The Problem Of Scarce Resources - IELTS Reading Answers & Explanations
From Cambridge IELTS 04 Academic Reading Test 4 · Part 3 · Questions 28–40
Reading Passage
You should spend about 20 minutes on Questions 28-40 which are based on Reading Passage 3 on the following pages.
The Problem of Scarce Resources
Section A
The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just and most efficient way, is not a new one. Every health system in an economically developed society is faced with the need to decide (either formally or informally) what proportion of the community's total resources should be spent on health-care; how resources are to be apportioned; what diseases and disabilities and which forms of treatment are to be given priority; which members of the community are to be given special consideration in respect of their health needs; and which forms of treatment are the most cost-effective.
Section B
What is new is that, from the 1950s onwards, there have been certain general changes in outlook about the finitude of resources as a whole and of health-care resources in particular, as well as more specific changes regarding the clientele of health-care resources and the cost to the community of those resources. Thus, in the 1950s and 1960s, there emerged an awareness in Western societies that resources for the provision of fossil fuel energy were finite and exhaustible and that the capacity of nature or the environment to sustain economic development and population was also finite. In other words, we became aware of the obvious fact that there were 'limits to growth'. The new consciousness that there were also severe limits to health-care resources was part of this general revelation of the obvious. Looking back, it now seems quite incredible that in the national health systems that emerged in many countries in the years immediately after the 1939–45 World War, it was assumed without question that all the basic health needs of any community could be satisfied, at least in principle; the 'invisible hand' of economic progress would provide.
Section C
However, at exactly the same time as this new realisation of the finite character of health-care resources was sinking in, an awareness of a contrary kind was developing in Western societies: that people have a basic right to health-care as a necessary condition of a proper human life. Like education, political and legal processes and institutions, public order, communication, transport and money supply, health-care came to be seen as one of the fundamental social facilities necessary for people to exercise their other rights as autonomous human beings. People are not in a position to exercise personal liberty and to be self-determining if they are poverty-stricken, or deprived of basic education, or do not live within a context of law and order. In the same way, basic health-care is a condition of the exercise of autonomy.
Section D
Although the language of 'rights' sometimes leads to confusion, by the late 1970s it was recognised in most societies that people have a right to health-care (though there has been considerable resistance in the United States to the idea that there is a formal right to health-care). It is also accepted that this right generates an obligation or duty for the state to ensure that adequate health-care resources are provided out of the public purse. The state has no obligation to provide a health-care system itself, but to ensure that such a system is provided. Put another way, basic health-care is now recognised as a 'public good', rather than a 'private good' that one is expected to buy for oneself. As the 1976 declaration of the World Health Organisation put it: 'The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.' As has just been remarked, in a liberal society basic health is seen as one of the indispensable conditions for the exercise of personal autonomy.
Section E
Just at the time when it became obvious that health-care resources could not possibly meet the demands being made upon them, people were demanding that their fundamental right to health-care be satisfied by the state. The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive) consumers of health-care resources. Thus in OECD countries as a whole, health costs increased from 3.8% of GDP2 in 1960 to 7% of GDP in 1980, and it has been predicted that the proportion of health costs to GDP will continue to increase. (In the US the current figure is about 12% of GDP, and in Australia about 7.8% of GDP.)
As a consequence, during the 1980s a kind of doomsday scenario (analogous to similar doomsday extrapolations about energy needs and fossil fuels or about population increases) was projected by health administrators, economists and politicians. In this scenario, ever-rising health costs were matched against static or declining resources.
1 Organisation for Economic Cooperation and Development
2 Gross Domestic Product
Questions
Questions 28–31 Matching Headings
Reading Passage 3 has five sections A-E.
Choose the correct heading for sections A and C-E from the list of headings below.
i. The connection between health-care and other human rights
ii. The development of market-based health systems
iii. The role of the state in health-care
iv. A problem shared by every economically developed country
v. The impact of recent change
vi. The views of the medical establishment
vii. The end of an illusion
viii. Sustainable economic development
Questions 32–35 Matching Features
Classify the following as first occurring
A. between 1945 and 1950
B. between 1950 and 1980
C. after 1980
Questions 36–40 Yes / No / Not Given
Do the following statements agree with the views of the writer in Reading Passage 3?
Answers & Explanations Summary
| # | Answer | Evidence | Explanation |
|---|---|---|---|
| Q28 | iv | Every health system in an economically developed society is faced with the need to decide (either formally or informally) what proportion of the community's total resources should be spent on health-care; how resources are to be apportioned; what diseases and disabilities and which forms of treatment are to be given priority; which members of the community are to be given special consideration in respect of their health needs; and which forms of treatment are the most cost-effective | Excerpt/Passage Explanation: The passage says that every healthcare system in a rich country has to make hard choices about how much money to spend on health, which sicknesses are most important to treat, and which people need the most help. Answer Explanation: The answer means that Section A describes a difficult situation that all wealthy nations have in common. Reason For Correctness: The correct answer is heading iv because Section A explains that every 'economically developed society' (a synonym for a wealthy country) deals with the same 'problem' of dividing limited healthcare resources. The text shows this is a shared issue by listing the questions that 'every' such health system must answer, such as which treatments to prioritize and how much money to spend. The phrase 'is faced with the need to decide' supports the idea that this is a challenge or problem they all share. |
| Q29 | i | Like education, political and legal processes and institutions, public order, communication, transport and money supply, health-care came to be seen as one of the fundamental social facilities necessary for people to exercise their other rights as autonomous human beings | Excerpt/Passage Explanation: The passage explains that health care is as important as schools or the law. It says that people need health care to be able to use their other rights as free people. Answer Explanation: The answer choice i means that Section C describes how having health care helps people use their other basic rights. Reason For Correctness: The correct answer is correct because Section C explains that health care is now seen as a basic right, much like education or legal systems. It argues that without health care, people are not truly free or able to use their other fundamental rights as independent individuals. The text directly connects health care to the ability to "exercise their other rights." |
| Q30 | iii | It is also accepted that this right generates an obligation or duty for the state to ensure that adequate health-care resources are provided out of the public purse. The state has no obligation to provide a health-care system itself, but to ensure that such a system is provided | Excerpt/Passage Explanation: The passage states that because health-care is a right, the government has a job to make sure there is enough medical care for everyone using money from the public. It clarifies that the government's job is to make sure the system works, even if they aren't the ones directly running the health services. Answer Explanation: The answer 'iii' indicates that Section D focuses on what the government is responsible for doing regarding medical care for the public. Reason For Correctness: The correct answer is 'iii' because Section D explicitly discusses the 'obligation' and 'duty' of the state (the government) regarding health-care. It explains that while the state does not necessarily have to run every medical facility itself, it is required to use public money to ensure that health resources are available to everyone. Keywords such as 'state', 'obligation', 'duty', and 'public purse' all point to the specific role of the government in managing these resources. |
| Q31 | v | The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive) consumers of health-care resources | Excerpt/Passage Explanation: The passage explains that worrying concerns about how to share health resources come from big changes, like much higher medical costs and changes in the population (like more older people needing care). Answer Explanation: The answer 'v' means that Section E focuses on how recent shifts in society and money have affected health care. Reason For Correctness: The correct answer is 'v' because Section E describes two main types of recent 'changes' that have caused problems for health-care systems. First, it mentions the 'dramatic rise in health costs' compared to a country's total income (GDP). Second, it mentions 'demographic and social changes,' such as having more elderly people who need expensive care. The section explains the 'impact' (effect) of these changes by describing a 'doomsday scenario' where costs keep rising while the money available stays the same or goes down. |
| Q32 | B | What is new is that, from the 1950s onwards, there have been certain general changes in outlook about the finitude of resources as a whole and of health-care resources in particular, as well as more specific changes regarding the clientele of health-care resources and the cost to the community of those resources | Excerpt/Passage Explanation: The passage explains that starting in the 1950s, people began to think differently and realized that both general resources and health-care resources have a 'finitude,' meaning they are limited and can run out. Answer Explanation: The answer B means that the discovery or understanding that health-care resources are limited first happened between the years 1950 and 1980. Reason For Correctness: The correct answer is B because the text indicates that people's thinking shifted starting in the 1950s. Specifically, it mentions that from that time forward, there were changes in how people viewed the 'finitude' or the limited nature of health-care resources. This 'new consciousness' about limits came after the period immediately following World War II, when people previously believed resources were unlimited. |
| Q33 | B | Thus in OECD countries as a whole, health costs increased | Excerpt/Passage Explanation: The passage says that in many developed countries, the amount of money spent on health grew from 3.8 percent in 1960 to 7 percent in 1980. Answer Explanation: The answer B means that the big increase in how much money is spent on healthcare happened between the years 1950 and 1980. Reason For Correctness: The correct answer is B because Section E specifically mentions that health costs went up significantly between 1960 and 1980. The text uses the phrase 'dramatic rise' to describe these costs and provides data showing that the percentage of money spent on health almost doubled during this time. Because 1960 and 1980 both fall between 1950 and 1980, choice B is the correct time period. |
| Q34 | A | Looking back, it now seems quite incredible that in the national health systems that emerged in many countries in the years immediately after the 1939–45 World War, it was assumed without question that all the basic health needs of any community could be satisfied, at least in principle; the 'invisible hand' of economic progress would provide | Excerpt/Passage Explanation: The passage explains that in the years right after 1945, many countries created new health systems. At that time, they firmly believed that as the economy became stronger, there would be plenty of resources for every person's health requirements. Answer Explanation: The answer means that right after World War II ended in 1945, people believed that a growing economy would naturally provide enough money to pay for everyone's health care. Reason For Correctness: The correct answer is A because Section B describes the situation in the years "immediately after the 1939–45 World War." Since the war ended in 1945, these years represent the 1945–1950 period. During this time, the text states it was believed that "economic progress" (which means economic growth) would "provide" for all the "basic health needs" (health-care resources) of the community. |
| Q35 | B | Although the language of 'rights' sometimes leads to confusion, by the late 1970s it was recognised in most societies that people have a right to health-care (though there has been considerable resistance in the United States to the idea that there is a formal right to health-care). It is also accepted that this right generates an obligation or duty for the state to ensure that adequate health-care resources are provided out of the public purse | Excerpt/Passage Explanation: The passage says that by the year 1979 (the late 1970s), most countries believed that because health care is a human right, the government must use public money to make sure there is enough medicine and help for everyone. Answer Explanation: The answer means that between the years 1950 and 1980, people began to believe and accept that the government (the state) should be responsible for making sure everyone has access to medical care. Reason For Correctness: The correct answer is B because the passage explains that a change in thinking happened between the 1950s and the late 1970s. During this time, health care began to be viewed as a 'right' rather than a 'private good' you buy for yourself. The passage specifically mentions that by the late 1970s, most societies agreed that this right creates an 'obligation' or 'duty' for the state to provide resources for health care using public money. |
| Q36 | NO | In a liberal society basic health is seen as one of the indispensable conditions for the exercise of personal autonomy | Excerpt/Passage Explanation: The passage explains that in certain types of societies, being healthy is considered a necessary requirement for people to use their personal freedom and make their own decisions. Answer Explanation: The answer "NO" means that the sentence in the question is incorrect according to the writer. The writer actually thinks that personal freedom and independence are connected to health-care. Reason For Correctness: The correct answer is "NO" because the passage states that health-care is a necessary requirement for people to act as independent individuals. The writer uses the term "autonomy," which is a synonym for independence or the ability to make one's own choices. By calling health-care a "condition" for this autonomy, the author confirms that there is a direct link between staying healthy and being free. |
| Q37 | YES | However, at exactly the same time as this new realisation of the finite character of health-care resources was sinking in, an awareness of a contrary kind was developing in Western societies: that people have a basic right to health-care as a necessary condition of a proper human life | Excerpt/Passage Explanation: The passage states that right when people began to understand that health-care resources are limited (the 'finite character'), they also started to think that everyone should have a basic right to receive medical care. Answer Explanation: The answer YES means that the statement matches what the writer believes, based on the information provided in the passage. Reason For Correctness: The correct answer is YES because Section C of the text clearly states that both of these ideas happened during the same period. The author explains that just as people were starting to understand that health-care money and supplies have limits (meaning they are 'finite'), they were also starting to believe that health-care is a basic human 'right.' The use of the phrase 'at exactly the same time' confirms that these two changes in thinking occurred together. |
| Q38 | YES | The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive) consumers of health-care resources | Excerpt/Passage Explanation: The passage says that in many developed countries (OECD countries), the amount of money spent on health has increased quickly. It explains that this is linked to changes in the population (demographic changes), like having more elderly people who need more medical help. Answer Explanation: The answer YES means that the writer agrees with the idea that the types of people living in certain countries (population) have changed, and this has affected the cost of medical care. Reason For Correctness: The correct answer is YES because the passage explains that in OECD countries, healthcare costs have gone up. It states that this increase happened alongside 'large-scale demographic and social changes.' In this context, 'demographic' refers to the population's makeup, such as age groups. The writer gives the example of 'elderly people' using more expensive medical services, which shows how a change in the population (more old people) has a direct effect on healthcare costs. |
| Q39 | NOT GIVEN | The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive) consumers of health-care resources | Excerpt/Passage Explanation: The passage explains that health costs in OECD countries have increased a lot due to changes in the population, such as more older people needing care. However, it does not say that governments made mistakes in planning for these costs or that they consistently expected the costs to be lower than they actually were. Answer Explanation: The answer is NOT GIVEN because the passage does not provide enough information to know if the writer believes OECD governments have repeatedly guessed too low for the amount of health-care resources needed. Reason For Correctness: The correct answer is NOT GIVEN because while the text mentions OECD countries and the rising cost of health-care, it never states that governments 'underestimated' (thought the need would be smaller than it was) the requirements. The passage discusses that costs went up and that certain groups, like elderly people, use more resources, but it does not evaluate the accuracy of government predictions or estimates over time. |
| Q40 | NOT GIVEN | The second set of more specific changes that have led to the present concern about the distribution of health-care resources stems from the dramatic rise in health costs in most OECD1 countries, accompanied by large-scale demographic and social changes which have meant, to take one example, that elderly people are now major (and relatively very expensive) consumers of health-care resources | Excerpt/Passage Explanation: The passage states that health care is becoming much more expensive and that older people are currently the main users of these services. However, it does not mention if older people will be expected to make their own private plans or set aside resources for their health care in the future. Answer Explanation: The answer is NOT GIVEN because the passage does not tell us if older people will need to save extra money or make their own special plans for health care in the years to come. Reason For Correctness: The correct answer is NOT GIVEN because while the text notes that health costs are rising and that elderly people use much of these expensive resources, it never says that these individuals will have to make 'special provision' (such as personal savings or private insurance) for themselves in the future. The passage discusses health care as a 'public good' managed by the state, but it stops short of predicting that the elderly will be required to take specific personal actions to ensure their future care. |