本文节选自《经济学人》2019.01.12期，Asia板块中的一篇关于日本应对老龄化问题的文章。

建议大家先自主阅读原文，再学习精读笔记。本文一共节选四段，读完笔记后，回头再读原文段落，测试自己是否能够流畅阅读，把握文章脉络。

文末会总结此次学习写作可以使用的词句，读者也可自己总结，我会定期将内容进行总结，做成word分享，希望大家也能坚持学习

1

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 for health care and nursing, excluding the charges itlevies 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.

ever-higher：不断升高的。Ever：不断地，总是。Ever-higher，不断地升高。【写作建议】sth continue to increase可以改换成 an ever-higher sth。如the number of overseas students continue to increase = there is an ever-higher number of overseas students nowadays.

a share of：一部分。Let me take a share of your sorrow，让我来承担你的一份哀愁。这里指的是老年人占总人口的一部分。【写作建议】可以替换a part of

fully：强调数量，the whole of，as much as，翻译为：足足，整整。

in turn：除了轮流的意思，还有“反过来”的意思。比如This in turn could trigger their feelings 这反过来会激起他们的情绪。文中即更多的老年人，反过来，意味着更高的医疗费用。

budget ¥1bn（for sth）：为……编制10亿预算

levy：征收，levy on sth or sb，向某人或某组织机构征收税款 levy for sth，为某项计划征收税款

health-insurance scheme：健康保险计划

cut costs：减少支出，【写作建议】可以替换reduce costs

日本的人均寿命为84岁，是全世界最高的国家。这对于其人民来说是好消息，但这意味着老年人口的比重会不断升高。足足有28%的日本人年龄超过65岁，与之相比，美国这个数字仅为15%，而德国也只有21%。老年人数增多，反过来，意味着更高的医疗费用。去年，日本政府为医疗和护理费用做了15万亿的预算，这还不包含为了公共健康保险计划所征收的税款。随着公共债务达到GDP的250%，债务服务费用又花去24%的支出，政府正迫切地寻找方法去降低支出。而照顾在家的人被认为是其中一个最好的办法。

2

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, 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.

entitled to：有权享有的。

a portion of：一部分。与上一段提到的a share of 可以替换

subject to a cap：cap是帽子的意思，subject to 是受制于。合起来，受制于一定头上的帽子，比喻具有一定上限的意思。

introduced：推行，如introduce a new scheme，推行新的计划。不是介绍的意思呦

into which people must pay from the age of 40：这里是定语从句介词提前，pay into存入，存钱，which指代前面新的保险计划。

reckons：这里是估计，估算的意思，与前几篇reckon作认为的意思不同。可以发现，《经济学人》很喜欢使用reckon一词。【写作建议】可以和estimate互换

所有日本人，要么通过他们的雇主，要么通过地方政府，每月支付给公共保险计划一笔保险金。尽管受到上限约束，他们必须支付治疗费用的一部分，但作为回报，他们有权享有公共或私人医生和医院的治疗以及药物。2000年，日本为那些65岁以上，需要长期医疗保健的人提供了另一个公共保险计划，在这个计划中，人们需要从40岁就开始存入。这个计划和前者运作相同。保险金和共付医疗费包含了大约60%的费用，而政府则支付剩余的。而且，老人所占的花费最高，日本政府估算，75岁以上的人每年的健康保健约花去943000的费用，而剩余的人平均只有221000.

3

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.

by the standards of：依据……的标准，可以翻译为以……的标准来衡量

fairly well：相当好，挺不错。例句：I have completed the task fairly well

perform procedures to：procedure是程序，步骤，可以配合动词 perform 执行程序；follow procedure 按程序办事

generic drugs：仿制药，也称非专利药。是指原厂药的专利权过期后，由合格厂商依照原厂药申请专利时所公开的信息，生产制作。

东京圣路加国际大学的池上直己教授说：“以老龄化国家的标准来衡量，日本在减少医疗费用方面做得相当不错。”政府设置了服务费来维持廉价的医疗费用（尽管这样会使那些提供服务的人执行不必要的程序来增加费用），这也会促进更便宜的仿制药物的使用。

4

Nonetheless, the country has crept up to sixth place in the OCED’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. 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.

Nonetheless：尽管如此，despite this fact

creep up：慢慢爬上，上升 【写作建议】creep up to 序数词 place in sth。如after two months’ efforts, he has crept up to second place in class rank. 经过两个月的努力，他的成绩达到了班级第二

It is not just that：这并不仅仅是因为……spending per person：另做主语（人均收入） 两句之间分号隔开。as：引导原因状语从句解释第二句话【写作推荐】

【注】OCED经济合作与发展组织（Organization for Economic Cooperation and Development）

尽管如此，在OCED健康保健支出占GDP百分比的排名中，日本已抬升至第六位，位居法国和美国之后，但在意大利和韩国两个老龄化国家之前。这并不仅仅是因为老年人口在增多，由于人们带病生存更久，如奥兹海默和糖尿病，人均支出也在增多。

总结

ever-higher：sth continue to increase可以改换成 an ever-higher sth。如the number of overseas students continue to increase = there is an ever-higher number of overseas students nowadays.

a share of：可以替换a part of

cut costs：减少支出，可以替换reduce costs

reckons：可以和estimate互换

creep up：慢慢爬上，上升 creep up to 序数词 place in sth。如 after two months’ efforts, he has crept up to second place in class rank. 经过两个月的努力，他的成绩达到了班级第二

It is not just that：这并不仅仅是因为……spending per person：另做主语（人均收入） 两句之间分号隔开。as：引导原因状语从句解释第二句话