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Section B
Directions : In this section , you are going to read a passage with ten statements attached to it. Each
statement contains information given in one of the paragraphs. Identify the paragraph from
which the information is derived. You may choose a paragraph more than once. Each
paragraph is marked with a letter. Answer the questions by marking the corresponding letter
on Answer Sheet 2.
How Telemedicine Is Transforming Healthcare
A) After years of big promises, telemedicine is finally living up to its potential. Driven by faster
internet connections, ubiquitous ( J"G 51-1:. � ;(£ aJ.i) smartphones and changing insurance standards,
more health providers are turning to electronic communications to do their jobs and it's
dramatically changing the delivery of healthcare.
B) Doctors are linking up with patients by phone, email and webcam ( Wl M}. .fl.1� �). They're also
consulting with each other electronically sometimes to make split-second decisions on heart attacks
and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and
other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also
allows for better care in places where medical expertise is hard to come by. Five to 10 times a day,
Doctors Without Borders relays questions about tough cases from its physicians in Niger, South Sudan
and elsewhere to its network of 280 experts around the world, and back again via internet.
C) As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans
received some kind of medical care remotely last year, according to the American Telemedicine
Association, a trade group, which expects those numbers to grow by 30% this year.
D) None of this is to say that telemedicine has found its way into all comers of medicine. A recent
survey of 500 tech-savvy( tk:iiAi� aJ.i) consumers found that 39% hadn't heard of telemedicine,
and of those who haven't used it, 42% said they preferred in-person doctor visits. In a poll of
1,500 family physicians, only 15% had used it in their practices but 90% said they would if it
were appropriately reimbursed ( ;f, H4£ ) .
E) What's more, for all the rapid growth, significant questions and challenges remain. Rules defining
and regulating telemedicine differ widely from state to state. Physicians groups are issuing
different guidelines about what care they consider appropriate to deliver and in what form.
F) Some critics also question whether the quality of care is keeping up with the rapid expansion of
telemedicine. And there's the question of what services physicians should be paid for: Insurance
coverage varies from health plan to health plan, and a big federal plan covers only a narrow range
of services. Telemedicine's future will depend on how and whether regulators, providers, payers
and patients can address these challenges. Here's a closer look at some of these issues:
G) Do patients trade quality for convenience? The fastest-growing services in telemedicine connect
consumers with clinicians they've never met for a phone, video or email visit on-demand, 24/7.
Typically, these are for nonemergency issues such as colds, flu, ear-aches and skin rashes, and
they cost around $45, compared with approximately $100 at a doctor's office, $160 at an
urgent-care clinic or $ 750 and up at an emergency room.H) Many health plans and employers have rushed to offer the services and promote them as a
convenient way for plan members to get medical care without leaving home or work. Nearly
three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year,
up from 48% last year. Web companies such as Teladoc and American Well are expected to host
some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the
American Telemedicine Association.
I) But critics worry that such services may be sacrificing quality for convenience. Consulting a
random doctor patients will never meet, they say, further fragments the health-care system, and
even minor issues such as upper respiratory (J:.'1'-?&..il�) infections can't be thoroughly evaluated
by a doctor who can't listen to your heart or feel your swollen glands. In a recent study, researchers
posing as patients with skin problems sought help from 16 telemedicine sites with unsettling
results. In 62 encounters, fewer than one-third disclosed clinicians' credential or let patients choose;
only 32% discussed potential side effects of prescribed medications. Several sites misdiagnosed
serious conditions, largely because they failed to ask basic follow-up questions, the researchers
said. "Telemedicine holds enormous promise, but these sites are just not ready for prime time,"
says Jack Resneck, the study's lead author.
J) The American Telemedicine Association and other organizations have started accreditation (�ft:)
programs to identify top-quality telemedicine sites. The American Medical Association this month
approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the
limitations of such services and ensure that they have sufficient information to make clinical
recommendations.
K) Who pays for the services? While employers and health plans have been eager to cover virtual urgent
care visits, insurers have been far less willing to pay for telemedicine when doctors use phone, email or
video to consult with existing patients about continuing issues. "It's very hard to get paid unless
you physically see the patient," says Peter Rasmussen, medical director of distance health at the
Cleveland Clinic. Some 32 states have passed "parity" (� � �) laws requiring private insurers to
reimburse doctors for services delivered remotely if the same service would be covered in person,
though not necessarily at the same rate or frequency. Medicare lags further behind. The federal
health plan for the elderly covers a small number of telemedicine services only for beneficiaries
in rural areas and only when the services are received in a hospital, doctor's office or clinic.
L) Bills to expand Medicare coverage of telemedicine have bipartisan( i1fJ ,Jt �) support in Congress.
Opponents worry that such expansion would be costly for taxpayers, but advocates say it would
save money in the long run.
M) Experts say more hospitals are likely to invest in telemedicine systems as they move away from
fee-for-service payments and into managed-care-type contracts that give them a set fee to provide
care for patients and allow them to keep any savings they achieve.
N) Is the state-by-state regulatory system outdated? Historically, regulation of medicine has been left
to individual states. But some industry members contend that having 50 different sets of rules,
licensing fees and even definitions of " medical practice " makes less sense in the era of
telemedicine and is hampering its growth. Currently, doctors must have a valid license in the statewhere the patient is located to provide medical care, which means virtual-visit companies can
match users only with locally licensed clinicians. It also causes administrative hassles (fef..;l:�i) for
world-class medical centers that attract patients from across the country. At the Mayo Clinic,
doctors who treat out-of-state patients can follow up with them via phone, email or web chats
when they return home, but they can only discuss the conditions they treated in person. " If the
patient wants to talk about a new problem, the doctor has to be licensed in that state to discuss it.
If not, the patient should talk to his primary-care physician about it," says Steve Ommen, who
runs Mayo's Connected Care program.
0) To date, 17 states have joined a compact that will allow a doctor licensed in one member state to
quickly obtain a license in another. While welcoming the move, some telemedicine advocates
would prefer states to automatically honor one another's licenses, as they do with drivers' licenses.
But states aren't likely to surrender control of medical practice, and most are considering new
regulations. This year, more than 200 telemedicine-related bills have been introduced in 42 states,
many regarding what services Medicaid will cover and whether payers should reimburse for
remote patient monitoring. "A lot of states are still trying to define telemedicine," says Lisa
Robbin, chief advocacy officer for the Federation of State Medical Boards.
36. An overwhehning majority of family physicians are willing to use telemedicine if they are duly paid.
3 7. Many employers are eager to provide telemedicine service as a benefit to their employees because
of its convenience.
38. Different states have markedly different regulations for telemedicine.
39. With telemedicine, patients in regions short of professional medical service are able to receive
better medical care.
40. Unlike employers and health plans, insurers have been rather reluctant to pay for some
telemedicine services.
41. Some supporters of telemedicine hope states will accept each other's medical practice licenses as valid.
42. The fastest growing area for telemedicine services is for lesser health problems.
43. As telemedicine spreads quickly, some of its opponents doubt whether its service quality can be
guaranteed.
44. The results obtained by researchers who pretended to be patients seeking help from telemedicine
providers are disturbing.
45. Some people argue that the fact that different states have different regulations concerning medical
services hinders the development of telemedicine.
Section C
Directions : There are 2 passages in this section. Each passage is followed by some questions or
unfinished statements. For each of them there are four choices marked A ) , B ) , C) and
D) . You should decide on the best choice and mark the corresponding letter on Answer
Sheet 2 with a single line through the centre.Passage One
Questions 46 to 50 are based on the following passage.
Danielle Steel, the 71-year-old romance novelist is notoriously productive, having published 179
books at a rate of up to seven a year. But a passing reference in a recent profile by Glamour magazine
to her 20-hour workdays prompted an outpouring of admiration.
Steel has given that 20-hour figure when describing her "exhausting" process in the past: "I start
the book and don't leave my desk until the first draft is finished." She goes from bed, to desk, to bath, to
bed, avoiding all contact aside from phone calls with her nine children. "I don't comb my hair for weeks,"
she says. Meals are brought to her desk, where she types until her fingers swell and her nails bleed.
The business news website Quartz held Steel up as an inspiration, writing that if only we all
followed her "actually extremely liberating" example of industrious sleeplessness, we would be quick
to see results.
Well, indeed. With research results showing the cumulative effects of sleep loss and its impact on
productivity, doubt has been voiced about the accuracy of Steel's self-assessment. Her output may be
undeniable, but sceptics have suggested that she is guilty of erasing the role of ghostwriters ( 1-\.flA.)
at worst, gross exaggeration at best.
Steel says working 20 hours a day is "pretty brutal physically." But is it even possible? "No,"
says Maryanne Taylor of the Sleep Works. While you could work that long, the impact on
productivity would make it hardly worthwhile. If Steel was routinely sleeping for four hours a night,
she would be drastically underestimating the negative impact, says Alison Gardiner, founder of the
sleep improvement programme Sleepstation. "It's akin to being drunk."
It's possible that Steel is exaggerating the demands of her schedule. Self-imposed sleeplessness
has "become a bit of a status symbol", says Taylor, a misguided measure to prove how powerful and
productive you are. Margaret Thatcher was also said to get by on four hours a night, while the 130-
hour work weeks endured by tech heads has been held up as key to their success.
That is starting to change with increased awareness of the importance of sleep for mental health.
"People are starting to realise that sleep should not be something that you fit in between everything
else," says Taylor.
But it is possible if statistically extremely unlikely that Steel could be born a "short sleeper"
with an unusual body clock, says sleep expert Dr. Sophie Bostock. " It's probably present in fewer
than 1 % of the population."
Even if Steel does happen to be among that tiny minority, says Bostock, it's " pretty
irresponsible" to suggest that 20-hour days are simply a question of discipline for the rest of us.
46. What do we learn from the passage about Glamour magazine readers?
A) They are intrigued by the exotic romance in Danielle Steel's novels.
B) They are amazed by the number of books written by Danielle Steel.
C) They are deeply impressed by Danielle Steel's daily work schedule.
D) They are highly motivated by Danielle Steel's unusual productivity.
47. What did the business news website Quartz say about Danielle Steel?
A) She could serve as an example of industriousness.
B) She proved we could liberate ourselves from sleep.
C) She could be an inspiration to novelists all over the world.
D) She showed we could get all our work done without sleep.48. What do sceptics think of Danielle Steel's work schedule claims?
A) They are questionable. C) They are irresistible.
B) They are alterable. D) They are verifiable.
49. What does Maryanne Taylor think of self-imposed sleeplessness?
A) It may turn out to be key to a successful career.
B) It may be practiced only by certain tech heads.
C) It may symbolise one's importance and success.
D) It may well serve as a measure of self-discipline.
50. How does Dr. Sophie Bostock look at the 20-hour daily work schedule?
A) One should not adopt it without consulting a sleep expert.
B) The general public should not be encouraged to follow it.
C) One must be duly self-disciplined to adhere to it.
D) The majority must adjust their body clock for it.
Passage Two
Questions 51 to 55 are based on the following passage.
Organic agriculture is a relatively untapped resource for feeding the Earth's population, especially
in the face of climate change and other global challenges. That's the conclusion I reached in reviewing
40 years of science comparing the long-term prospects of organic and conventional farming.
The review study, "Organic Agriculture in the 21 st Century," is featured as the cover story for
the February issue of the journal Nature Plants. It is the first to compare organic and conventional
agriculture across the main goals of sustainability identified by the National Academy of Sciences:
productivity, economics and environment.
Critics have long argued that organic agriculture is inefficient, requiring more land to yield the
same amount of food. It's true that organic farming produces lower yields, averaging 10 to 20 percent
less than conventional. Advocates contend that the environmental advantages of organic agriculture
far outweigh the lower yields, and that increasing research and breeding resources for organic systems
would reduce the yield gap. Sometimes excluded from these arguments is the fact that we already
produce enough food to more than feed the world's 7.4 billion people but do not provide adequate
access to all individuals.
In some cases, organic yields can be higher than conventional. For example, in severe drought
conditions, which are expected to increase with climate change in many areas, organic farms can produce
as good, if not better, yields because of the higher water-holding capacity of organically farmed soils.
What science does tell us is that mainstream conventional farming systems have provided
growing supplies of food and other products but often at the expense of other sustainability goals.
Conventional agriculture may produce more food, but it often comes at a cost to the environment.
Biodiversity loss, environmental degradation, and severe impacts on ecosystem services have not only
accompanied conventional farming systems but have often extended well beyond their field boundaries.
With organic agriculture, environmental costs tend to be lower and the benefits greater.
Overall, organic farms tend to store more soil carbon, have better soil quality and reduce soil
erosion compared to their conventional counterparts. Organic agriculture also creates less soil and
water pollution and lower greenhouse gas emissions. And it's more energy-efficient because it doesn'trely on synthetic fertilizers or pesticides.
Organic agriculture is also associated with greater biodiversity of plants, animals, insects and
microorganisms as well as genetic diversity. Biodiversity increases the services that nature provides
and improves the ability of farming systems to adapt to changing conditions.
Despite lower yields, organic agriculture is more profitable for farmers because consumers are
willing to pay more. Higher prices, called price premiums, can be justified as a way to compensate
farmers for providing ecosystem services and avoiding environmental damage or external costs.
51. What do we learn from the conclusion of the author's review study?
A) More resources should be tapped for feeding the world's population.
B) Organic farming may be exploited to solve the global food problem.
C) The long-term prospects of organic farming are yet to be explored.
D) Organic farming is at least as promising as conventional farming.
52. What is the critics' argument against organic farming?
A) It cannot meet the need for food. C) It is not really practical.
B) It cannot increase farm yields. D) It is not that productive.
53. What does the author think should be taken into account in arguing about organic farming?
A) Growth in world population. C) Inequality in food distribution.
B) Deterioration in soil fertility. D) Advance in farming technology.
54. What does science tell us about conventional farming?
A) It will not be able to meet global food demand.
B) It is not conducive to sustainable development.
C) It will eventually give way to organic farming.
D) It is going mainstream throughout the world.
55. Why does the author think higher prices of organic farm produce are justifiable?
A) They give farmers going organic a big competitive edge.
B) They motivate farmers to upgrade farming technology.
C) Organic farming costs more than conventional farming.
D) Organic farming does long-term good to the ecosystem.
Part IV Translation (30 minutes)
Directions: For this part, you are allowed 30 minutes to translate a passage from Chinese into English.
You should write your answer on Answer Sheet 2.
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Directions：几r this part, you are al如ved30 minutes to write an essay on the saying "W加is
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第3套除写作和翻译题目外，其余题目和第2套完全相同，故而未再重复
附：第3套作文及翻译
Part I Writing (30 minutes)
（请千正式开考后半小时内完成该部分，之后将进行听力考试）
Dlrecdons: For this part, you OTe allowed 30 minutes to write an essay on the sayi "Wealth
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Part IV Translation (30 minutes)
Dlrecdons : For this part, you OTe allowed 30 minutes t,o tra心late a passage from Chinese into
E /i,sh. You should write your answer on Answer Sheet 2.
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《水浒传》(Water Margin)是中国文学四大经典小说之 一。 这部小说基千历史人物宋江及
其伙伴反抗封建帝王的故事，数百年来一直深受中国读者的喜爱。
亳不夸张地说，几乎每个中国人都熟悉小说中的一些主要人物。 这部小说中的精彩故事在
茶馆、戏剧舞台、广播电视、电影屏幕和无数家庭中反复讲述。 事实上，这部小说的影响已经远
远超出了国界。 越来越多的外国读者也感到这部小说里的故事生动感人、趣味盎然。
