重医附二院靠谱吗?重庆星宸医院好吗重庆人民医院网站 Obamacare奥巴马医改Experimental medicine实验医学A year after the big launch, is Obamacare working?实施一年的奥巴马医改到底奏效吗？TEXAS has a higher share of uninsured citizens than any state in America. Until recently Shane, a 38-year-old from Houston, was one of them. “I just couldnt afford it,” he says. Shane has HIV; his job does not cover him. Because of his illness, insurers would offer him only a costly plan with limited benefits. Such discrimination is now illegal. Since January the Affordable Care Act, better known as Obamacare, has required insurers to charge the healthy and the sick the same price. For the first time in 20 years, Shane can afford health cover.堪萨斯州未参与医疗保险的人数比美国其他任一州都多。直到近期来自休斯顿38岁的谢恩才刚刚参保。他说，“我只是无法负担医疗保险费。”谢恩是艾滋病患者，他的工作薪金无法负担他的医药费。由于他的疾病，保险公司只愿意提供有限福利但保费昂贵的保险方案。但是现在，这样的歧视是非法的。自今年一月平价医疗法案，即人们熟知的奥巴马医改要求保险公司向患病及健康的投保人收取同样的保费。这是20年来首次谢恩能够付得起他的医疗费用。Across town, Suezen Salinas is less fortunate. Having recently returned to college, she has no job. Her two children qualify for Medicaid, the public health programme for the poor, but she does not. Texas is one of the nearly two dozen states that did not expand Medicaid, despite Obamacares offer that the federal government would cover most of the cost. Ms Salinas also earns too little to qualify for Obamacares subsidies. So she used some of her college financial aid to buy health cover.城镇另一端的Suezen Salinas就没有那么幸运了。最近刚返回大学校园继续深造的她还没有工作。她的两个孩子有资格享受专为穷人设置的公共医疗项目—医疗补助计划，但是她不行。尽管奥巴马医改表示联邦政府将会付医保的绝大部分开，堪萨斯州是近20个未扩大医疗补助计划覆盖面的州之一。Health care in America is changing, thanks to Obamacare and the efforts of innovative private firms (see article). And not before time. Americas health system, the worlds biggest, involves a tangled mess of rules and a hotch-potch of public and private institutions. It combines dazzling technology with minimal cost controls and spotty coverage. In 2012 it left some 48m people uninsured despite gobbling up 17.2% of GDP, a figure that dwarfs spending in any other country and has shot up from 4.4% in 1950.由于奥巴马医改以及锐意创新的私人企业的努力，美国的医疗保健正在改变。在此之前，作为全球最大的医疗体系，美国的医疗体系包含有一堆杂乱无章的规章制度以及混乱的公私机构。它集毫无节制地购买令人眼花缭乱的科技产品和零星的覆盖面于一体。2012年，尽管医疗体系开占GDP17.2%，但仍然有0.48亿人未享受到医疗保险的福利，而这一数据远远高出其他国家的医疗保险开，并且远远高出1950年占GDP4.4%的比率。Rather than scrap this system, Obamacare rejigs it. It expands Medicaid to include millions of not-quite-poor Americans. It seeks to create a market where individuals can buy health insurance, pooling risks without the backing of a large employer. Ultimately, it aims to expand coverage and deliver better care at a lower price. Its record is mixed so far.奥巴马医改重新整顿了这个原本应该弃置的医疗体系。它扩大了医疗补助计划的覆盖范围，将那些不是那么富裕但又处于贫困线以上的数百万人纳入新的医疗救助体系中。它试图创造一个个人能够负担得起的医疗保险市场，在没有大型雇主的持下让风险集中。最终达到以更低的价格扩大医疗保险的覆盖率同时提供更好的医疗务。目前为止奥巴马医改所创的记录是多方面的。Obamacare created new health exchanges, where individuals can shop for private insurance and, if they earn between ,670 and ,680, qualify for subsidies. As well as barring insurers from charging the sick more, it requires individuals to have health insurance or pay a fine.奥巴马医改创造了新的健康交易模式，在该种模式下，若个体收入在46680美元一下11670美元以上就有资格获得补助金，能够购买私人医疗保险。同时由于它阻止保险公司向病人收取更高的保费，它要求个体购买医疗保险或者缴纳罚款。In some states Obamacare works well. In others, it does not. Many Republican-run states refused to expand Medicaid on the grounds that taxpayers would be stuck with the bill. That left almost 9m adults who earn less than ,670 a year, like Ms Salinas, too rich for Medicaid but too poor to receive subsidies on the exchanges.在有些州奥巴马医改实施得非常好，但是在另一些州则不然。许多共和党人治理的州由于担心纳税人在付账单时有困难而拒绝扩大医疗救助计划的覆盖面。这让像萨林纳斯一样年收入在11670美元以下的将近900万成年人既没有资格获得医疗救助又无法负担得起购买医疗保险的金额。Thirty-six states did not set up their own exchanges (as Congress had assumed they would), instead relying on the federal government to do the work. That put a lot of pressure on Healthcare.gov, the federal insurance website, which hardly worked at all when it was launched on October 1st last year. It is working better now, but problems remain. A new audit warns that more must be done to make the site secure.36个州没有像国会预设的那样建立他们自己的医疗保险交易，而是寄希望于联邦政府去做这件事。这给联邦保险网站—医疗保健政府官网极大的压力，而该网站自去年十月一日上线以来几乎没做任何工作。尽管现在运转良好但是问题依然存在。新的审计警告要使该网站安全要投入更多的工作。For now Obamacare seems to have expanded cover. Data-crunchers at Gallup, Harvard University, the Urban Institute and the Commonwealth Fund agree that the proportion of American adults who are uninsured dropped by 22%-26% from the third quarter of 2013, just before Obamacares exchanges opened, to the second quarter of 2014, when enrolment ended. Between 8m and 10.3m adults have gained cover. Much of this gain appears to have come from the expansion of publicly-funded Medicaid, however. Nearly 20% of adults are uninsured in states that did not expand Medicaid, about twice the share in states that did, according to the Urban Institute.目前奥巴马医改似乎已经扩大了其覆盖面。在哈佛大学、盖洛普、城市研究所及联邦基金会搞数据工作的人同意，在奥巴马医改交易实施以前，登记截止之时，未参保的美国成年人的比例由2013年第三季度到2014年第二季度的比例下降了22%-26%。大约有800万至1030万成人被纳入医疗保险中。但是，这其中的绝大多数人似乎是来自公共基金持的医疗救助计划的扩展。根据城市研究所的数据，在医疗救助计划未扩展的州府将近20%的成人未被纳入医保中，而在医疗救助计划扩展的州府纳入医保的成人的比例是40%。How many people have gained coverage through the new exchanges is unclear. Officials say that more than 8m have signed up, but this includes some who had insurance before. In May McKinsey, a consultancy, estimated that 26% of those who had bought policies on the individual market had been previously uninsured.到底有多少人通过新的交易被纳入到医保中还不是很明确。官员声称超过800万人已签订合同，但这包含那些原本就参保的人。五月份，麦肯锡咨询公司估计在个体市场26%购买保险的人之前都未参保。Politically, Obamacare remains highly controversial. A poll of polls finds that 51% of Americans disapprove of it; only 41% approve. Republicans bash it in stump speeches; Democrats mention it only in passing. A lawsuit, Halbig v Burwell, contends that the law allows insurance subsidies only through state-run exchanges, not through the federal one. If the plaintiffs win, they could kneecap the entire reform.政治上来讲，奥巴马医改依然备受争议。民意测验的比较发现51%的美国民众不赞同该医改，仅有41%的人持它。共和党人在竞选演说中猛烈抨击奥巴马医改，而民主党只是顺便提一提。Halbig v Burwell诉讼案件争论法律只允许通过国营的交易而非联邦交易给予保险补助金。如果原告获胜，他们将保障整个改革。Assuming it survives legal challenges, however, Obamacares success depends largely on how many uninsured people eventually sign up for coverage on the exchanges. Legally, they are obliged to have coverage, but if prices are too high, some will opt to pay the penalty instead. Education should help—most of the uninsured are unaware of the subsidies available to them. But premiums matter more, and are rising, by an average of 7% across 33 states, according to PwC, a consultancy. There is broad variation. Premiums are to rise by an average of only 2.4% in Colorado, but by a whopping 14% in Tennessee, according to PwC. The next round of enrolment starts in November; many people will discover whether their premiums are to rise or fall just before the mid-term elections.假设奥巴马改革能够挺过法律这一挑战，它的成功依然在很大程度上依赖于最终多少未参保的人会在医疗保险单上签字。法律上说，他们应该被纳入到医保覆盖范围，但是倘若保费泰国高昂，有些人将会选择付罚金而非保费。教育程度应该会起作用——许多未参保的人都意识不到他们能得到的补助金。但是保险费所起的作用更大，并且价格一直在上涨。根据普华永道咨询公司的数据在33个州府中，保费平均涨幅达7%。并且各地的保费差异很大——在科罗拉多州保费的平均涨幅仅2.4%，而在田纳西州涨幅高达14%。下一轮的参保将在一月展开，在中期选举之前许多人将会讨论他们的保费到底是会涨还是会跌。Growth in health spending per person slowed from a shocking 7.4% a year from 1980 to to 3% from to 2012. It may rise again, alas. The lousy economy caused some of the recent slowdown. The governments actuaries expect spending to jump by 5.6% this year and 6% a year from 2015 to 2023. As more Americans age and gain insurance, they will demand more health care. Shane, for example, ignored an aching shoulder and blocked sinuses when he was uninsured. Now that he has cover, he is seeking treatment. Big hospitals say they are seeing more patients: Tenet, a giant hospital firm, reported a 4% jump in patient volumes in the second quarter, compared with a year earlier.用于医疗保险的开年增长率在1980年至年是7.4%，但是到年至2012年却急剧降至3%。或许它还可能上涨。疲软的经济在某种程度上也导致了近段时间增长率的下滑。政府精算师希望今年医疗开能够上涨5.6%，2015年至2023年能上涨6%。由于越来越多的美国人年龄增长并参保，他们更需要医疗保健。比如说，谢恩在未参保时，会忽视肩膀的酸痛以及因鼻窦炎堵塞的鼻子。现在既然他享受医疗保险他也会寻求治疗。大型医院称他们迎来越来越多的病患。大型医疗公司特内特报告指出相较一年以前，病人的数量增长了4%。Higher public spending on health threatens to crowd out education, infrastructure and more besides. In July the Congressional Budget Office predicted that, despite the recent slowdown, government health programmes would become the single biggest area of public spending within 20 years, and grow from 4.8% of GDP now to 8% in 2039.在医保上投入更多的公共出会将缩减用于教育、基础设施建设及其他更多方面的公共出。七月，国会预算局预计，尽管近几年用于医疗保险的共公开有所减少，在今后的20年，政府的医保项目将仍然是唯一的最大的公共开出领域，到2039年前，其占GDP的比重将由现在的4.8%涨至8%。Americas health system is terrible at controlling costs for two main reasons. First, insurers and Medicare usually pay doctors when they deliver many services, rather than when they keep patients well. Second, America relies on a private market of doctors and insurers, yet their costs and quality remain opaque. For decades the doctors lobby has fought to hide detailed data on doctors performance and prices. Robert Kocher and Ezekiel Emanuel report that 30-40% of top academic hospitals have contracts that bar insurers from relaying hospital prices to employers or patients. What quality measures exist are mostly tied to procedures, not results.美国的医保体系由于两大原因在控制成本方面做得很糟糕。第一，保险公司和医疗保险经常在医生提供务而非他们治好病人时付薪水。第二，美国依赖于医生和保险公司的私人市场，然而他们的成本及质量都模棱两可、不清不楚。数十年来，医生的游说者试图隐藏医生工作表现及治疗价格的详细数据。罗伯特·柯歇尔和伊其基尔·伊曼纽尔报告指出30%至40%的顶级学院型医院订有合同阻止保险公司给予投保人或病人医院原有的价格。什么样的质量检测的存在与结果无关而在很大程度上于步骤过程有关。So patients have been left in the dark. When they have visited the doctor, they have had no idea what anything costs or that it all ultimately comes out of their wages. So they have not objected when doctors gave them unnecessary tests, or overcharged.因此病人就被这样的机制遗漏在病痛的黑暗中。当他们去找医生时，他们对那些药品的花费或者药费最终出自于他们的工资一无所知。因此，当医生要求他们做不必要的检查或收取高额费用时他们不会拒绝。Thus the cost of a back scan in New York City ranges from 6 to more than ten times that amount, according to Castlight, a firm in California. A prostate-specific antigen test in Philadelphia could be or 7 (see chart 3). Quality is erratic, too. Laurent Glance of the University of Rochester found that rates of complications from caesarean deliveries varied nearly fivefold among American hospitals.因此，根据一个名为“揭露真相”的一家加利福尼亚公司的资料，在纽约，脊背扫描检查的费用在416美及甚至高于这一数据的十倍之多之间波动。在费城，一项前列腺特定抗体检查费用可能在20美元至407美元之间波动。并且检查的质量也有很大的不确定性。罗切斯特大学的劳伦·格兰仕发现美国剖腹产并发症的概率变化达到5倍。Obamacare tries various ways to curb costs. For example, it urges groups of doctors and hospitals to become Accountable Care Organisations (ACOs), rewarded for keeping Medicare patients costs below a set limit. However, data published on September 16th show that only a quarter saved enough to earn a bonus. Obamacare also orders the health department to make costs and quality more transparent. This, too, is proceeding fitfully. In April health officials published Medicare payments to specific doctors. This revealed which doctors perform a lot of procedures. However, it did not reveal whether those interventions were appropriate or successful. Medicares more useful data, which would show which doctors keep patients well, have yet to be broadly released; there are worries about privacy.奥巴马医改试图通过多种途径抑制医疗开。比方说，它敦促医生团体及医院成为负责任医疗组织，该组织奖励那些将医疗保险病人的出控制在一定的限制一下的医护行为。但是，9月16号公布的数据表明所节约的资金中仅有四分之一用于奖金。奥巴马医改同时要求卫生部门进一步将成本与质量透明化。这同样也在顺利稳步进行。四月，卫生官员想特定的医生公开医疗保险开。这透露哪些医生执行了一系列的程序步骤。但是它并不能说明哪些干涉是合适并且成功地。有关医疗保险更为有用的资料，即能表现哪些医生治好了病人的疾病却还没能广泛地公开。因为人们担心会侵犯相关人员的隐私。A long way to go医疗改革任重道远18. Mark McClellan of the Brookings Institution, a think-tank, points out that insurers and doctors groups are testing their own versions of ACOs, which might be more successful than the governments. Companies are also slowly lifting the veil from doctors costs and quality. Castlight compiles data from employers insurance bills, then presents prices to patients. edHealthcare, Aetna, Humana and Kaiser Permanente, four huge insurance and health companies, have given reams of data to an independent research centre. Next year it will launch a website where any insured patient can log in and view quality and cost information for specific doctors and hospitals.智囊团布鲁金斯学会的马克·麦克莱伦指出保险公司及医生行业正在检测他们自己的负责任的医疗组织版本，这将比政府的版本更为成功。公司也逐渐揭开医生看病成本及治疗质量的面纱。“揭露真相”根据雇员的保险单编制资料，然后将价格告知病患。联合医疗保险公司、安泰保险公司、瑚玛纳及凯撒永久医疗集团这四家大型保险及医疗公司已经给一个独立的研究中心大量的资料。明年它将推出一个专门网站，在该网站任何参保的病人都能登录进去查看特定医院特定医生诊治的开以及医治质量。Patients may increasingly demand change, too. Employers are pushing workers into plans with high deductibles, which means they must pay for more care out of their own pockets before insurance kicks in. The share of workers with deductibles jumped from 55% in 2006 to 80% in 2014. This gives patients a good reason to shop around for cheaper treatment. In some cases, employers are asking workers to shop around for insurance too, giving them cash to buy coverage on privately-run health exchanges.现在病患也越来越追求变化。雇主驱使工人参保高的自付额的医疗保险，这意味着在医保生效之前他们必须自己掏腰包为健康付费。有自付额的工人的比重由2006年的55%增加到2014年的80%。这是病患货比三家寻求更廉价治疗方案的一个很好的理由。在某些情况下，雇主会建议工人通过货比三家选择医疗保险，为他们提供资金购买私人运营的医疗保险交易。When patients act like shoppers, health-care providers serve them better. In August the number of retail clinics, which treat patients at malls and outside regular hours, was up 17% over last year, according to Merchant Medicine, a consultancy. Obamacares exchanges have inspired new insurance entrepreneurs. Oscar, started by techies in New York, tries to be the patients ally, swapping insurers usual perplexing drivel for clear information. Medicare Advantage, a complement to the traditional public scheme for the elderly, often pays doctors a capped fee to care for patients. Providers profit when patients are well and costs are cut. Americas health market has long been an example of what not to do. If it can serve patients, it just might become the opposite.当病患像消费者一样货比三家时，提供医疗务的人将会更好的微病患务。根据商业药品这个咨询公司的消息，八月，那些在大型商场或者在紧急时段治疗病患的零售药房的数量自去年以来增长了17%。奥巴马医改交易激励了新的保险企业家。奥斯卡，通过纽约哥布林工程师开始，试图与病患组成同盟以厘清保险公司令人费解的说辞获取清晰的信息。医保利益组织，作为传统年长者公共计划的补充，在一身个提供医疗务时通常付他们限定额治疗费。当治好病患并且治疗费用减少时提供务的而机构将会有所收获。长久以来，美国的医疗市场已成为一个典型的反面教材。但倘若它能为病患务，那么它将成为典型的正面教材，成为大家效仿的楷模。 /201409/330713On Tuesday, President Obama called for quicker development of tests, vaccines and treatments to fight the mosquito-transmitted Zika virus. 周二，奥巴马总统呼吁加快对蚊传播病毒的检测、疫苗和治疗。The fast-sping virus has been linked to birth defects and could sp to the ed States in warmer months. 迅速传播的病毒与婴儿出生缺陷有关，在暖和的月份可能会扩散到美国。The White House said in a statement, ;The president emphasized the need to accelerate research efforts to make available better diagnostic tests, to develop vaccines and therapeutics, 白宫在一份声明中表示，“总统强调需要加快研究工作，以便更好的诊断测试、开发疫苗和治疗，and to ensure that all Americans have information about the Zika virus and steps they can take to better protect themselves from infection.; 并确保所有美国公民了解寨卡病毒，更好的保护自己免受传染。”On Monday, the World Health Organization also predicted the virus would sp to all countries across the Americas except for Canada and Chile.周一，世界卫生组织还预测，除了加拿大和智利以外该病毒将扩散到美洲的所有国家。译文属。201601/424516重庆星宸医院属于几级?
重庆新桥医院好嘛重庆市星宸医学美容医院官方网站 Donald Trump is now the presumptive GOP presidential nominee so, what does that portend for Republicans further down the ballot?For Donald Trump to win the presidency, hell have to change the Electoral College map to win states Republicans dont usually win. And, based on Trumps apparent appeal to blue collar voters in old Rust Belt states, Michigan is high on that list.Michigan Republican Congresswoman Candice Miller endorsed Trump last week.;In this case, with Donald Trump, I think Michigan is very much in play. I think the entire electoral map is going to be changing as evidenced by the recent poll that showed that he was neck and neck in three critical states, uh, literally, a dead-heat in Florida, Ohio and Pennsylvania, and if that is happening in Pennsylvania, I believe it is going to be happening in Michigan, as well. And, certainly in Macomb County, home of the Reagan Democrats,; Miller said last week.But, at the same time, Democrats are hoping a lightning rod candidate like Trump will hand them opportunities.In Michigan, were specifically talking about some congressional seats and control of the state House of Representatives.Thats a big deal when you consider its been six years since Democrats controlled the state House. Control would put Dems at the table for the final two years of Governor Rick Snyders administration and it would break the complete GOP hegemony in Lansing.So, the question is: what is the net effect of Donald Trump at the top of the ballot? The definitive answer is: we dont know.This election year has been a wild, unpredictable ride and theres no reason to believe thats going to change. But, that wont keep us from sorting through the possibilities.First off, Bernie Sanders won the Michigan Democratic primary, at least partially, because of opposition to free trade deals that he says have outsourced U.S. jobs overseas. Well, Donald Trump won Michigans Republican primary also slamming trade deals. Might there be some crossover appeal?Meantime, this election, of course, wont be decided just by who turns out, but by who doesnt. And that means something in 2016 when both top candidates—Trump and Clinton—have high negative ratings in most polls.Trumps got the bigger problem in the aggregate, but Republicans say in most of the state House and congressional districts theyre competing in, Clintons got the higher negatives. Democrats say they expect the Trump effect will mostly turn in their favor. So will voter distrust of either or both candidates suppress turnout? And, if so, which side loses more?201605/444367重庆星宸整形整形手术多少钱
重庆星宸医学美容医院有没有位置According to officials, a suicide bomber on a motorcycle killed six NATO troops in Afghanistan on Monday. 据官员报道，周一阿富汗一自杀式炸弹在托车上引爆，造成6名北约士兵死亡。A spokesperson for the coalition said the troops died as the result of a vehicle-born explosive device near Bagram Airfield. 该联盟的一名发言人表示，是巴格拉姆机场附近的车载爆炸装置造成军队死亡。Further details on the circumstances of the attack and nationalities of those involved were not immediately available. 目前还尚不清楚袭击的细节以及涉嫌人员的国籍。Bagram is a large U.S. military base north of Kabul, the Afghan capital. The Taliban posted a message on Twitter claiming responsibility for the attack. 巴格拉姆空军基地是一个大型的美国军事基地，位于阿富汗首都喀布尔以北。塔利班发布消息，声称对此次袭击事件负责。译文属。201512/417347 Social change社会的改变The weaker sex弱男子Blue-collar men in rich countries are in trouble. They must learn to adapt在发达国家的蓝领男性群体正处于困境中，他们必须学会适应。AT FIRST glance the patriarchy appears to be thriving. More than 90% of presidents and prime ministers are male, as are nearly all big corporate bosses. Men dominate finance, technology, films, sports, music and even stand-up comedy. In much of the world they still enjoysocial and legal privileges simply because they have a Y chromosome. So it might seem odd to worry about the plight of men.父系社会现在咋一看似乎正兴盛。超过90%的国家总统总理，和几乎所有大型公司的大boss都是男性。男性统治着经济，科技，企业，体育，音乐，甚至连说相声的都基本是男的。在大多数国家里男人仅仅因为拥有一条Y染色体便享有在社会和法律上的特权，这样看来，担心男性的“悲催命运”般的困境似乎是在杞人忧天。Yet there is plenty of cause for concern. Men cluster at the bottom as well as the top. They are far more likely than women to be jailed, estranged from their children, or to kill themselves. They earn fewer university degrees than women. Boys in the developed world are 50% more likely to flunk basic maths, ing and science entirely.但有却又大量的原由让人不得不担心。男性群体从渣男到精英男，他们在被关进监狱啊，被他们的孩子疏远嫌弃啊，或者自杀率啊都远远大于女性，却在取得更多的大学学位上败给了女性。在发达国家中，有50%左右的男孩会在基础数学，阅读和科学学科上挂掉。One group in particular is suffering. Poorly educated men in rich countries have had difficulty coping with the enormous changes in the labour market and the home over the past half-century. As technology and trade have devalued brawn, less-educated men have struggled to find a role in the workplace. Women, on the other hand, are surging into expanding sectors such as health care and education, helped by their superior skills. As education has become more important, boys have also fallen behind girls in school (except at the very top). Men who lose jobs in manufacturing often never work again. And men without work find it hard to attract a permanent mate. The result, for low-skilled men, is a poisonous combination of no job, no family and no prospects.在男性群体中又有一类人尤其遭罪。在过去的半个世纪里，发达国家里的受教育程度低的男性已经非常难应对发生了巨变的劳工市场和家庭。现代技术革新和贸易已经使原先的靠劳力形式的肌肉男的价值直线下降，缺少教育的男性，不得不在职场中苦苦挣扎，才能得一席之地。相反的，女性却依靠着自身出众的技能，在像医疗卫生和教育这样的领域里大放异。教育已经变成更重要的事情，而男孩却学校里被女孩甩在了身后（尖端领域学科除外）。从工厂失业的男性常从此不再去工作。而没有工作的男性会发现去吸引永久的伴侣是件非常难的事。由此导致低技术的男性被无工作，无家庭，无前景的“三无”剧毒环环围住。From nuclear families to fissile ones从核心家庭到易碎家庭Those on the political left tend to focus on economics. Shrinking job opportunities for men, they say, are entrenching poverty and destroying families. In America pay for men with only a high-school certificate fell by 21% in real terms between 1979 and 2013; for women with similar qualifications it rose by 3%. Around a fifth of working-age American men with only a high-school diploma have no job.持左翼 的人倾向于专注于经济，他们认为减少男性工作的机会会加剧贫穷，并，并摧毁家庭。在美国，只有高中学历的男性的实际收入，从1979年到2013年减低了21%，而同等学历的女性，在此期间的实际收入却提高了3%。约有5分之一的只有高中学历的处在工作适龄的男性，处在失业中。Those on the right worry about the collapse of the family. The vast majority of women would prefer to have a partner who does his bit both financially and domestically. But they would rather do without one than team up with a layabout, which may be all that is on offer: American men without jobs spend only half as much time on housework and caring for others as do women in the same situation, and much more time watching television.持右翼的人担心着家庭的崩溃。绝大多数的女性倾向于和愿兼顾家里财政收入职能和家务劳动职能的男性成为两口子。她们宁愿单身也不愿随便和一个游手好闲的卢瑟勉强过一辈子，而这是有依据的：美国失业男性仅仅只付出同等条件下失业女性的一半的时间来做家务事和照顾彼此的生活，这些男人会花更多的时间来看电视。Hence the unravelling of working-class families. The two-parent family, still the norm among the elite, is vanishing among the poor. In rich countries the proportion of births outside marriage has trebled since 1980, to 33%. In some areas where traditional manufacturing has collapsed, it has reached 70% or more. Children raised in broken homes learn less at school, are more likely to drop out and earn less later on than children from intact ones. They are also not very good at forming stable families of their own.因此工人阶级的家庭变的更易解体。双亲家庭这种形式还是精英阶层的标配，而这种家庭形式却在穷人中正在消失。在发达国家，非婚生子占新生儿的比重比1980年高出了3倍，已经达到了33%。而在一些传统制造业崩坏的地区，这一比例达到70%甚至更高。生活在破碎家庭里的孩子比起一般家庭的孩子而言，在学校里会学的更少，更可能辍学和收入较低。同时，因为不善于处理家庭问题，他们自己日后的家庭也趋于不稳定（简言之单亲家庭的孩子长大后更易于组成新的单亲家庭）。These two sides often talk past each other. But their explanations are not contradictory: both economics and social change are to blame, and the two causes reinforce each other. Moreover, these problems are likely to get worse. Technology will disrupt more industries, creating benefits for society but rendering workers who fail to update their skills redundant. The OECD, a think-tank, predicts that the absolute number of single-parent households will continue to rise in nearly all rich countries. Boys who grow up without fathers are more likely to have trouble forming lasting relationships, creating a cycle of male dysfunction.这两种政治倾向的讨论话题往往会相互交叉重叠。但二者的观点却并不矛盾：经济状况和社会这二者的变革都是造成此类现状的原因，而这二者还互为因果，形成恶性循环。此外，这些问题可能变得更糟。科技将瓦解更多的行业，为社会创造更多的价值，但也将使更多的无法升级自身技能的劳动者失业。 经济合作与发展组织里的一个诸葛天团预测单亲家庭的比例定会继续在所有发达国家中上升。在没有父性角色的家庭长大的男孩，将更可能不能处理好长久关系（如夫妻关系）以至于形成新的单亲家庭，由此形成一个男性功能紊乱的死循环。Tinker, tailor, soldier, hairdresser锅匠，裁缝，士兵和美发师What can be done? Part of the solution lies in a change in cultural attitudes. Over the past generation, middle-class men have learned that they need to help with child care, and have changed their behaviour. Working-class men need to catch up. Women have learned that they can be surgeons and physicists without losing their femininity. Men need to understand that traditional manual jobs are not coming back, and that they can be nurses or hairdressers without losing their masculinity.那么问题来了，我们能做什么呢？其一在于改变文化态度。在过去的一代，中产阶层的男士知晓了他们需要帮忙照看小孩，并由此改变了他们的行为。工人阶层的男士们需要加紧脚步赶上来了。女士知晓了她们可以成为外科医师和物理学家而不失其女性魅力。男人们需要明白传统的体力工作一去不复返，他们可以成为护士或美发师而不失其男性霸气侧漏之美。Policymakers also need to lend a hand, because foolish laws are making the problem worse. America reduces the supply of marriageable men by locking up millions of young males for non-violent offences and then making it hard for them to find work when they get out (in Georgia, for example, felons are barred from feeding pigs, fighting fires or working in funeral homes). A number of rich countries discourage poor people from marrying or cohabiting by cutting their benefits if they do.政府决策人也需搭把手，因为愚蠢的法令会令问题变得更糟。美国减少了对被关押的以百万数计的非暴力犯罪的处于适婚年龄的年轻男子的持，并在他们出狱后找工作这种事上还要制绊脚石造（以乔治亚州为例，罪犯被禁止从事养猪，救火或在殡葬馆工作）。在一些发达国家，为了阻止穷人结婚或者同居这一目的，通过如果他们这么干的话就砍掉他们的福利这种手段来达到。Even more important than scrapping foolish policies is retooling the educational system, which was designed in an age when most men worked with their muscles. Politicians need to recognise that boysunderachievement is a serious problem, and set about fixing it. Some sensible policies that are good for everybody are particularly good for boys. Early-childhood education provides boys with more structure and a better chance of developing verbal and social skills. Countries with successful vocational systems such as Germany have done a better job than Anglo-Saxon countries of motivating non-academic boys and guiding them into jobs, but policymakers need to reinvent vocational education for an age when trainees are more likely to get jobs in hospitals than factories.不过比起废弃愚蠢的政策，改革设计于大多数男人都是用肌肉（而非脑）工作的年代的教育系统显得更为重要。政治家门应该意识到男孩们的学习成绩不良师一个很严峻的问题，并应立足于改善之。一些明智的政策是为每个人都好，特别是对男孩。早期儿童教育会提供男孩们更系统并更能更好的发展他们的口语能力和社会技能。有着成功的职业教育系统的国家如德国，在鼓励男孩去学术化，重职业化，并指导他们工作上，已经做的比起盎格鲁-撒克逊国家而言要好的多了。但政策制定者应将恢复职业教育的重心放在使受训者更倾向于日后在医院工作而不是在工厂工作这种时代要求上。More generally, schools need to become more boy-friendly. They should recognise that boys like to rush around more than girls do: it’s better to give them lots of organised sports and energy-eating games than to dose them with Ritalin or tell them off for fidgeting. They need to provide more male role models: employing more male teachers in primary schools will both supply boys with a male to whom they can relate and demonstrate that men can be teachers as well as firefighters.更广泛而言，学校需要变得更亲男孩化一些。他们应该意识到男孩比起女孩而言就是会更可能到处闯祸：比起给他们吃药或告诫他们不要乱动而言，最好还是提供给他们一些有组织的运动和耗费精力的游戏。他们需要男性榜样角色：在小学阶段，雇佣更多的男性教师，这不但可以给男孩子提供他们可以认同的男性角色，还可以为男人可以像成为消防员一样的成为教师提供实。The growing equality of the sexes is one of the biggest achievements of the post-war era: people have greater opportunities than ever before to achieve their ambitions regardless of their gender. But some men have failed to cope with this new world. It is time to give them a hand.男女越来越平等是战后我们取得的重大成就之一：比起以前，现今人们不论性别都可以拥有更好的机会去实现他们的梦想。但是一些男士未能适应这个新的世界，是时候对他们伸出援手了。 译者:张家铭 译文属译生译世 /201506/379374重庆星辰网上预约重庆市中心医院是正规医院吗?重庆星辰医院正规吗? 重庆新桥医院的评价 重庆市星辰美容医院是私立的吗？健步面诊 重庆星辰医生 光明对话重庆市第四人民医院过年 重庆第四人民医院什么时候建立 重庆市第九人民医院是正规医院嘛 重庆市星辰整形是什么意思导医面诊重庆市星辰整形医院院长是谁 平安大全重庆星宸医院做微创整形手术要多少钱乐视共享