开始给出一个问题，可以是明确的设问，也可以是给出一个困难(difficulty)或者任务(task)，后面会对该问题作出解答。
Many United States companies believe that the rising cost of employees' health care benefits has hurt the country's competitive position in the global market by raising production costs and thus increasing the prices of exported and domestically sold goods. As a result, these companies have shifted health care costs to employees in the form of wage deductions or high deductibles. This strategy, however, has actually hindered companies' competitiveness. For example, cost shifting threatens employees' health because many do not seek preventive screening. Also, labor relations have been damaged: the percentage of strikes in which health benefits were a major issue rose from 18 percent in 1986 to 78 percent in 1989.
Health care costs can be managed more effectively if companies intervene in the supply side of health care delivery just as they do with other key suppliers: strategies used to procure components necessary for production would work in procuring health care. For example, the make/buy decision--the decision whether to produce or purchase parts used in making a product--can be applied to health care. At one company, for example, employees receive health care at an on-site clinic maintained by the company. The clinic fosters morale, resulting in a low rate of employees leaving the company. Additionally, the company has constrained the growth of health care costs while expanding medical services.
第一段
观点：许多美国公司认为员工医保福利成本增加损害了美国在国际市场的竞争地位。
事实：结果，上述公司把医保成本以工资扣减的形式转嫁给员工。
观点（问题）：上述策略世纪损害了公司的竞争性。
举例：比方说，成本转嫁威胁员工的健康，因为许多人不会寻求预防性检查。
举例：劳工关系恶化：罢工比例显著上升。
第二段
解决方案：医保成本问题可以得到更有效的解决，如果公司干预医保的供给方，就像他们对其他关键供应商做的事情那样：这样的策略将在设法获得医保方面发挥作用。
举例：比方说购买决策可以应用于医保。
举例：在一家公司，员工在一家由该公司所有的临床诊所获得医保。该诊所鼓舞士气，有助于降低离职率。此外，该公司通过增加医疗服务，控制了医保成本的增长。
