如前所述，在自由社会中，基本健康被视为行使个人自主权不可或缺的条件之一。
E部分
Just at the time when it became obvious that health-care resources could not possibly meet the demands being made upon them, people were demanding that their fundamental right to health-care be satisfied by the state. The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive)consumers of health-care resources. Thus in OECD countries as a whole, health costs increased from 3.8% of GDP2 in 1960 to 7% of GDP in 1980, and it has been predicted that the proportion of health costs to GDP will continue to increase. (In the US the current figure is about 12% of GDP, and in Australia about 7.8% of GDP.)
就在医疗保健资源可能无法满足对人们对其要求这一现象变得非常明显的时候，人们要求国家满足其基本的医疗保健权。第二组更具体的变化引起了当前对医疗资源分配的担忧，这是由于大多数经合组织国家（OECD）的医疗成本急剧上升，同时伴随着大规模的人口和社会变化。举例来说，这意味着老年人现在是医疗资源的主要（且相对非常昂贵）的消费者。这样，经合组织国家作为一个整体，医疗费用从1960年占国内生产总值的3.8％上升到1980年占国内生产总值的7％。已经有预测指出，医疗成本占GDP的比重将继续增加。（在美国，当前数字为大约GDP的12％，在澳大利亚，约占GDP的7.8％。）
As a consequence, during the 1980s a kind of doomsday scenario (analogous to similar doomsday extrapolations about energy needs and fossil fuels or about population increases) was projected by health administrators, economists and politicians. In this scenario, ever-rising health costs were matched against static or declining resources.
结果，在20世纪80年代末，卫生行政人员，经济学家和政治家预测了一种世界末日情景（类似于关于能源需求和化石燃料或人口增长的世界末日推断）。在这种情况下，不断增长的医疗费用与静态或下降的资源相对。
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