Democratic 民主的-led states and cities pitch 推进 ambitious 有雄心的 reforms to health care

No wonk asked to describe their ideal health system would reach for the adjective American. Those who can afford it have

access 享受，接受 to the best care in the world, but costs are high and the country’s rate of health-insurance coverage 覆盖 is

second to last 倒数第二 among the oecd 经合组织 club of mostly rich countries—only Greece does a poorer job. Things would

look worse had the Affordable Care Act (aca) 负担得起的医疗法案, better known as Oba- macare, not become law. In 2010,

15.5% of Americans lacked health insurance, compared with 8.7% in 2017. Reducing that to zero would require the kind of

universal scheme 通用方案 Democrats crave. But that will not come soon. Meanwhile, Democrats in charge of big states and

cities are taking it upon 想法设法 themselves to reduce their uninsured 未参保 rates even further 进一步. Their ideas range

from sensible 明智的 to pie-in-the-sky.

Pitch 扔，投;树起，搭起;定位于

wonk[常识词汇]

 n. 书呆子；刻苦用功的学生

adjective[常识词汇]

 adj. 形容词的；从属的

 n. 形容词

crave[常识词汇]

 vt. 渴望；恳求

 vi. 渴望；恳求

pie-in-the-sky[常识词汇]

 不能保证实现的诺言；渺茫的希望

The share 比例 of people lacking health insurance varies enormously 极大地 from state to state. Those that chose not to

expand Medicaid (government health insurance for the very poor) out of 出于 their disdain for Obamacare have a higher

proportion 比例 of uninsured people—more than twice as high as those that did expand. Having large numbers of illegal

immigrants, who are four times likelier 可能的 to be uninsured than citizens, also affects the number. Texas, a state with a

large undocumented population and tight 严格的 eligibility criteria 资格标准 for Medicaid, has the nation’s highest

uninsured rate, at 17.3%. In Massachusetts, by contrast, it is 2.8%.

Medicaid

 n. （美）医疗补助计划

disdain

 n. 蔑视

 vt. 鄙弃

undocumented[2015 年英语一 text2]

 adj. 无事实证明的；无正式文件的

Most Democrat-led states have already expanded their Medicaid programmes, though they must still contend with high

health-care costs and the problem of uninsured, undocumented people. Gavin Newsom, the new governor of California,

issued a plan on day one of the job. Mr Newsom would like to reinstate the re- quirement that everyone must have health
 insurance or else pay a penalty. Republicans killed that in the tax legislation of 2017. With those funds he would increase

subsidies for people purchasing insurance on the exchanges set up under the aca. He would use state funds to expand

Medicaid coverage for young, undocumented people up to the age of 26 (the current cut-off is 19). Mr Newsom also suggested

that California should negotiate directly with pharmaceutical firms over drug prices, a common tactic in other developed

countries.

reinstate[重点词汇]

 vt. 使恢复；使复原

penalty[高频真题词汇]

 n. 罚款，罚金；处罚

pharmaceutical[2005 年英语一 ]

 adj. 制药（学）的

 n. 药物

tactic[重点词汇]

 n. 策略，战略

 adj. 按顺序的，依次排列的

Bill de Blasio, the mayor of New York, turned heads when he announced a seem- ingly ground breaking proposal to guarantee

health care for the city’s 600,000 uninsured people. Mr de Blasio, who appears to be flirting with a presidential run, chose

“Morning Joe”, a television talk show, to unveil his “most comprehensive plan in the nation”—perhaps the kind of

announcement aimed at Democratic primary voters who swoon at those three magic words, “Medicare for all”. It certainly

seemed welcome to people like Michelle Fraser, a home-health aide in the city who looks after people for a living but cannot

afford her own insurance.

flirt

 n. 急扔；调情的人；卖弄风骚的人

 vt. 挥动；忽然弹出

 vi. 调情；玩弄；轻率地对待；摆动

comprehensive[重点词汇]

 adj. 综合的；广泛的；有理解力的

 n. 综合学校；专业综合测验

swoon

 vi. 昏晕；惊讶；着迷

 n. 昏晕；狂喜

aide[常识词汇]

 n. 助手；副官；侍从武官

Yet, on inspection, the plan is less grand. It is a moderate expansion of existing programmes providing access to city

hospitals, pharmacies, primary care and addiction-treatment services for the undocumented and uninsured. The estimated

cost of the proposal, about $100m a year, also hints at its modesty. That works out at an expenditure of $167 per uninsured
 person. The average New Yorker spent $6,056 on health care in 2015, according to the Health Care Cost Institute, which

collects data from large insurers.

inspection[2010 年英语一 text1]

 n. 视察，检查

pharmacies

 n. 药房；配药学，药剂学；制药业；一批备用药品

insurer[高频词汇]

 n. 保险公司；承保人

Other Democratic states are not sitting out. Jay Inslee, the governor of Washing- ton, has proposed a public option on the

state’s health-insurance exchanges, to provide choice in rural areas and control costs. From New Mexico to Minnesota,

Democratic governors may allow residents to buy Medicaid. Each of these approaches could move America closer towards

universal coverage, while avoiding the trap of trying to remake its health-care system overnight. Those Democrats vying for

the presidential nomination are sure to run on a message of radical upheaval; their lesser-known comrades might

actually get something done.

overnight[常识词汇]

 adv. 通宵；突然；昨晚

 adj. 晚上的；通宵的；前夜的

 n. 头天晚上；一夜的逗留

 vt. 连夜快递

 vi. 过一夜

vie

 vi. 争；竞争

 vt. 使针锋相对；提出...来竞争；以...作较量

nomination[真题词汇]

 n. 任命，提名；提名权

upheaval[2018 年英语一 text1]

 n. 剧变；隆起；举起

comrades[常识词汇]

 n. 同志；伙伴

——

JANUARY 19TH–25TH 2019 | United States