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16-A. Heart Disease: Treat or Prevent?
One of the greatest killers in the Western world is heart disease. The death rate from the disease has been increasing at an alarming speed for the past thirty years. Today in Britain, for example, about four hundred people a day die of heart disease. Western healthcare systems are spending huge sums of money on the surgical treatment of the disease.
This emphasis on treatment is clearly associated with the technological advances that have taken place in the past ten to fifteen years. In this time, modern technology has enabled doctors to develop new surgical techniques and procedures. Many operations that were considered impossible a few years ago are now performed every day in U.S. hospitals. The result has been a rapid increase in heart surgery.
Although there is no doubt that a large number of people benefit from heart surgery, critics of our health-care systems point out that the emphasis on the surgical treatment of the disease has three clear disadvantages. First, it attracts interest and financial resources away from the question of prevention. Second, it causes the costs of general hospital care to rise. After hospitals buy the expensive equipment that is necessary for modern heart surgery, they must try to recover the money they have spent. To do this, they raise costs for all their patients, not just those patients whose treatment requires the equipment. The third disadvantage is that doctors are encouraged to perform surgery -- even on patients for whom an operation is not at all necessary -- because the equipment and surgical expertise is available. A federal government office recently said that major heart surgery was often per-formed even though its chances of success were low. In one type of heart surgery, for example, only 15 percent of patients benefited from the surgery.
In the recent past, medical researchers have begun to emphasize the fact that heart disease is associated with stress, smoking and a lack of exercise, and we can often reduce the risk of heart disease by paying more attention to these factors.
More and more people are realizing that there is a connection between heart disease and the way they live. As a result of this new awareness, attitudes toward health are changing. In the past, people tended to think that it was sufficient for good health to have a good doctor who could be relied on to know exactly what to do when they became ill. Now they are realizing that merely receiving the best treatment for illness or injury is not enough. They are learning that they must take more responsibility for their own health. Today many people are changing their dietary habits and eating food with less fat and cholesterol. Many are paying more attention to reducing stress in their lives. The number of smokers in the United States is now far below the level of twenty years ago as many people succeed in breaking the habit and as fewer people take it up. More and more people are aware of the benefits of regular exercise like walking, running, or swimming; some have begun to walk or ride bicycles to work instead of driving. Millions have become members of health clubs and have made health clubs one of the fastest growing businesses in the United States today. And now the beneficial effects of these changing attitudes and behaviors are beginning to appear: an encouraging decrease in deaths from heart disease.
【课文译文】
心脏病：治疗还是预防
心脏病是西方世界最大的杀手之一。在过去的30年里，心脏病患者的死亡率一直在以惊人的速度增加。例如：在今天的英国，每天约有400人死于心脏病。西方的卫生保健系统正在把大量的钱用于手术治疗心脏病上。
很明显，这种治疗法和过去10～15年间技术的发展是紧密相关的。在这段时间里，现代技术使得医生能够开发新的外科技术及治疗过程。许多在几年前还被认为是不可能的手术，现在在美国的医院里每天都在进行，其结果是心脏手术治疗快速增加。
毫无疑问，许多人得益于这种手术治疗的办法。然而卫生保健系统的专家们却指出，重点以手术治疗心脏病有以下三个明显的弱点。首先，它使人们忽略了预防，而把兴趣和财力集中在治疗上。第二，它引起了医疗费用的上涨。在购置了为进行现代手术治疗所需的昂贵的医疗设备后，医院不得不想法补偿已花掉的钱。为此，他们提高了病人的治疗费用，而这些病人并不仅仅是那些需要这种仪器进行治疗的人。第三是鼓励医生对病人施行手术——甚至是那些根本不需要手术的病人，因为设备和专家鉴定随处可得。联邦政府最近宣称尽管大型心脏手术成功的机会很低，但仍常常被施行。例如，有一种类型的心脏外科手术，仅有15名病人能从中得益。
在过去一段时间里，医学研究者们开始重视到一个事实，即心脏病与压力、吸烟和缺乏锻炼有关，我们可以通过对这些因素加以注意，而减少患心脏病的危险。
愈来愈多的人认识到心脏病和他们的生活方式有关系，这种新意识使人们对健康的态度正在发生改变。过去，人们一般认为，健康的身体只需要一个可以依赖的好医生就足够了。医生知道在他们生病的时候，他应该做什么。现在，他们逐渐认识到仅仅对疾病与伤痛进行最好的治疗还不够。他们学会了必须对自己的健康负责。今天许多人正在逐步改变他们的饮食习惯，开始食用低脂肪和胆固醇含量低的食物。还有许多人更加注意减少他们生活中的压力。在美国吸烟者的人数现在大大少于20年前，这都是由于许多人成功地戒了烟，而且学吸烟的人也很少了。愈来愈多的人意识到按时锻炼的好处，例如像散步，跑步和游泳等运动，有些人已经不再驾车去上班，而是开始步行或骑自行车。成百万的人已经成为健康俱乐部的成员，并且使得健康俱乐部在今天的美国成为了一个发展最为迅猛的产业。现在，由于在态度和行为方面的转变而带来的有益的影响正开始在显露：心脏病的死亡率已经下降。