2019年CATTI三级笔译实务练习题：中国医疗改革

　　汉译英

　　医疗改革

　　过去二十年来，所有的工业国都实施过某种形式的医疗改革，美国也不例外。就在几年前，美国掀起了一场轰轰烈烈的关于医疗改革的公众辩论。最终，这场辩论重新确认美国应继续保留原有的基本上以市场为导向的医疗体制。美国的医疗体制未曾进行过自上而下的改革，而是在强大的市场推动下经历了一些深刻的自我变革。私营医疗保健市场的水分，是依靠市扬、而不是政府的作用来挤掉的。

　　如今，美国的医疗费用似乎再次呈上涨趋势。与此同时，和其他国家的病患一样，美国的病患对于他们医疗保健计划中所受到的种种限制也越来越怨声载道。让政府来领导医疗改革的话题又一次被提起。

　　然而，政府所主导的医疗改革如果仅仅意味着加大对医疗市场的限制的话，那我们可要三思而后行了。其实，更为明智的做法是制定一些对消费者更为有利的政策，改善市场的运作。这个观点是基于我们公司在全球医疗系统中数十年来的经验而提出来的。这些经验给了我们独特的视角，来判断医疗改革中正确和错误的做法。我们认为，强加层层规定和限制的做法是错误的。很多国家都曾经采取过这种改革方式，但这样的改革总是以失败告终：因为它们既没能降低医疗成本，也无法给患者提供优质的治疗。医药的发展速度实在是太快了，任何政府机构或专家委员会都无法跟上。唯一能跟上这一发展速度的只有开放、信息充分而又有竞争力的市场。这一经验教训既适用于美国，同样也适用于所有正在筹划医疗改革的国家。政府想做却又无法做到的事情，自由的市场可以做到。

　　进行医疗改革的正确途径是建立一套灵活的、以市场为导向的医疗体制。在这套体制下，消费者既享有权利也承担义务.而且还能自由地做出选择。如果患者只是被动地接受医疗服务，这样的医疗体制根本就是行不通的。相反，如果患者能充分了解药物质量、医疗费用以及最新的治疗方法，然后再根据这些情况自由选择医疗方案，这样的体制才是可行的。

　　当然，医疗改革绝不能单纯只受价格因素的驱动。相反，我们应该寻求新的途径来资助医疗保健事业，使所有的患者都能享受最好的医疗服务。理想的改革方式不仅能使个人和家庭受益，而且还能鼓励医疗创新，使得整个医疗体制的运行效率更高，成效更大，最终使患者获益更多。

　　选择怎样的改革路线与我们每个人息息相关。我们正处在一个科学发展的黄金时代，而生物医学又是目前最具探索前景的一个科学领域。我们不仅可以期待找到治愈各种急、慢性疾病的药物，还可以期待研制出各种疗法，帮助人们过上更有意义、更有价值的生活。过去，关节炎和心血管疾病的患者很有可能致残;而现在，新型的药物可以使他们继续活动自如。抗抑郁药和抗精神病药的疗效提高了，能缓解人们精神方面的疾病，使患者在社会上正常、快乐地生活。简单地说，生物医学给我们带来的希望就是，它能使人们更长寿、更健康。

　　现在还有待解决的问题就是新药开发的步伐有多快、范围有多广，以及需要多长时间才能让那些有需要的患者从中受益。

　　因此，下个世纪制药业所面临的政策环境将会决定生物医学领域是否会出现新一波的突破。改革后的政策环境会保护知识产权吗?会允许市场自由定价吗?会为建立强大的科研基地而提供支持吗?改革后的医疗体制是有助于培养创新意识，还是会抑制创新?这样的医疗体制是为消费者提供更多的信息和选择，还是用苛刻的规则和条例限制他们的信息来源和选择权?对于美国和世界上其它国家来说，关于医疗体制的争论绝没有结束。而对我们所有人来说，医疗体制改革的风险比以往任何时候都要大。

　　参考译文

　　Healthcare Reform

　　During the past two decades, all of the industrialized nations have enacted some form of healthcare reform. America is no exception. Just a few years ago, the U. S. was consumed by a vigorous public debate about healthcare. In the end, the debate reaffirmed that the U. S. would retain its essentially market-based system. Instead of reform imposed from the top down. the American healthcare system underwent some rather profound self-reform, driven by powerful market forces. The market - not the government - managed to wring inflation out of the private healthcare market. Today, it appears that U. S. healthcare costs are again on the rise. At the same time, American patients - like patients elsewhere - are becoming more vocal about the restrictions many face in their healthcare plans. Talk of government-led reform is once again in the air. We must think twice, though, before embarking on "reform" if that means imposing further restrictions on our healthcare markets. The more sensible course is to introduce policies that make the market work better - that is, to the advantage of consumers. I base this argument on our company's decades of experience in healthcare systems around the world, which has given us a unique global perspective on the right and wrong way to reform healthcare. The wrong way is to impose layer after layer of regulation and restrictions. We have seen this approach tried in many countries, and we have always see it fail - fail to hold down costs, and fail to provide the best quality care. Medicine is changing at so rapid a pace that no government agency or expert commission can keep up with it. Only an open, informed and competitive market can do that.

　　This lesson holds true for the U. S. and for all countries contemplating healthcare reform. Free markets do what governments mean to do - but can't.

　　The right approach  is to foster a flexible, market-based system in which consumers have rights, responsibilities, and choices. Healthcare systems do not work if patients are treated as passive recipients of services: they do work if consumers are well-informed about quality, costs, and new treatments, and are free to act responsibly on that knowledge. Of course, reform should never be driven purely by cost considerations. Instead, we ought to devise new ways of funding healthcare that will make it possible for all patients to afford the best care. Ideally, these new approaches would not only reward individuals and families but also encourage innovation, which can make healthcare systems more efficient, more productive, and ultimately of greater value for patients.

　　The path we choose will have enormous implications for all of us. We are in a golden age of science, and no field of scientific inquiry holds more promise than that of biomedicine. Not only can we look forward to the discovery of cures for chronic and acute disease, but also to the development of enabling therapies that can help people enjoy more rewarding and productive lives.  New drugs are already helping people who would once have been disabled by arthritis or cardiovascular disease stay active and mobile.  More effective anti-depressants and anti-psychotics are beginning to relieve the crippling illness of the mind, allowing sufferers to function normally and happily in society. The promise is quite simply - one of longer, healthier lives.  What is at issue are the pace and breadth of discovery, and how quickly we can make the benefits of our knowledge available to the patients who need them.

　　Therefore, the policy environment the biomedical industry will face in the next century may make or break the next wave of biomedical breakthroughs.  Will that environment include protection for intellectual property, freedom for the market to determine price, and support for a robust science base? Will healthcare systems nurture innovation, or remove incentives for discovery? Will they give consumers information and options, or impose stringent rules and regulations that limit access and choice? For the U. S., as for the rest of the world, the healthcare debate is by no means over. And for all of us, the stakes are higher than ever.

　　第二篇

　　汉译英

　　我国为9亿农民提供医疗保障

　　我国的农村人口超过9亿。虽然他们的收入远比城镇居民要低，抗风险的能力更差，但是长期以来，他们却不能像城镇居民一样享受基本的医疗保障。为此，我国正在推行一项前所未有的计划：用8年的时间，在全国农村基本建立起新型的合作医疗制度，以解决9亿农民的医疗保障问题，使他们不必再为看不起病而犯愁。在这种新型的医疗保障制度下，我国农村将建立合作医疗基金。合作医疗基金的资金来源有三条：中央政府拨付一部分，地方政府补助一部分，农民自己缴纳一部分。三方缴纳资金的比例可根据各地实际情况来定。参加合作医疗的农民一旦生病住院，就可以按比例报销部分医药费。

　　经济发达的浙江省已率先实行这一制度，并决定提前四年实现在全省推行合作医疗制度的目标。

　　浙江省省委书记习近平说：“新型的合作医疗制度将切实增强农村居民抵御重大疾病风险的能力，防止因病致贫、因病返贫”。目前，我国农村还有3000万贫困人口，有6000万人徘徊在温饱线上。国务院发展研究中心研究员陈锡文撰文指出，目前农民90%的医药费需自己支付，这一比例在城市是60%，而农民收入仅相当于城市居民的三分之一，相当多的农民因此有病无力就医。

　　2003年春非典疫情的爆发暴露出农村居民对非典一类传染疾病的抗风险能力严重不足，引起了政府对农民医疗健康和卫生保障问题的高度重视。

　　我国正致力于在未来的二十年内全面建设小康社会。如何提高占全国人口70%的农民的生活水平和生存质量，是实现这个目标的最大难题。

　　统计数据显示：农村因病致贫、因病返贫的人口已经占到贫困人口的约50%。“从这一点看，不解决农民的看病问题，就很难最终实现中国社会的全面小康目标。”浙江大学教授张小蒂说。

　　为此，我国政府下决心为9亿农民建立有效的农村医疗合作制度。按计划，该制度要在2010年覆盖全国。

　　参考译文

　　China Offers Medicare to 900 Million Farmers

　　China has a farmer population of over 900 million, who were not entitled, for a very long period of time, to the basic medical service as urban people were, although they were more vulnerable because of their far lower income.

　　Thus, an unprecedented project is launched in China to build a new cooperative medicare system within eight years in rural areas, which will cover 900 million farmers and free them from worries of being unable to afford a cure.

　　Under this new medicare system, cooperative medical funds will be set up in rural areas with money from three parties: the central government, local governments and farmers themselves. The portions of funds paid by three parties vary in different regions. A farmer covered by the system will get varying portions of subsidies after he or she becomes ill and hospitalized.

　　The eastern booming province of Zhejiang, has taken a lead in employing the new system, aiming to make it fully operational in the province four years earlier than the timetable for the whole nation.

　　"This will certainly enhance farmers' ability to shield themselves from risks of being unable to afford a cure when they are seriously ill, and will help prevent farmers from falling into or falling back to poverty because of catching diseases," said Xi Jinping, Party Secretary of Zhejiang.

　　In Chinese rural areas, there are about 30 million people still in poverty and 60 million living close to the poverty line. According to Chen Xiwen, a research fellow with the State Development and Research Center, a think-tank to the Chinese cabinet, farmers have to pay 90 percent of medical expenses solely by themselves, compared to 60 percent of urban dwellers, while f'armers' income is about one third that of urban residents. As a result, a large number of farmers are unable to afford a cure when catching illness.

　　The outbreak of severe acute respiratory syndrome (SARS) in the spring of 2003 exposed farmers' vulnerability to epidemics like SARS, which awakened policymakers' attention to health and medicare problems for rural people.

　　China is vowing to build a relatively affluent society in two decades, and it is a key issue in reaching this goal to raise the living standards and quality of farmers, who account for 70 percent of the Chinese population.

　　Official statistics show that half of the poverty population suffer from poverty caused by disease. "This shows that, it is hardly possible to realize a relatively rich Chinese society in overall scale without a solution to farmers' medicare problem," said Professor Zhang Xiaodi of Zhejiang University.

　　The central government is resolute to set up an effective cooperative system to offer medicare for 900 million farmers and the system is scheduled to cover all farmers by 2010.