【解题原则分析】

求同存异123原则：文章的相邻段落之间存在着联系又同时存在差别。段落之间的联系体现为二者之间共享同一主题词；段落之间的差别体现为后面的段落比前面段落要多出一些内容，而且这些多出的内容恰恰体现了“启下”的关系。因此，利用段落之间的差额主题名词，即“相同表联系，相异引下文”的原则，便可以确定下一段落的主题词。

【解题步骤分析】

第一段：Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, to reduce health-care costs.

【主题词】Canada’s premiers-Ottawa-annual meeting-health-care costs.

第二段：They’re all groaning about soaring health budgets, the fastest-growing component of which are pharmaceutical costs.

【主题词】health budgets-pharmaceutical costs.

第二段主题词与第一段主题词做减法得出的差额决定供选择的41题目主题词为：pharmaceutical costs. 在备选答案中找到以该词为主题词的段落，即E。

第三段：According to the Canadian Institute for Health Information, prescription drug costs have risen since 1997 at twice the rate of overall health-care spending. Part of the increase comes from drugs being used to replace other kinds of treatments part of it arises from new drugs costing more than older kinds. Part of it is higher prices.

【主题词】health budgets-pharmaceutical costs.

第四段：What to do? Both the Romanow commission and the Kirby committee on health care-to say nothing of reports from other experts-recommended the creation of a national drug agency. Instead of each province having its own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.

【主题词】Romanow commission and the Kirby committee-health care-national drug agency-a national institution.

第四段主题词与第三段主题词做减法得出的差额决定供选择的42题目主题词为：national institution. 在备选答案中找到以该词为主题词的段落，即C。

第四段：What to do? Both the Romanow commission and the Kirby committee on health care-to say nothing of reports from other experts-recommended the creation of a national drug agency. Instead of each province having its own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.

【主题词】Romanow commission and the Kirby committee-health care-national drug agency-a national institution.

第五段：What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council.

【主题词】“national” -provinces-“national” organization-better prices-drug manufacturers-the provincial list-the national agency-Quebec-the national agency-better price.

第五段主题词与第四段主题词做减法得出的差额决定供选择的43题目主题词为：drug manufacturers, Quebec, better price. 在备选答案中找到以该词为主题词的段落，即G。

第八段：A small step has been taken in the direction of a national agency with the creation of the Canadian Co-coordinating Office for Health Technology Assessment, funded by Ottawa and the provinces. Under it, a Common Drug Review recommends to provincial lists which new drugs should be included. Predictably and regrettably Quebec refused to join.

【主题词】“national”-provinces-“national” organization-better prices, if possible, with drug manufacturers-the provincial list, the national agency-Quebec-the national agency-better price.

第九段：A few premiers are suspicious of any federal-provincial deal-making. They (particularly Quebec and Alberta) just want Ottawa to fork over additional billions with few, if any, strings attached. That’s one reason why the idea of a national list hasn’t gone anywhere while drug costs keep rising fast.

【主题词】premiers-deal-making-additional billions-national-drug costs.

第九段主题词与第八段主题词做减法得出的差额决定供选择的44题目主题词为：additional billions, drug costs 在备选答案中找到以该词为主题词的段落，即F。

第十段：So, if the provinces want to run the health-care show, they should prove they can run it, starting with an interprovincial health list that would end duplication, save administrative costs, prevent one province from being played off against another, and bargain for better drug prices.

【主题词】premiers-deal-making-additional billions-national-drug costs.

第十一段：Premiers love to quote Mr. Romanow’s report selectively, especially the parts about more federal money perhaps they should read what he had to say about drugs: “A national drug agency would provide governments more influence on pharmaceutical companies in order to constrain the ever-increasing cost of drugs.”

【主题词】Premiers-Mr. Romanow’s report-drugs-national drug agency-governments-pharmaceutical companies-cost of drugs.”

第十一段：Premiers love to quote Mr. Romanow’s report selectively, especially the parts about more federal money perhaps they should read what he had to say about drugs: “A national drug agency would provide governments more influence on pharmaceutical companies in order to constrain the ever-increasing cost of drugs.”

【主题词】Premiers-Mr. Romanow’s report-drugs-national drug agency-governments-pharmaceutical companies-cost of drugs.”

第十一段主题词与第十段主题词做减法得出的差额决定供选择的45题目主题词为：report, drug costs 在备选答案中找到以该词为主题词的段落，即B。

Directions: In the following text, some sentences have removed. For Questions 41-45, choose the most suitable one from the list A-G to fit into of the numbered blank there are two extra choices, which do not fit in any of the gaps. Mark your answers on ANSWER SHEET1. (2005年真题原文)

Canada’s premiers (the leaders of provincial governments), if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, to reduce health-care costs.

They’re all groaning about soaring health budgets, the fastest-growing component of which are pharmaceutical costs.

41.

What to do? Both the Romanow commission and the Kirby committee on health care-to say nothing of reports from other experts-recommended the creation of a national drug agency. Instead of each province having its own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.

42.

But “national” doesn’t have to mean that. “National” could mean interprovincial-provinces combining efforts to create one body. Either way, one benefit of a “national” organization would be to negotiate better prices, if possible, with drug manufacturers. Instead of having one province-or a series of hospitals within a province-negotiate a price for a given drug on the provincial list, the national agency would negotiate on behalf of all provinces. Rather than, say, Quebec, negotiating on behalf of seven million people, the national agency would negotiate on behalf of 31 million people. Basic economics suggests the greater the potential consumers, the higher the likelihood of a better price.

43.

A small step has been taken in the direction of a national agency with the creation of the Canadian Co-coordinating Office for Health Technology Assessment, funded by Ottawa and the provinces. Under it, a Common Drug Review recommends to provincial lists which new drugs should be included. Predictably and regrettably Quebec refused to join.

A few premiers are suspicious of any federal-provincial deal-making. They (particularly Quebec and Alberta) just want Ottawa to fork over additional billions with few, if any, strings attached. That’s one reason why the idea of a national list hasn’t gone anywhere while drug costs keep rising fast.

44.

Premiers love to quote Mr. Romanow’s report selectively, especially the parts about more federal money perhaps they should read what he had to say about drugs: “A national drug agency would provide governments more influence on pharmaceutical companies in order to constrain the ever-increasing cost of drugs.”

45.

So when the premiers gather in Niagara Falls to assemble their usual complaint list, they should also get cracking about something in their jurisdiction that would help their budgets and patients.

Quebec’s resistance to a national agency is provincialist ideology. One of the first advocates for a national list was a researcher at Laval University. Quebec’s Drug Insurance Fund has seen its costs skyrocket with annual increases from 14.3 per cent to 26.8 per cent!

Or they could read Mr. Kirby’s report:“the substantial buying power of such an agency would strengthen the public prescription-drug insurance plans to negotiate the lowest possible purchase prices from drug companies”

What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council.

The problem is simple and stark: health-care costs have been, are, and will continue to increase faster than government revenues.

According to the Canadian Institute for Health Information, prescription drug costs have risen since 1997 at twice the rate of overall health-care spending. Part of the increase comes from drugs being used to replace other kinds of treatments part of it arises from new drugs costing more than older kinds. Part of it is higher prices.

So, if the provinces want to run the health-care show, they should prove they can run it, starting with an interprovincial health list that would end duplication, save administrative costs, prevent one province from being played off against another, and bargain for better drug prices.

Of course the pharmaceutical companies will scream. They like divided buyers, they can lobby better that way. They can use the threat of removing jobs from one province to another. They can hope that, if one province includes a drug on its, list the pressure will cause others to include it on theirs. They wouldn’t like a national agency, but self-interest would lead them to deal with it

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