Technology is a two-edged sword. Rarely is this as clear as it is in the realm of health care. Technology allows doctors to test their patients for genetic defects——and then to turn around and spread the results throughout the world via the Internet. For someone in need of treatment， that's good news. But for someone in search of a job or an insurance policy， the tidings can be all bad.

　　Last week President Bill Clinton proposed a corollary to the patients' bill of rights now before Congress： a right to medical privacy. Beginning in 2002， under rules set to become law in February， patients would be able to stipulate the conditions under which their personal medical data could be divulged. They would be able to examine their records and make corrections. They could learn who else had seen the information. Improper use of records by a caregiver or insurer could result in both civil and criminal penalties. The plan was， said Clinton， “an unprecedented step toward putting Americans back in control of their own medical records.”

　　While the administration billed the rules as an attempt to strike a balance between the needs of consumers and those of the health-care industry， neither doctors nor insurance companies were happy. The doctors said the rules could actually erode privacy， pointing to a provision allowing managed-care plans to use personal information without consent if the purpose was “health-care operations.” That， physicians said， was a loophole through which HMOs and other insurers could pry into the doctor-patient relationship， in the name of assessing the quality of care. Meanwhile， the insurers protested that the rules would make them vulnerable to lawsuits. They were especially disturbed by a provision holding them liable for privacy breaches by “business partners” such as lawyers and accountants. Both groups agreed that privacy protections would drive up the cost of health care by at least an additional $3.8 billion， and maybe much more， over the next five years. They also complained about the increased level of federal scrutiny required by the new rules' enforcement provisions.

　　One aim of the rules is to reassure patients about confidentiality， thereby encouraging them to be open with their doctors. Today various cancers and sexually transmitted diseases can go untreated because patients are afraid of embarrassment or of losing insurance coverage. The fear is real： Clinton aides noted that a January poll by Princeton Survey Research Associates found that one in six U.S. adults had at some time done something unusual to conceal medical information， such as paying cash for services.

　　注(1)：本文選自By EVAN THOMAS Newsweek; 11/08/99， Vol. 134 Issue 19， p67， 1/2p， 1c

　　注(2)：本文習(xí)題命題模仿對象2003年真題text 2

　　1. The author begins his article with “technology is a two-edged sword” to _____________.

　　[A] show that doctor‘s improper use of technology can end up in bad results

　　[B] call on people‘s attention to the potential danger technology can bring to us

　　[C] warn of the harm patients are prone to suffer

　　[D] show the advantages and disadvantages of technology

　　2. According to the proposal made by President Clinton， patients will be able to do the following EXCEPT _____________.

　　[A] enjoy more rights to their medical records

　　[B] be open with their doctors

　　[C] decide how to use their medical information

　　[D] sue their insurers for improper use of their medical records

　　3. Doctors tend to think that the rules _____________.

　　[A] may ruin doctor-patient relationship

　　[B] can do more harm than good

　　[C] will prevent doctors from doing medical research

　　[D] will end up in more health care cost and poorer medical service

　　4. The example of the January poll by Princeton Survey Research Associates is used to show that __________________.

　　[A] American patients‘ concealment of their medical information has become a big concern

　　[B] a large portion of patients would rather leave their diseases untreated

　　[C] concealing medical information is widespread in the U.S.

　　[D] paying cash for medical service is a common practice among American patients

　　5. From the article we can learn that ________________.

　　[A] American government will tighten its control over the use of patients‘ personal information.

　　[B] doctors and insurers are both against the rules for the same reasons

　　[C] patients are entitled to have complete control of their medical information

　　[D] the new rules put insurers in a very disadvantageous position

　　答案：ABBAD

　　篇章剖析

　　本文主要講述了病人醫(yī)療隱私權(quán)立法及其引發(fā)的爭議，采用的是指出問題——分析問題的模式。作者首先說明了病人醫(yī)療隱私泄露可能帶來的問題，接著談了提議中的病人醫(yī)療隱私權(quán)法案的內(nèi)容。在第三段作者說明了反對該法案一方的觀點。最后一段則強調(diào)了新法規(guī)的宗旨和不立法可能造成的不良后果。

　　詞匯注釋

　　brewing adj. 醞釀中的;逐漸形成的;即將發(fā)生的

　　HMO： Health Maintenance Organization 醫(yī)療保健機構(gòu)

　　tidings n. 消息

　　corollary n. 必然的結(jié)果;推論

　　stipulate v. 規(guī)定，保證

　　divulge v. 泄露， 暴露

　　bill v. 宣布，宣告

　　managed-care plan： n. 管理式醫(yī)療保健計劃

　　loophole n. 漏洞

　　pry v. 探查，偵查，窺探

　　provision n. 規(guī)定

　　liable adj. 有責(zé)任的

　　breach n. 違背;不履行

　　難句突破

　　1.The doctors said the rules could actually erode privacy， pointing to a provision allowing managed-care plans to use personal information without consent if the purpose was “health-care operations.”

　　主體句式：The doctors said …

　　結(jié)構(gòu)分析：本句中pointing to 這個作伴隨狀語的分詞短語又包含了一個介詞without引出的方式狀語和由if引導(dǎo)的條件狀語從句，使得句子的結(jié)構(gòu)變得較為復(fù)雜。

　　句子譯文：醫(yī)生認(rèn)為這些法規(guī)實際上是在破壞隱私權(quán)，因為其中一條規(guī)定允許管理式醫(yī)療保健計劃(managed-care plan)在“開展醫(yī)療保健工作”時可以不經(jīng)許可使用個人信息。

　　題目分析

　　1. 答案為A，屬推理判斷題。文章以醫(yī)生利用先進的互聯(lián)網(wǎng)技術(shù)傳播病人醫(yī)療信息會有助于治療某些病人的疾病，但同時又給一些病人在就業(yè)和購買保險方面帶來困難為例說明保護病人醫(yī)療信息的重要性，以及不當(dāng)使用技術(shù)可能帶來的不良后果。

　　2. 答案為B，屬事實細節(jié)題�！癰e open with their doctors ”只是這項法規(guī)試圖達到的效果，并不是該法規(guī)賦予病人的權(quán)利。因此答案應(yīng)該是B.

　　3. 答案為B，屬事實細節(jié)題。文章引用醫(yī)生的觀點認(rèn)為新法規(guī)不但不利于保護病人的隱私，反而會actually erode privacy，由此可見答案應(yīng)該是B.

　　4. 答案為A，屬推理判斷題。前文講到了病人因為羞于啟齒或者擔(dān)心失去保險賠付而隱瞞病情，使疾病得不到治療;然后說The fear is real. 繼而引用普利斯頓調(diào)查研究協(xié)會的調(diào)查結(jié)果，意在說明這一問題的嚴(yán)重性。

　　5. 答案為D，屬事實細節(jié)題。文章中提到保險公司的反對意見時，引用了保險公司的說法：the rules would make them vulnerable to lawsuits.由此可見答案應(yīng)該是D.A項中提出的政府加強對病人私人信息的控制的說法是不正確的，因為保險公司抗議的是政府要加強對法規(guī)實施情況的審查(the increased level of federal scrutiny required by the new rules' enforcement provisions)。

　　參考譯文

　　技術(shù)是一把雙刃劍。這一點在醫(yī)療保健領(lǐng)域尤為明顯。借助技術(shù)，醫(yī)生可以測試病人的遺傳缺陷——并通過互聯(lián)網(wǎng)很快將結(jié)果傳遍全世界。對于那些需要治療的人來說，這是好消息;但對于那些正在找工作，或者想要買一份保險的人來說，這樣的消息可能非常糟糕。

　　上周比爾。克林頓總統(tǒng)向國會提交了一份病人權(quán)利法案的推論：醫(yī)療隱私權(quán)。從2002年開始，根據(jù)2月即將生效的法規(guī)，病人將有權(quán)規(guī)定透露其個人醫(yī)療資料的條件。他們可以檢查自己的病歷并進行更正。他們也可以了解哪些人曾看過他們的信息。醫(yī)護人員或者保險公司對病歷使用不當(dāng)將會導(dǎo)致民事或者刑事處罰�？肆诸D說，這一提案“在促使美國人重新獲得對自己的病歷控制權(quán)方面邁出了極其重要的一步�！�

　　雖然政府稱這些法規(guī)旨在平衡消費者和醫(yī)療保健行業(yè)的需求，但醫(yī)生和保險公司對此都頗有微詞。醫(yī)生認(rèn)為這些法規(guī)實際上是在破壞隱私權(quán)，因為其中一條規(guī)定允許管理式醫(yī)療保健計劃(managed-care plan)在“開展醫(yī)療保健工作”時可以不經(jīng)許可使用個人信息。醫(yī)生們稱其為一個漏洞，它使得醫(yī)療保健機構(gòu)(HMO)和其他保險公司可以打著評估醫(yī)療保健質(zhì)量的旗號窺探醫(yī)患關(guān)系。同時，保險公司也對這些法規(guī)持反對意見，他們認(rèn)為這些法規(guī)很容易讓他們?nèi)巧瞎偎�。其中一條法規(guī)令他們尤為不滿，該法規(guī)規(guī)定：保險公司對律師和會計這樣的“商業(yè)伙伴”的侵犯隱私行為負責(zé)。這兩個群體都一致認(rèn)為，保護隱私會使醫(yī)療保健成本增加至少38億美元，在接下來的五年里也許還會增加更多。根據(jù)新法規(guī)的執(zhí)行條例，聯(lián)邦政府將加大對醫(yī)療保健行業(yè)的審查力度，他們對此也表示不滿。

　　新法規(guī)的目標(biāo)之一就是要讓病人不再擔(dān)心自己的隱私被泄漏，從而鼓勵他們對醫(yī)生坦誠相告。今天各種各樣的癌癥和性病可能會因為病人羞于啟齒或者擔(dān)心失去保險賠付而得不到治療。這種擔(dān)心并非無中生有：克林頓的助手補充說，由普林斯頓調(diào)查研究協(xié)會在一月份進行的一項民意測試顯示，在美國，每六個成年人中就有一個曾經(jīng)做過刻意隱瞞醫(yī)療信息的事情，比如用現(xiàn)金支付服務(wù)費。

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