afflict_afflict搭配

1. 这是Planet English的第二篇文章~\x0a2. 人口老龄化的主题阅读：日本如何控制老年人的医疗支出？

 

导读这是一篇关于日本老龄化的文章。上一篇文章讲到日本的移民政策，今天来看看日本是如何通过居家看护来控制医疗支出上涨的，又有啥问题呢~

音频&原文（可以先听听上方 ↑ 的音频，  再滑动下方 ↓ 查看全文~）Ageing in JapanHome helpThe government is struggling to curb the rising cost of health care

【1】IN A SUNNY room in a small apartment in the Tokyo satellite town of Kunitachi lies Yasuyuki Ibaraki, eyes closed and breathing laboured. Yukio Miyazaki, his doctor, who visits fortnightly from a local clinic, suspects that he does not have much time left: he has brain damage from a cerebral infarction, a tumour in his digestive system and is unable to swallow or talk. Reiko, his wife, feeds him through a tube to his stomach and clears phlegm from his throat. “He is from a close-knit family and is a quiet man, so I think it is better for him to be here rather than in a hospital,” she says, over green tea and grapes.

【2】Life expectancy in Japan is the highest in the world, at 84. This is good news for its people, but means that an ever-higher share of the population is elderly. Fully 28% of Japanese are older than 65, compared with 15% of Americans and 21% of Germans. More old people, in turn, means higher health-care costs. Last year the government budgeted ¥15trn ($138bn, or 15% of its total expenditure) for health care and nursing, excluding the charges it levies for the public health-insurance scheme. With public debt at 250% of GDP, and debt service consuming a further 24% of spending, the government is looking desperately for ways to cut costs. It reckons caring for people at home is one of its best options.

【3】All Japanese pay a monthly premium to the public insurance scheme, either through their employer or the local municipality. In return they are entitled to treatment and drugs from public and private doctors and hospitals, although they must also pay a portion of the cost of treatment (a co-payment, in American parlance), subject to a cap. In 2000 Japan introduced an additional public insurance scheme for long-term care for those over 65, into which people must pay from the age of 40. It works the same way. The premiums and co-payments cover around 60% of the cost of the services provided; the government pays for the rest. And it is the old who cost the most. The government reckons that the average annual cost of health care for someone over 75 is ¥942,000, compared with just ¥221,000 for everyone else.

【4】By the standards of ageing nations, Japan has managed to curb medical costs fairly well, says Naoki Ikegami of St Luke’s International University in Tokyo. The government sets fees for services to keep costs down (although that encourages providers to perform unnecessary procedures to make more money: Japan has more CT scanners relative to its population than any other country). It has also promoted the use of generic drugs, which are cheaper.

Life-giving, budget-busting【5】Nonetheless, the country has crept up to sixth place in the OECD’s ranking of the share of GDP spent on health care, behind France and America, but ahead of Italy and South Korea—two other ageing countries (see chart). It is not just that the number of old people is increasing; spending per person is rising, too, as people live longer with diseases like Alzheimer’s and diabetes.

【6】Japan has promoted home care for many years, but it is pushing it harder now. The policy is especially beneficial given that the average hospital stay in Japan is three times longer than in the Netherlands, for instance. The health ministry reckons that 1m people will receive care at home in 2025—one-and-a-half times the current total. The number of special nursing units exclusively for home visits has risen from 7,473 in 2014 to 10,418 in 2018.

【7】Last year a government panel suggested raising the amount doctors are paid for home visits and making consultations conducted via video-conferencing services eligible, too. It also proposed new rules to encourage care at home. Hospitals should be obliged to talk to social services when they discharge a patient, for example.

【8】Some municipalities are already offering good care in the community. Onomichi, a small provincial city that is even older than the country as a whole, is one. Its medical facilities have 15-minute “care conferences” with doctors, nurses, family members and even dentists, to discuss how they will go about looking after people. “It used to be hard for hospitals to tell a patient to return home as there was no system for that; that has changed,” says Hisashi Katayama, a doctor.

【9】Community care for specific diseases is improving, too. Take dementia, which currently affects 5m Japanese (4% of the population), and will afflict 6-7% by 2030. Rather than provide only institutional care and medicine, some towns, such as Matsudo, north-east of Tokyo, have set up cafés to offer advice and companionship to patients and their carers. Day centres that give respite to families tending to elderly relatives are common. Much more could be done: only 13% of Japanese die at home, although most say they want to.

【10】But more widespread home care will not be enough to make Japan’s health care affordable. The government of Shinzo Abe wants to revamp the social-security system, which it reckons will help reduce health-care costs. Raising the retirement age, for example, will keep people active, healthier and paying tax for longer. The government also wants to try to reduce the incidence of diseases that affect older people, but have their origins in behaviour at a younger age. “We have tended to focus on the old, but we need to look at the younger to prevent disease,” says Kazumi Nishikawa of the economy ministry. He is particularly focused on giving people more information on what causes diabetes, which is on the rise in Japan, or exercises that can stem the progression of dementia.

【11】People are likely to have to pay more for health care, too. Co-payments for many of those over 75 are only 10%, compared with 30% for everyone else. The government should start by doubling that to 20%, says Shigefumi Kawamoto, managing director of Kenporen, the national federation of health-insurance societies. “Some elderly people don’t have resources, but many do,” he avers. The government could exclude some items from coverage, he says, such as over-the-counter drugs.

【12】Meanwhile, back in Kunitachi, Dr Miyazaki talks to Reiko about her husband’s condition. She is worried that her husband is getting worse, she says, and is anxious between visits. The doctor promises to come weekly from now on.

    注：原文选自《经济学人》20190102期Asia板块

阅读笔记原文较长，这里选取部分段落进行精读为了保证纯英文的沉浸式阅读，没有提供中文译文哦~The government is struggling to curb the rising cost of health care。

curb释义：to control or limit something in order to prevent it from having a harmful effect控制，抑制，约束拓展：curb还可表示“路缘”，俗称“马路牙子”（the raised edge of a road, between where people can walk and cars can drive）

Life expectancy in Japan is the highest in the world, at 84. This is good news for its people, but means that an ever-higher share of the population is elderly.

Life expectancy 预期寿命ever- [写作积累]释义：You use ever in adjectives such as ever-increasing and ever-present, to show that something exists or continues all the time. 用以构成形容词，强调持续状态一直，不断。

这是一个很好用的前缀 ~常见搭配：~ever-increasing / ever-present = increasing, present etc all the time 不断增加的/始终存在的原文中：an ever-higher share of the population 在人口中的比重越来越高。

后文中的“More old people, in turn, means higher health-care costs.”可以改写为 More old people, in turn, means an ever-increasing share of government expenditure lies in the cost of health care.。

外刊例句：20180818的经济学人关于网恋的文章写道 But the feedback loop between large pools of data, generated by ever-growing numbers of users attracted to an ever-improving product, still exists.

[The economist. Modern love]  由不断完善的产品不断吸引而来的用户所产生的大量数据之间的反馈回路让人担心，网络配对会仅仅掌握在少数公司和他们手中的算法中Last year the government budgeted ¥15trn ($138bn, or 15% of its total expenditure) for health care and nursing, excluding the charges it levies for the public health-insurance scheme.。

levy释义to officially say that people must pay a tax or charge 征收，收取〔税项或费用〕常见搭配：levy a tax / charge / fine etc (on sth)

public health-insurance scheme  公共医疗保险计划联想：文章还提到了其他体系，如social-security system 社会保障制度（体系）；the public insurance scheme 公共保险计划。

All Japanese pay a monthly premium to the public insurance scheme, either through their employer or the local municipality. In return they are entitled to treatment and drugs from public and private doctors and hospitals, although they must also pay a portion of the cost of treatment (a co-payment, in American parlance), subject to a cap.

premium释义：the cost of insurance, especially the amount that you pay each year〔尤指每年支付的〕保险费例句：It is too early to say whether insurance premiums will be affected. 现在说保险费是否会受影响还为时过早。

municipality 自治市；自治区be entitled to (do) sth  有资格，有权利做....co-payment 共同付费，部分分单金额parlance 说法；用语如 in medical / advertising parlance 用医学上的/广告上的说法（用语）；in common parlance 用通俗的说法。

cap [熟词僻义]释义：an upper limit that is put on the amount of money that someone can earn, spend, or borrow 〔收入、支出或借贷金额的〕最高限额

联想：今天听podcast时学到glass ceiling，其中的ceiling是cap的近义词，表示“the largest number or amount of something that is officially allowed上限，最高限度”。

而glass ceiling的意思是“〔妇女或某一群体的人在职务晋升上遇到的〕无形障碍，无形顶障”It has also promoted the use of generic drugs, which are cheaper.

generic释义：a generic product does not have a special name to show that it is made by a particular company〔产品〕无商标的

例句：They encourage doctors to prescribe cheaper generic drugs instead of more expensive brand names. 他们鼓励医生给患者开较便宜的非专利药，而不是价格更高的品牌药。

Nonetheless, the country has crept up to sixth place in the OECD’s ranking of the share of GDP spent on health care, behind France and America, but ahead of Italy and South Korea—two other ageing countries.

creep释义：If something creeps somewhere, it moves very slowly. 缓慢移动creep原本指“（人或动物）悄悄行进，蹑手蹑脚地移动”，用来表示“攀升”简直在形象不过~。

运用：原文中(Japan) has crept up to sixth place in the OECD’s ranking of...日本已经攀升至OECD（经合组织）..排名的第六位，在描述某排名慢慢升高到一定位置时，就可以用creep表示。

外刊例句：20180119金融时报一篇关于中国二胎政策后出生率下降的文章中，有位专家分析道“Age at marriage is creeping up finally, which will also depress fertility rates.”人们越来越晚婚也在一定程度上压低了出生率。

（/笑哭）

~休息一下~Take dementia, which currently affects 5m Japanese (4% of the population), and will afflict 6-7% by 2030.

take sb / sth (for example)  [写作积累]释义：举例说明; 以某人/某事为例例句：People love British cars. Take the Mini. In Japan, it still sells more than all the other cars put together.人们喜欢英国车。

就拿“迷你”汽车来说，在日本它的销量仍然比其他所有汽车加起来还要高dementia释义：an illness that affects the brain and memory, and makes you gradually lose the ability to think and behave normally 痴呆。

60%-70%的痴呆为我们熟知的阿尔茨海默病（Alzheimers disease）afflict释义：to affect someone or something in an unpleasant way, and make them suffer使受痛苦，折磨

常见搭配：afflict + with / by，如 a country afflicted by famine 一个饱受饥荒之苦的国家He is particularly focused on giving people more information on what causes diabetes, which is on the rise in Japan, or exercises that can stem the progression of dementia.

on the rise [写作积累]释义：on the rise = rising，不断增长运用：描写青少年犯罪率升高时，可以用on the rise替代increasing，如Serious crime is once again on the rise among adolescents.

stem 释义：to stop something from happening, spreading, or developing 阻止，遏制，封堵常见搭配：stem the tide / flow / flood of sth；stem the growth / rise / decline etc

外刊例句：20180303期经济学人有一篇讲述环境的文章《塑料“整容”》中写道，The rich world should focus its attention—and resources, including charity—on chivvying them along. That is the surest way to stem the plastic tide. [The economist. Plastic surgery]，说西方国家应该携手发展中国家（句中的them），一起整顿垃圾问题。

SYN：标题中的curb是stem的近义词，此外还有check（to stop something bad from getting worse or continuing to happen阻碍，制止; 抑制），都有“遏制，阻止”的意思。

progression释义：a gradual process of change or development 变化，发展，演变例句：Both drugs slow the progression of HIV, but neither cures the disease... 这两种药物都可以延缓艾滋病病情发展，但是都不能治愈这种疾病。

The government could exclude some items from coverage, he says, such as over-the-counter drugs.coverage

[熟词僻义]释义：the protection an insurance company gives you, so that it pays you money if you are injured, something is stolen etc 保险范围。

如health care coverage 医疗保险承保范围SYN：cover，同样是熟词生义，cover作名词表示“保险”（the protection insurance gives you, so that it pays you money if you are injured, something is stolen etc）

句型积累提出一个解决方案：由于...问题（背景），xxx需要/急需寻找解决的方案，...是其中的最佳选择With public debt at 250% of GDP, and debt service consuming a further 24% of spending, the government

is looking desperately for ways to cut costs. It reckons caring for people at home is one of its best options

.表示原因：...不仅是由于xxx，还有xxx原因Nonetheless, the country has crept up to sixth place in the OECD’s ranking of the share of GDP spent on health care...

It is not just that the number of old people is increasing; spending per person is rising, too, as people live longer with diseases like Alzheimer’s and diabetes.

因为...，xxx尤其有用The policy is especially beneficial given that the average hospital stay in Japan is three times longer than in the Netherlands, for instance.

写在后面关于我和这个公众号：我是一个喜欢英语的工科生，去年暑假开始接触《经济学人》等外刊，从此将它们作为我的主要学习材料开这个公众号是为了督促自己能坚持阅读，也是记录自己的学习点滴通过公众号分享出来的笔记，至少是我经过一些思考整理出来的，相对于零散的笔记，它“更系统”地把我觉得。

值得反复看、反复记忆的笔记呈现出来，日后只需要搜索关键词就可以找到我暂时忘记的知识点！想想就亦可赛艇٩(๑>◡<๑)۶！其他：1.  用公众号记录学习是受到「英语学习笔记」的Eric启发，他说：“最好的学习方法是去教别人

”，我佩服他对英语的坚持，也希望自己能一天天进步  2. 文中词条的释义和例句来自朗文双解、柯林斯高阶英汉双解、牛津高阶等词典  3. 文中观点不代表本人立场，文章仅用于语言学习立个小flag：每周更新当周的一篇《经济学人》精读文章，并以此篇进行。

主题阅读。如果你也喜欢英语，欢迎来和我交流呀~关注我

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