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According to legend, Aesculapius bore two daughters, Panacea and Hyegeia, who gave rise to dynasties of healers and hygienists. The schism remains today, in clinical training and in practice; and because of the imperative nature of medical care and the subtlety of health care, the former has tended to dominate. Preventive medicine has as its primary objective the maintenance and promotion of health. It accomplishes this by controlling or manipulating environmental factors that affect health and disease. For example, in Califorina presently there is serious suffering and substantial economic loss because of the failure to introduce controlled fluoridation of public water supplies. Additionally, preventive medicine applies prophylacitc measures against disease by such actions as immunization and specific nutritional measures. Third, it attempts to motivate people to adopt healthful life-styles through education.
For the most part, curative medicine has as its primary objective the removal of disease from the patient. It provides diagnostic techniques to identify the presence and nature of the disease process. While these may be applied on a mass basis in an attempt to "screen" out persons with preclinical disease, they are usually applied after the patient appears with a complaint. Second, it applies treatment to the sick patient. In every case, this is, or should be, individualized according to the particular need of each patient. Third, it utilizes rehabilitation methodologies to return the treated patient to the best possible level of functioning.
While it is true that both preventive medicine and curative medicine require cadres of similarly trained personnel such as planners, administrators, and educators, the underlying delivery systems depend on quite distinctive professional personnel. The requirements for curative medicine call for clinically trained individuals who deal with patients on a one-to-one basis and whose training is based primarily on an understanding of the biological, pathological, and psychological processes that determine an individual's health and disease status. The locus for this training is the laboratory and clinic. Preventive medicine, on the other hand, calls for a very broad of professional personnel, few of whom require clinical expertise. Since their actions apply either to environmental situations or to population groups, their training takes place in a different type of laboratory or in a community not necessarily associated with the clinical locus.
The economic differences between preventive medicine and curative medicine have been extesively descussed, perhaps most convincingly by Winslow in the monograph. The Cost of Sickness and the Price of Health_. The sickness is almost always a negative, nonproductive and harmful state. All resources expended to deal with sickness are therefore fundamentally economically unproductive. Health, on the other hand, has a very high value in our culture. To the extent that healthy members of the population are replaced by sick members, the economy is doubly burdened. Neveretheless, the per capita cost of preventive measures for specific diseases is generally far lower than the per capita cost of curative medicine applied to treatment of the same disease. Prominent examples are dental caries, poliomyelitis and phenylketonuria.
There is an imperative need to provide care for the sick person within a single medical care system, but there is no overriding reason why a linkage is necessary between the two components of a health care system, prevention and treatment. A natioanl health and medical care program composed of semiautonomous systems for personal health care and medical care would have the advantage of clarifying objectives and strategies and of permitting a more equitable division of resources between prevention and cure.
1. The author’s primary concern is to
(A) refute a counterargument
(B) draw a distinction
(C) discuss a dilemma
(D) isolate causes
(E) describe new research
2. The author mentions which of the following as differences between curative and preventive medicine?
I. Curative medicine is aimed primarily at people who are already ill, whereas preventive medicine is aimed at healthy people.
II. Curative medicine is focused on an individual patient, whereas preventive medicine is applied to larger populations.
III. The per capita cost of curative medicine is generally much higher than the per capita cost of preventive medicine.
(A) I only
(B) II only
(C) I and II
(D) II and III only
(E) I, II, and III
3. It can be inferred that the author regards a program of controlled fluoridation of public water supplies as
(A) an unnecessary government program that wastes economic resources
(B) a potentially valuable strategy of preventive medicine
(C) a government policy that has relatively little effect on the health of a population
(D) an important element of curative medicine
(E) an experimental program the health value of which has not been proved
4. Which of the following best explains the author’s use of the phrase “doubly burdened” (Highlighted)?
(A) A person who is ill not only does not contribute to production; treatment consumes economic resources.
(B) The per capita cost of preventive measures is only one-half of the per capita cost of treatment.
(C) The division between preventive medicine and curative medicine requires duplication of administrative expenses.
(D) The individual who is ill must be rehabilitated after the cure has been successful.
(E) The person who is ill uses economic resources that could be used to finance prevention rather than treatment programs
5. It can be inferred that the author regards Winslow’s monograph (Text in Red) as
(A) ill-conceived
(B) incomplete
(C) authoritative
(D) well organized
(E) highly original
6. The author cites dental caries, poliomyelitis, and phenylketonuria in order to prove that
(A) some diseases can be treated by preventive medicine
(B) some diseases have serious consequences if not treated
(C) preventive medicine need not be linked to treatment
(D) the cost of preventing some diseases is less than the cost for treatment
(E) less money is allocated to prevention of some diseases than to treating them
7. The main reason the author advocates separating authority for preventive medicine from that for curative medicine is
(A) the urgency of treatment encourages administrators to devote more resources to treatment than to prevention
(B) the cost of treating a disease is often much greater than the cost of programs to prevent the disease
(C) the professionals who administer preventive health care programs must be more highly trained than ordinary doctors
(D) curative medicine deals primarily with individuals who are ill, whereas preventive medicine is applied to healthy people
(E) preventive medicine is a relatively recent development, whereas curative medicine has a long history
参考答案： BEBACDA
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发表于 2021-8-27 07:59:55
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