2006年VOA标准英语-Russia Readies Radical Health Care Reform

By Lisa McAdams
Moscow
01 May 2006

According to an age-old proverb, it is better to be rich and healthy than poor and sick - a saying made all the more true in a country where some say the public health care system is nearly as ill as its patients. Russian health care has not been seriously reformed since the collapse¹ of the former Soviet² Union in 1991. But earlier this year, the Russian government launched a so-called national projects plan that aims to improve four sectors³ of Russian life, including health care.

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In the last decade, the health of the average Russian has grown significantly worse. Overall life expectancy⁴ has fallen from 70 years to 65, with Russian men at particular risk. On average, a Russian man lives 13 years less than his female contemporaries the widest gender⁵ gap in the world.

The three major causes of illness among Russians are respiratory disease, circulatory disorders⁶, and alcohol-related injury and poisoning. Russia also has sky-rocketing HIV/AIDS infection rates and growing problems with multi-resistant strains of tuberculosis⁷.

Yet, despite these alarming trends, public health has not been high on the governments agenda. For years, only about three percent of Russias Gross Domestic Product was spent on health care. But according to the Kremlin that will soon change.

That is because beginning this year, the government has approved an additional $3.2 billion in spending on health care as part of its so-called national priority projects. The funds, mostly drawn⁸ from Russias oil revenues, are expected to cover salary hikes for doctors and nurses, the purchase of new equipment for clinics, and the construction of eight high-tech⁹ medical centers in Russias vast, outlying regions.

Addressing reporters at his annual press conference in Moscow earlier this year, President Vladimir Putin said his government views the reforms as a vital first step.

Mr. Putin says national projects are not a panacea¹⁰ (or quick fix) for all the problems that Russia faces. But he says they are a signal of the areas his government considers crucial at this stage of the countrys development.

One of the more controversial elements of the health reform plan calls for a major shift in emphasis on quality of treatment, rather than Soviet-style obsession¹¹ with the number of people treated.

The plan also reportedly calls for doing away with tens of thousands of specialists - the idea being to encourage more doctors to become general practitioners¹³ or front-line, first responders.

Russian media say that means about 300,000 doctors and health care workers or about half the nation's total could be laid off, and scores of hospitals shut down in the next few years.

This promotion¹⁴ of general practitioners over specialists has many in the medical field worried, including Dr. Olga Golubkova. She is the head of a private clinic in Moscow called Spectra¹⁵. She told VOA that, in her view, the plan will see Russian health care slide backwards¹⁶ by about twenty years.

Golubkova says a general practitioner¹², by nature, is not supposed to be curing all kinds of illness. She says there is a limited number of routine medical problems that a general practitioner is competent to treat. She says a general practitioner's job should be to identify and classify an illness and then send the patient to the appropriate specialist.

Now, she says, we will see GPs being forced to be all things to all people, including surgeons, with results one can only imagine.

Russias Deputy Health Minister downplays these concerns. Victor Starodubov told a recent health conference in Moscow that the shift in focus will lead to increased prestige for general practitioners. Starodubov says physicians will soon face less specialist competition, greater wages, and more opportunity to practice streamlined care. He says the result for patients will also be better.

The minister says many of Russias doctors appeared inadequately¹⁷ prepared or not interested enough in their work to deliver the necessary care. All our efforts must be placed on first-line doctors, he says, because, for any patient, they are often the first and only doctor a patient will see.

Sergei Smirnov says the reforms sound good on the surface. But, as the head of Russias Institute of Social Policies and Social-Economic programs, he says there are few plans he has not heard or seen tried.

Smirnov also told VOA he has serious concerns about how this major overhaul¹⁸ of Russias health care system will turn out. How is it possible, he asks, that a national health care project is managed not by the health ministry¹⁹, but by the presidential administration?

Criticism aside, most agree reform of Russias health care system is urgently needed. But the question on the minds of many is whether this is really the plan to improve things, or will the Russian people be forced to pay the highest price with their health?

1 collapse   

vi.累倒；昏倒；倒塌；塌陷

参考例句：

• The country's economy is on the verge of collapse.国家的经济已到了崩溃的边缘。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做了一次彻底的调查分析。

2 Soviet   

adj.苏联的，苏维埃的；n.苏维埃

参考例句：

• Zhukov was a marshal of the former Soviet Union.朱可夫是前苏联的一位元帅。
• Germany began to attack the Soviet Union in 1941.德国在1941年开始进攻苏联。

3 sectors   

n.部门( sector的名词复数 )；领域；防御地区；扇形

参考例句：

• Berlin was divided into four sectors after the war. 战后柏林分成了4 个区。 来自《简明英汉词典》
• Industry and agriculture are the two important sectors of the national economy. 工业和农业是国民经济的两个重要部门。 来自《现代汉英综合大词典》

4 expectancy   

n.期望，预期，（根据概率统计求得）预期数额

参考例句：

• Japanese people have a very high life expectancy.日本人的平均寿命非常长。
• The atomosphere of tense expectancy sobered everyone.这种期望的紧张气氛使每个人变得严肃起来。

5 gender   

n.（生理上的）性，（名词、代词等的）性

参考例句：

• French differs from English in having gender for all nouns.法语不同于英语，所有的名词都有性。
• Women are sometimes denied opportunities solely because of their gender.妇女有时仅仅因为性别而无法获得种种机会。

6 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

7 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

8 drawn   

v.拖，拉，拔出；adj.憔悴的，紧张的

参考例句：

• All the characters in the story are drawn from life.故事中的所有人物都取材于生活。
• Her gaze was drawn irresistibly to the scene outside.她的目光禁不住被外面的风景所吸引。

9 high-tech   

adj.高科技的

参考例句：

• The economy is in the upswing which makes high-tech services in more demand too.经济在蓬勃发展，这就使对高科技服务的需求量也在加大。
• The quest of a cure for disease with high-tech has never ceased. 人们希望运用高科技治疗疾病的追求从未停止过。

10 panacea   

n.万灵药；治百病的灵药

参考例句：

• Western aid may help but will not be a panacea. 西方援助可能会有所帮助，但并非灵丹妙药。
• There's no single panacea for the country's economic ills. 国家经济弊病百出,并无万灵药可以医治。

11 obsession   

n.困扰，无法摆脱的思想(或情感)

参考例句：

• I was suffering from obsession that my career would be ended.那时的我陷入了我的事业有可能就此终止的困扰当中。
• She would try to forget her obsession with Christopher.她会努力忘记对克里斯托弗的迷恋。

12 practitioner   

n.实践者，从事者；(医生或律师等)开业者

参考例句：

• He is an unqualified practitioner of law.他是个无资格的律师。
• She was a medical practitioner before she entered politics.从政前她是个开业医生。

13 practitioners   

n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师）

参考例句：

• one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
• The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句

14 promotion   

n.提升，晋级；促销，宣传

参考例句：

• The teacher conferred with the principal about Dick's promotion.教师与校长商谈了迪克的升级问题。
• The clerk was given a promotion and an increase in salary.那个职员升了级，加了薪。

15 spectra   

n.光谱

参考例句：

• The infra-red spectra of quinones present a number of interesting features. 醌类的红外光谱具有一些有趣的性质。
• This relation between the frequency and the field spectra was noted experimentally. 实验上已经发现频率和场频谱之间的这种关系。

16 backwards   

adv.往回地，向原处，倒，相反，前后倒置地

参考例句：

• He turned on the light and began to pace backwards and forwards.他打开电灯并开始走来走去。
• All the girls fell over backwards to get the party ready.姑娘们迫不及待地为聚会做准备。

17 inadequately   

ad.不够地；不够好地

参考例句：

• As one kind of building materials, wood is inadequately sturdy. 作为一种建筑材料，木材不够结实。
• Oneself is supported inadequately by the money that he earns. 他挣的钱不够养活自己。

18 overhaul   

v./n.大修，仔细检查

参考例句：

• Master Worker Wang is responsible for the overhaul of this grinder.王师傅主修这台磨床。
• It is generally appreciated that the rail network needs a complete overhaul.众所周知，铁路系统需要大检修。

19 ministry   

n.(政府的)部；牧师

参考例句：

• They sent a deputation to the ministry to complain.他们派了一个代表团到部里投诉。
• We probed the Air Ministry statements.我们调查了空军部的记录。