The Problem of Scarce Resources: reading answers and analysis
The passage looks at how health-care resources should be shared out. After the war people assumed economic growth would meet every health need, but from the 1950s the limits became clear, just as health-care came to be seen as a basic right that the state must guarantee. Rising costs and ageing populations then made the problem urgent.
The headings (28-31) cover A, C, D and E in order, with B given as the example. The time-period classification (32-35) uses B, D and E. The YES / NO / NOT GIVEN statements (36-40) run from C to E.
Answer key and self-check
Type what you wrote and hit mark. Hide the key first if you haven't done the passage yet. Every question number jumps to its explanation.
How to attack this block: C and D both discuss rights, so separate them carefully: C links health-care to other rights, and D sets out what the state must do. A states a problem that is 'not new' and faced by every developed society.
Question 28
Answer: ivSection A, second sentence
Which heading fits Section A?
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
Question says → Passage says
A problem shared by every economically developed countryEvery health system in an economically developed society is faced with the need to decide
Why: A sets out the problem of how to divide health-care resources and says every developed society faces it. 'Every' and 'economically developed' appear in both the heading and the text. iv.
The trap: Heading v (recent change) can seem right because A is the opening. But A says the problem is 'not a new one', which is the opposite of a recent change.
Question 29
Answer: iSection C, second sentence
Which heading fits Section C?
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
Question says → Passage says
The connection between health-care and other human rightsnecessary for people to exercise their other rights
Why: C argues that health-care is a basic right because without it you can't use your other rights, such as personal liberty. That connection is heading i.
The trap: Heading iii (role of the state) is tempting because rights often lead to government duties, but the state isn't mentioned until D.
Question 30
Answer: iiiSection D, second and third sentences
Which heading fits Section D?
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
Question says → Passage says
The role of the state in health-carean obligation or duty for the state to ensure… The state has no obligation to provide a health-care system itself
Why: D defines exactly what the state must do (make sure care is funded) and what it doesn't have to do (run the system itself). That's iii.
The trap: D starts with the right to health-care and ends with autonomy, which echoes heading i. Those are links back to C. The new material in D is the state's duty.
Question 31
Answer: vSection E, second sentence
Which heading fits Section E?
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
Question says → Passage says
The impact of recent changemore specific changes that have led to the present concern / the dramatic rise in health costs
Why: E describes changes (rising costs, an ageing population) and their effect: today's worry and the 1980s doomsday scenario. Changes plus their impact is heading v.
The trap: Heading vii (the end of an illusion) is tempting because E opens with resources that 'could not possibly meet the demands'. But E's focus is the cost figures and their consequences, not a belief being lost.
Classification (time periods A-C)
Questions 32-35
How to attack this block: Three of the four are between 1950 and 1980, so don't expect an even spread. Find the date attached to each development, not the date of the paragraph around it, and watch the near-misses: 'the late 1970s' is before 1980, and the post-war belief is before 1950.
Question 32
Answer: BSection B, third and fourth sentences
When did people first realise national health resources were limited?
in the 1950s and 1960s, there emerged an awareness in Western societies that resources for the provision of fossil fuel energy were finite… The new consciousness that there were also severe limits to health-care resources was part of this general revelation
Question says → Passage says
the realisationThe new consciousness
were limitedsevere limits to health-care resources
Why: The realisation about health-care limits was 'part of' the 1950s-60s awareness of finite resources. That's between 1950 and 1980, B.
The trap: A is tempting because the 1945-50 period is mentioned in the same paragraph, but that's when people assumed resources were unlimited, the opposite belief.
Question 33
Answer: BSection E, third sentence
When did health-care costs first rise sharply?
health costs increased from 3.8% of GDP… in 1960 to 7% of GDP in 1980
Question says → Passage says
a sharp rise in the cost of health-carethe dramatic rise in health costs / increased from 3.8% of GDP… in 1960 to 7% of GDP in 1980
Why: Costs almost doubled as a share of GDP between 1960 and 1980. That's when the sharp rise first happened, so B.
The trap: C is the trap. The 1980s doomsday scenario and predictions of further rises come after 1980, but the question asks when the rise first occurred.
Question 34
Answer: ASection B, last sentence
When did people believe economic growth would supply all the health-care needed?
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… the 'invisible hand' of economic progress would provide
Question says → Passage says
a beliefit was assumed without question
would be produced by economic growththe 'invisible hand' of economic progress would provide
Why: 'Immediately after the 1939-45 World War' places this belief right after 1945, so A.
The trap: B is tempting because this sentence sits in a paragraph about the 1950s. Look for the date in the sentence itself: just after the war.
Question 35
Answer: BSection D, first two sentences
When was it accepted that the state must guarantee health-care?
by the late 1970s it was recognised in most societies that people have a right to health-care… It is also accepted that this right generates an obligation or duty for the state
Question says → Passage says
an acceptanceIt is also accepted
the role of the state in guaranteeing the provisionan obligation or duty for the state to ensure that adequate health-care resources are provided
Why: The right, and the state's duty that comes with it, was recognised 'by the late 1970s'. The 1976 WHO declaration fits the same period. That's before 1980, so B.
The trap: 'Late 1970s' is close to 1980, and some students pick C. The late 1970s still come before 1980.
YES / NO / NOT GIVEN
Questions 36-40
How to attack this block: The NO turns on 'never', and the YESes are straight paraphrases of the timing and the population changes. The two NOT GIVENs ask about government estimates and elderly people paying their own way, which the writer never discusses.
Question 36
Answer: NOSection C, last two sentences
Has personal freedom never been seen as linked to health-care?
People are not in a position to exercise personal liberty and to be self-determining if they are poverty-stricken… In the same way, basic health-care is a condition of the exercise of autonomy.
Question says → Passage says
Personal liberty and independencepersonal liberty and to be self-determining / autonomy
never been regarded as directly linkedbasic health-care is a condition of the exercise of autonomy
Why: The writer says health-care is a condition for autonomy, so the two are directly linked. Section D repeats it. The statement says they've never been linked, so NO.
The trap: 'Never' is the giveaway. The passage shows the link being made, so this is a clear contradiction, not NOT GIVEN.
Question 37
Answer: YESSection C, first sentence
Did health-care become a right at about the same time its limits became obvious?
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
Question says → Passage says
at about the same timeat exactly the same time
the limits of health-care resources became evidentthis new realisation of the finite character of health-care resources was sinking in
came to be seen as a rightpeople have a basic right to health-care
Why: The writer stresses the timing: the two ideas developed together, even though they pull in opposite directions. E opens with the same point. YES.
The trap: 'Exactly' versus 'about' worries some students, but 'exactly the same time' certainly supports 'about the same time'.
Question 38
Answer: YESSection E, second sentence
Have population changes affected health-care costs in OECD 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
Question says → Passage says
population changeslarge-scale demographic and social changes
had an impact on health-care costselderly people are now major (and relatively very expensive) consumers
Why: 'Demographic' means to do with population. These changes made elderly people major and expensive users of health-care, which pushes costs up. YES.
Question 39
Answer: NOT GIVENSection E, third sentence
Have OECD governments always underestimated how much health-care was needed?
health costs increased from 3.8% of GDP… 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
Question says → Passage says
OECDin OECD countries as a whole
Why: The passage gives cost figures and predictions, but never says governments got their estimates wrong, let alone consistently. NOT GIVEN.
The trap: Rising costs and a 'doomsday scenario' make it easy to assume governments underestimated. That's a guess about planning the passage never discusses.
Question 40
Answer: NOT GIVENSection E, second sentence
Will elderly people in most developed countries have to pay for their own health-care in future?
elderly people are now major (and relatively very expensive) consumers of health-care resources
Question says → Passage says
the elderlyelderly people
Why: The writer only says the elderly are now big and expensive users of health-care. There's no prediction about them making their own arrangements. NOT GIVEN.
The trap: The doomsday scenario of rising costs and shrinking resources might suggest the elderly will have to pay. The writer never draws that conclusion, and D says the state must ensure basic care is provided.
The elderly are expensive health-care users, but the writer never says they'll have to pay for themselves. NOT GIVEN.
Words from this passage worth keeping
apportioned(A)
shared out or divided among people
finitude(B)
the state of being limited
exhaustible(B)
able to be used up completely
autonomous(C)
independent and able to make your own decisions
poverty-stricken(C)
extremely poor
indispensable(D)
absolutely necessary
demographic(E)
relating to the structure of a population, such as age
extrapolations(E)
predictions made by extending current trends
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The full Cambridge 4 Test 4 reading paper: all three passages, 60 minutes, marked the second you finish with a review of every answer. Already done it? Take it again and see if the same traps still get you.
Cambridge IELTS 4, Test 4, Reading Passage 3. The passage and questions belong to Cambridge University Press and are not reproduced here. We quote short extracts only as evidence for our own commentary, and the answers are published for self-marking. Get the book for the full text, or sit the test on Langujet.
