Read the passage and mark the letter A, B, C or D on your answer sheet to indicate the best answer to each of the following questions from 3...

Read the passage and mark the letter A, B, C or D on your answer sheet to indicate the best answer to each of the following questions from 33 to 40.

        The pandemic made plain that resilient systems are not a luxury but an obligation: financing, staffing, and infrastructure must be orchestrated so care remains affordable and universal. In Europe – facing ageing populations and chronic disease – out-of-pocket charges remain a salient barrier, especially where benefits are narrow or cost-sharing is steep. If coverage were broadened while procurement became leaner, households would be less exposed to onerous bills. Yet geography matters: uneven provider distribution means rural residents may still be stranded even when nominal entitlements look generous.

        Ireland’s 2023 expansion of GP Visit Cards lifted income thresholds and ages, pairing access with training funds to avert bottlenecks. Romania, by contrast, tackled informality through household-work vouchers that pull domestic workers into contributory health insurance. If reforms ignore informality, universality remains a slogan rather than a lived guarantee. Together, these moves show coverage is not merely a legal promise but an administrative craft: rules, incentives, and enrolment pathways must be engineered so marginalized groups can actually enter the system.

        Croatia reorganized provision to standardize waiting times, centralize procurement, and rebalance urban–rural capacity; patient co-payment ceilings were adjusted, while counties shifted toward single integrated health centers. Finland executed an even larger redesign, consolidating health and social care into welfare counties financed mainly by central government so risks and responsibilities could be pooled. This seeks to blunt fragmentation, align primary with specialized services, and reduce postcode lotteries – because governance architecture, though invisible to patients, quietly decides who waits, who pays, and who falls through the cracks.

        Beyond UHC, care reforms targeted adequacy for people needing long-term or family-based support: Austria boosted allowances and bonuses for low-income carers; Germany indexed home-care benefits and extended support leave; Slovakia compensated wage losses for relatives providing palliative care. Such measures braid social protection with health delivery. If sustained, they can stabilize households during shocks, from pandemics to recessions, by cushioning both clinical needs and the unpaid labor that keeps frail dependents safe.

(Adapted from https://www.issa.int/analysis/recent-health-reforms-europe)

Question 33. Which of the following is TRUE according to paragraph 2?

A. Ireland’s reform mainly raised hospital budgets rather than altering eligibility thresholds.

B. Romania’s voucher reform channels informal domestic workers into contributory health insurance.

C. Ireland’s GP expansion focuses on specialist referrals instead of primary care access.

D. Romania’s reform reduces employer taxes by abolishing social contributions entirely.

Question 34. The word salient in paragraph 1 can be best replaced by ______?

A. peripheral                B. conspicuous                C. evanescent                D. trifling

Question 35. Which of the following is NOT mentioned in paragraph 3 as an organizational objective?
A. Pooled financial risk across wider units                B. Reduced service fragmentation

C. Expansion of private insurance markets        D. Standardized waiting times

Question 36. The word This in paragraph 3 refers to ______.

A. Finland’s consolidation of health and social services into welfare counties

B. Croatia’s increase in the co-payment ceiling

C. Ireland’s GP Visit Card threshold changes

D. Slovakia’s palliative-care wage compensation

Question 37. Which of the following best paraphrases the underlined sentence in paragraph 2?
A. If reforms fail to address informal employment, universal coverage becomes aspirational rather than operationally realized.

B. Neglecting informal sectors ensures that universality exists in principle but not in tangible service delivery.

C. Without addressing informality, universal health systems risk remaining rhetorical commitments rather than practical realities.

D. Unless policies confront informal work, legal promises of universal care will not materialize in everyday access.

Question 38. The word onerous in paragraph 1 is OPPOSITE in meaning to ______.

A. trivial                B. effortless                        C. lightweight                        D. simple

Question 39. Which paragraph mentions measures that integrate social protection with health to support family carers?

A. Paragraph 1        B. Paragraph 2                C. Paragraph 3                D. Paragraph 4

Question 40. Which paragraph mentions incentives and administrative pathways designed to bring marginalized workers into coverage?

A. Paragraph 2        B. Paragraph 1                C. Paragraph 3                D. Paragraph 4