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Joseph: Health insurance premiums are growing at an alarming rate. This is, in part, because many hospitals and clinics bill for unnecessary diagnostics and tests that inflate the subsequent amount that insurers pay out to them. These expenses are then passed on to consumers in the form of increased insurance premiums. Therefore, reducing the number of unnecessary tests performed by health care providers will be effective in controlling growing health insurance premiums.

Ronald: Often times, the unnecessary diagnostics that you speak of are the result of decisions made by doctors on behalf of their patients. Doctors will often choose the diagnostics that will allow them to bill insurers for more money, but may not be necessarily benefit the patient in a meaningful way or influence the course of treatment chosen. As a result, in order to succeed in reducing the number of unnecessary tests, we should allow the patient to decide which course of diagnostics they would like to undergo.

In the table below, identify the assumptions upon which each person's argument depends. Make only one selection in each column, one for Joseph and one for Ronald.
JosephRonaldAssumptions
Doctors are generally able to determine, with great reliability, which diagnostic procedures and tests would yield the most effective results.
Tests and diagnostic procedures do not make up an insignificant portion of the bills that are sent to insurers.
Insurance companies in other industries such as auto and home, have been able to reduce costs by reducing the number of unnecessary repairs and replacements on claims for automobiles and homes.
Patients are not just as likely as doctors to choose the most expensive diagnostics and tests.
Health insurance premiums have increased twice as fast in the past 5 years than they have over an average of the past 25 years.



JosephRonaldAssumptions
  Doctors are generally able to determine, with great reliability, which diagnostic procedures and tests would yield the most effective results.
 Tests and diagnostic procedures do not make up an insignificant portion of the bills that are sent to insurers.
  Insurance companies in other industries such as auto and home, have been able to reduce costs by reducing the number of unnecessary repairs and replacements on claims for automobiles and homes.
 Patients are not just as likely as doctors to choose the most expensive diagnostics and tests.
  Health insurance premiums have increased twice as fast in the past 5 years than they have over an average of the past 25 years.


Joseph argues that growing health insurance premiums can be controlled by reducing the number of unnecessary tests performed by doctors. He says this because many tests that are performed, and then billed to insurance providers, are unnecessary. But note the assumption -- while this practice may relate to **some** excess expenditure, the argument assumes that it's enough excess spending that, if it were cut, the health care industry could save quite a bit. Accordingly, the second assumption, that "tests and diagnostic procedures DO NOT make up an insignificant portion of the bills to insurers", is required. Without it -- if we could then say (via the Assumption Negation Technique) that these tests DO represent an insignificant portion of the bill, then their presence or absence does not matter. Accordingly, Joseph's argument requires that fact.

Ronald argues that, if patients are allowed to make decisions instead of doctors doing so, the number of unnecessary tests will decline. He believes this because of the stated fact that doctors are purposely selecting expensive tests to perform. However, his conclusion is a two-part conclusion -- it's not just that "doctors shouldn't be making these decisions", it's that "patients should, instead". And so his argument assumes that patients will make better decisions. That corresponds with the fourth choice, that "patients are NOT just as likely as doctors to choose the most expensive diagnostics and tests". If that assumption is not true -- if patients ARE just as likely to choose the expensive tests, then Ronald's proposal does not reach his stated aim, to succeed in reducing the number of tests.