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[阅读小分队] 【Native Speaker每日综合训练—43系列】【43-15】文史哲 health care

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发表于 2014-10-26 21:59:44 | 显示全部楼层 |阅读模式
内容:油桃F编辑:cyndichiang

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Part I: Speaker

Rebecca Onie: What if our healthcare system kept us healthy?
Source: TED Talks
http://www.ted.com/talks/rebecca_onie_what_if_our_healthcare_system_kept_us_healthy#t-2247

[Rephrase 1, 16:31]

                                                                       

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 楼主| 发表于 2014-10-26 21:59:45 | 显示全部楼层
Part II: Speed



Walmart’s Affordable Care Act
By Alison Griswold  |  Oct. 22, 2014

[Time 2]
Earlier this month, Walmart made a pair of unfortunately timed announcements. First, on Oct. 6, Walmart said it would begin working with DirectHealth.com, an online health insurance agency, to help shoppers compare coverage options and sign up for Medicare or plans on the Affordable Care Act exchanges. The very next day, Walmart stated it would cut health insurance for 30,000 part-time workers and raise premiums for its full-time employees, effective Jan. 1.

Walmart is among several retailers racing to make a name for itself in the nearly $3 trillion U.S. health care market. And, in many ways, it’s already proven to be a leader. In 2006, Walmart introduced its $4 prescription program, which cut the cost of roughly 300 generic drugs to $4 for a 30-day supply. It has dozens of simple-service clinics that test for common ailments and provide vaccinations, and this year has focused on rolling out a handful of primary care facilities that charge $40 per visit in Texas, South Carolina, and Georgia. The partnership with DirectHealth.com is a logical next step in Walmart’s push into wellness—a perk that might help draw consumers into Walmart’s stores and build their trust in its brand for not just cheap groceries, but also cheap health services.

At the same time, Walmart’s interest in building faith in its health offerings does not extend to its own employees. It made that much clear when it slashed benefits and raised premiums the day after publicizing its DirectHealth.com initiative. People are already sensitive when it comes to health services. Should they trust a giant corporation to handle them, especially one that appears to be so callous about the health care of its own employees?
[281 words]

[Time 3]
The simple answer, health policy experts say, is yes. “Consumers are going to benefit from new entrants who think more like retailers than health care providers,” says Zack Cooper, professor of health policy and management at the Yale School of Public Health. “If I had one word to describe Walmart coming in, it would be cool.” The influx of retailers like Walmart into health care means that consumers are suddenly getting more information about and access to crucial services. While many doctor’s offices are used to operating from 9 to 5, Cooper says that retailers are starting to extend those hours. Walmart’s new primary care clinics are open from 8 a.m. to 8 p.m. during the week and for slightly shorter hours on Saturday and Sunday; CVS’s Minute Clinics run on similar schedules.
The DirecHealth.com partnership should also be a useful tool for people struggling to navigate the exchanges and healthcare.gov. “When people choose insurance plans, they have a hard time because the information is so complex,” says Ateev Mehrotra, professor of health care policy and medicine at Harvard Medical School. “A lot of times patients are not choosing the best plan for them.” The DirectHealth.com agents stationed in Walmart’s stores will make the same commission on all policies they sell, a Walmart spokesperson said, meaning there are no incentives to steer customers toward more expensive options. “For consumers, more information from a trusted source is better,” Cooper says.
[239 words]

[Time 4]
In April, PricewaterhouseCoopers wrote in a report on the health industry that consumers “are ready to abandon traditional care models for ones that echo experiences in banking, retail, and entertainment.” Nearly 50 percent of people surveyed told PwC they would be likely to have a wound treated at a clinic in a retail store or pharmacy, or have stitches removed there, if it cost less than the traditional option of a hospital or physician’s office. Fifty-nine percent said they would be interested in using an at-home strep test.
Then again, health policy is rarely simple. It’s hard to know if the advance of Walmart and other retailers like CVS (which rebranded as CVS Health in September), Target, and Walgreens will actually decrease health care spending. “The more you make health care accessible and the easier it is for people to touch the health care system, the more that they’re probably going to consume,” Cooper explains. The economic term for this is induced demand: Make it cheaper and easier for patients to seek treatment, and they’re more likely to do so. At the same time, Walmart and its peers are offering a potentially valuable addition to the U.S. primary care system—bridging a gap between problems that can’t or shouldn’t wait for a visit to the doctor’s office and issues that require a trip to the emergency room. “You see a lot of innovation historically in healthcare at the high [cost] end,” Cooper says. “Those are the big-ticket items; that’s where pharma is focused.”
As for Walmart’s treatment of its own employees, it’s far from the first retailer to cut benefits from part-timers. Target ended health coverage for part-time workers earlier this year, and Home Depot did the same in 2013. But it’s the timing of the Walmart announcement that makes it feel gross and manipulative, in the same way that it feels gross when Walmart profits off the food-stamp spending of its poorly paid employees. Walmart’s strides in healthcare might indeed be good for the market, and if they are, people should take advantage of that. But that can’t shake the thought that Walmart, by cutting off 30,000 employees from health care benefits, has also conveniently supplied DirectHealth.com with 30,000 new customers.
[372 words]

Source: Slate
http://www.slate.com/articles/business/moneybox/2014/10/walmart_and_health_care_partnership_with_directhealth_com.html



For Africa, health care that works
by Mandy Moore  |  Oct. 22, 2014
                                                                                             
[Time 5]
(CNN) -- I've just returned from a visit to Tanzania with the global health and development organization Population Services International to better understand the challenges facing health workers in the developing world. The outbreak of Ebola only underscores the dire need for trained health workers -- a global shortage of nearly 7.2 million health workers, according to the World Health Organization.

About half of the spending on health care in Africa goes to private providers and care can be unregulated and quality inconsistent. During my week on the ground, however, I met PSI community health workers, nurses, doctors and business owners who deliver controlled and quality health care across Tanzania.

PSI has ensured quality care by applying proven commercial franchising strategies -- think McDonalds or Subway -- to health care. PSI operates a franchise network that spans 31 countries and serves 10 million people every year. In Tanzania, the franchise is called Familia.

Lucy, a Familia community health worker, goes out into the community every day and educates women about family planning and other health issues. Lucy then refers these women back to the neighborhood Familia clinic located right in the village she serves.

I joined Lucy for a session she organized at a modest apartment building with a few rooms separated by concrete walls and colorful fabric curtains. When I climbed the stairs to the front porch, about a dozen women with babies who were seated on straw mats greeted me. Lucy began to talk with them about their contraception options, and they had lots of questions for her. The most vocal was a gregarious woman named Sophia.

Sophia had used condoms and pills to space her births, but when Familia began offering longer-term methods like implants, she switched. The implant prevents pregnancy for up to three years, and she shared with us how it was a great weight off her shoulders. She told the group that she wanted to be able to plan her family size, so she and her husband could save for the future. Lucy reiterated that for women like Sophia, access to family planning is a key to health and economic stability.
[356 words]

[Time 6]
According to a report by the United Nations Population Fund and Guttmacher Institute, returns on investment in contraception can be recouped four times or more by reducing the need for public spending on social services. This is something Lucy knows well -- before she ended the session, she gave out vouchers to our new friends for a consultation at their local Familia clinic.

After the session, we walked back to the clinic together and Lucy introduced me to Dr. John -- the clinic owner and care provider. He's the kind of doctor anyone would want: one with a gentle bedside manner who cares deeply for the community he serves. We talked about the clinic, his needs and the number of clients he sees -- up to 200 per day.

Dr. John said what he most needed was better business management skills. He was most appreciative about that component of PSI's franchise model -- the ongoing training he and his staff receive. This helps him retain employees -- a major problem in developing countries underscored by this most recent epidemic -- and maintain a standard of care his clients can trust.

The Familia franchise incorporates 260 private health facilities across 16 regions in Tanzania. PSI establishes the quality standards that clinics in the network, like Dr. John's, must meet. And prices for products and services are set based on people's ability and willingness to pay. With this structure, the health facilities can reach the very poor with free services and those who can afford to pay something with reduced fees.

It's working and clients are happy with the services they receive. According to PSI's study of the Familia Network, the client retention rate is 81%. From 2009 to 2011, Familia health workers provided 45,000 IUDs and 14,000 implants to women who wanted a long-lasting method of contraception -- which equals 143,000 years of protection from unintended pregnanc y for Tanzanian couples.

This innovative model takes an unregulated sector with varying degrees of quality and standardizes the level of care. It provides the vital infrastructure necessary for a woman like Sophia to take care of herself and her family, and a doctor and business owner like John to earn a decent living.

As we left, I asked Dr. John if his future plans included opening a few more clinics. He smiled, and simply said, "That's my dream."
[395 words]

Source: CNN opinions
http://edition.cnn.com/2014/10/22/opinion/moore-tanzania-health-care-africa/index.html?iref=allsearch

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 楼主| 发表于 2014-10-26 21:59:46 | 显示全部楼层
Part III: Obstacle


The world is in denial about Ebola’s true threat
By Michael Gerson  |  Oct. 23, 2014                    
          
[Paraphrase 7]
It is such a relief about that Ebola thing. The threat of a U.S. outbreak turned out to be overhyped. A military operation is underway to help those poor Liberians. An Ebola czar (what is his name again?) has been appointed to coordinate the U.S. government response. The growth of the disease in Africa, by some reports, seems to have slowed. On to the next crisis.

Except that this impression of control is an illusion, and a particularly dangerous one.

The Ebola virus has multiplied in a medium of denial. There was the initial denial that a rural disease, causing isolated outbreaks that burned out quickly, could become a sustained, urban killer. There is the (understandable) denial of patients in West Africa, who convince themselves that they have flu or malaria (the symptoms are similar to Ebola) and remain in communities. And there is the form of denial now practiced by Western governments — a misguided belief that an incremental response can get ahead of an exponentially growing threat.

The remarkable success of Nigerian authorities in tracing and defeating their Ebola outbreak has created a broad impression that the disease is contained. Some administration officials are privately citing the news of empty hospital beds in parts of Liberia as a welcome development.

But the disease is not contained within Liberia and Sierra Leone. Aid officials debate the reasons for empty beds in some health-care facilities. Are people infected with Ebola staying at home out of fear (since reporting to a health-care facility must seem like a death sentence)? Is this a dip in infections before the next rise — a phenomenon we’ve seen before? Are there many more invisible cases beyond the reach of roads and communications? (The relief organization Samaritan’s Purse reports finding some remote villages in Liberia decimated by the disease.) The least likely explanation, at this point, is that Ebola has run its course.

Until there is a vaccine, limiting the spread of Ebola depends on education and behavior change. People must be persuaded to do things that violate powerful human inclinations. A parent must be persuaded not to touch a sick child. A relative must be persuaded not to respectfully prepare a body for burial. A man or woman with a fever must be persuaded to prepare for the worst instead of hoping for the best. This is the exceptional cruelty of Ebola — it requires human beings to overcome humane instincts for comfort, tradition and optimism. And this difficult education must come from trusted sources in post-conflict societies where few institutions have established public trust.

The Ebola virus has sometimes been like a fire in a pine forest — burning in hidden ways along the floor before suddenly flaring. There are, perhaps, 12,000 Ebola cases in West Africa. The World Health Organization warns there may be 5,000 to 10,000 new cases each week by December. This would quickly overwhelm existing and planned health capacity (1,700 proposed beds in Liberia from the U.S. military, perhaps 1,000 beds in community care centers).

At this level of infection, the questions become: Is Ebola containable? Will we see disease-related hunger? How will rice crops be harvested and transported? What effects will spiking food prices have on civil order? Might there be large-scale, disease-related migration? What would be the economic effects on all of Africa? Many are still refusing to look at these (prospective) horrors full in the face.

This denial is reflected in the scale and urgency of the global response, including by the United States. Of the 3,000 troops promised by President Obama in September, just a few hundred are now on the ground. The first U.S.-built hospital — a 25-bed facility for foreign health workers — will not open until early November. The airlift of supplies for aid groups within Liberia is still not functioning at scale. Some local capabilities (such as corpse removal) have improved. But few aid officials believe Liberia or Sierra Leone are prepared for the coming wave.

The appointment of Ron Klain as Ebola czar — commanding no immediate respect from either the military or the public health community — reveals a disposition. The White House believes it has a management and communications challenge. But the problem is far larger: the inability (so far) to get ahead of the crisis in West Africa with decisive action. This points to a useful role for Klain and other White House staffers — not to make the current Ebola policy process run smoothly but to blow it up in search of sufficient answers.
[747 words]

Source: the Washington Post
http://www.washingtonpost.com/opinions/michael-gerson-america-is-still-in-denial-about-ebola/2014/10/23/fe4417e6-5ad8-11e4-b812-38518ae74c67_story.html?tid=pm_opinions_pop

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发表于 2014-10-26 22:34:42 | 显示全部楼层
回归小分队了。。还是要好好练阅读吧~~三战继续~
-------------------------------------------------------------------------------------
time2: Walmart is planning to make a name for itself in the nearly $3 trillion U.S. health care market. It has announced
       cooperation with DirectHealth.com. Walmart wants to leave an impression on shoppers that they not only provide cheap
       groceries but also provide cheap health services.
time3: The professor of Yale University considers Walmart providing healthcare service a cool idea. On one hand, it can
       provide more flexible and longer time for people to get health care. On the other hand, consumers can get more information
       needed from a trusted source.
time4: People will be more likely to be induced to consume healthcare if it is easier for them to get the healthcare. But some
       large providers achieve this goal on cutting the healthcare of their part-time workers. The author thought the behavior
       was gross and manipulation.
time5: The author paid a visit to Tanzania with the global health and development organization Population Services International
       to bette understand the challenges facing health workers in the developing world. The author has found that PSI provides
       ensured quality care in Tanzania and paid a visit to a community health worker called Lucy.
time6: The author paid a visit to Dr. John with Lucy. The author learned about how PSI operates and provides ensured healthcare
       services. Their price is based on the extent that customers can afford. PSI has high rate of customer retention.
Obstacle: The world is in denial about Ebola's true threat. Actually the Ebola virus has multiplied in a medium of denial. The empty
          beds in the hospital of Liberia do not mean that Ebola is now under control. Until there is a vaccine, limiting the spread
          of Ebola depends on education and behavior change. This denial is reflected in the scale and urgency of the global response,
          including by the United States.
发表于 2014-10-27 01:30:42 | 显示全部楼层
02'18
01'36
03'03
03'00
02'42
发表于 2014-10-27 06:23:34 | 显示全部楼层
thank you, Have a nice day!
 楼主| 发表于 2014-10-27 07:01:47 | 显示全部楼层
回自己的帖感觉棒棒哒嘿嘿,,谢谢猴哥和小分队成员给我这个机会,还要谢谢队长油桃的全程指导。。
Speaker
In one frontline conversation during the intern,the speaker found that low-income family has no access to decent medical services.
The poors always have to waiting for a long time in a tiny clinic to see the doctor and only get impatient treatment and over-simplified prescribtions.
The spearker urges society to refine the basic health care system and appeals more college students to make efforts in the health care system for ordinary people.

Obstacle: 3‘58’‘
The denial od ebola causes more serious consequence.
Inability of government, delayed medichine actions and people's awareness all take into consideration the sudden spread of infection.
发表于 2014-10-27 08:59:16 | 显示全部楼层
Time 2:1’32 Walmart is trying to build its own prescription department in order to make the brand more than cheap groceries.
Time 3: 0’58  Experts think the  health care program is good for consumers.
Time 4:  1’44 There are reports showing that program will be supported. The policy about its part-time employee.
Time 5: 2’13 The author had a experience in T when the Ebola was spreading. He/She followed one of the workers to see people’s health situation.
Time 6: 2’08 After the session, author saw a doctor and knew more about the model.

obstacle: 4’51 two denials in Ebola. What should people really do facing the epidemic disease. What we should do is more than what we have done now. The officials should make decisive choices more quickly.
发表于 2014-10-27 09:11:54 | 显示全部楼层
T2        281        84        200.71         Walmart would cooperate with DirectHealth.com to provide cheap health service in order to make a name in the health care market. but they don't extend its health care to  its own employees
T3        239        82        174.88         Experts think it is benefitial for  consumers to have more information from retailors apart from health care providers .
T4        372        166        134.46         the PWC reported that customers are ready to give up traditional health care.Walmart makes health care more accessible and solves some urgent problems.Walmart is not the first one to cut the benefits of part-timers
T5        356        153        139.61         the problem facing africa is the shortage of trained health workers .PSI does provide qualified health care. PSI ensures quality care by applying proven commercial franchising. the story about lucy and Sophia tole me that access to family planning is a key to health and economic stability
T6        395        158        150.00         PSI franchise model not only provides customers with quality health care but also helps the owner to retain employees and maitain a standard care.
OB        747        267        167.87         "ebola has not been contained yet
"
发表于 2014-10-27 11:25:16 | 显示全部楼层
1’03
1’01
1’29
1’40
1’36
3’36
It’s too early to disseminate denial about Ebola’s true threat. The empty hospital beds in Africa may not be a good signal and more dangers are still waiting for us, such as people choose to stay at home when they have a fever to avoid the death sentence and some remote villages have already suffered from decimation without delivering the message to the outside world.
What makes the situation worse is that many medical instruments in US still don’t prepare for the epidemic as they are ordered.
So, we should still maintain sharp vigilance and prepare for the worst situation instead of sticking to the fantasy dream.
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