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. Medical experts know that people can reduce their chances of getting heart disease by exercising regularly, by not smoking, by changing their diets, and by paying more attention to reducing stress in their work.
心脏病是西方世界最大的杀手之一。在过去的三十年里，心脏病的病死率增长速度惊人。例如，现在在英国，每天大约有400人死于心脏病。医学专家知道，人们可以通过定期锻炼、戒烟、改变饮食习惯以及更加注意减轻工作压力来降低患心脏病的几率。
However, Western health-care systems are still not paying enough attention to the prevention of the disease. There is a need for more programs to educate the public about the causes and prevention of heart disease. Instead of supporting such programs, however, the U.S. health-care system is spending large sums of money on the surgical treatment of the disease after it develops. This emphasis on treatment clearly has something to do 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．Many operations that were considered impossible or too risky a few years ago are now performed every day in U.S. hospitals. The result has been a huge increase in heart surgery.
然而，西方卫生保健系统仍然没有对预防心脏病给予足够重视，需要更多的项目来对公众进行心脏病病因和预防的教育。美国卫生保健系统没有支持这些项目，却在疾病发展后外科手术治疗上投入了大量资金。这种对治疗的强调显然与过去十到十五年的技术进步有关。这一时期，现代技术使医生们能够开发出新的外科技术。许多几年前被认为不可能或风险太大的手术现在每天都在美国的医院里进行，结果就是心脏手术的数量大幅增加。
Although there is no doubt that heart surgery can help a large number of people, some people point out that the emphasis on the surgical treatment of the disease has three clear disadvantages. First, it attracts interest and money 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 unnecessary－because the equipment and exert skills are there. A government office recently stated that major heart surgery was often performed even though its chances of success were low. In one type of heart surgery, for example, only 15 percent of patients improved their conditions after the surgery. However, more than 100 000 of these operations are performed in the United States every year.
毫无疑问，尽管心脏手术可以帮助很多人，但一些人指出，强调对这种疾病的外科治疗有三个明显的缺点。第一，它吸引走了人们对预防问题的兴趣和资金；第二，在医院购买了现代心脏手术所需的昂贵设备后，他们必须设法回收所花费的钱。为此，提高了所有患者的成本，不仅是那些治疗需要设备的患者；第三，鼓励医生进行手术——即使对不需要手术的患者也是如此——因为设备和技能都有。政府办公室最近表示，尽管大型心脏手术的成功率很低，但通常都会进行。例如，手术后，只有15%的患者病情有所改善。然而，美国每年有超过10万例此类手术。
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