Patient advocate: A new pancreatic cancer treatment has proven

Question

Patient advocate: A new pancreatic cancer treatment has proven to decrease mortality by 10% over the treatments currently available under your company's insurance plans. Allowing doctors to prescribe the new treatment could save many lives.

Insurer: You fail to recognize that the new treatment is more than twice as expensive as the others. Including the new treatment in our plans would more than double our costs - and therefore dramatically increase premiums - while providing only marginally better care.

Which of the following is an assumption required by the insurer's argument?

(A) Insurance companies should not value the saving of lives more than they value corporate profits.

(B) New treatments should only be included in insurance plans if they increase positive patient outcomes at a higher percentage than they increase costs.

(C) There is no affordable test to determine which patients' lives would be more likely saved by the new treatment than by the old treatment.

(D) No other insurance companies offer the new cancer treatment in their insurance plans.

(E) The pancreatic cancer treatments currently offered by the insurer's plans will not become more effective over time.

aditya201819 · Accepted Answer

I will go with C here is why:-
Patient's Advocate:-
Premise: A new treatment has proven to decrease mortality rate by 10 % and therefore Conclusion 1: Allowing doctor to prescribe new prescription can save many life.
Insurance Company:- 
Premise: The new treatment is 2 times more expensive and including new treatment in our plan will increase the premium while only marginally provide better care.
Conclusion 2:  dramatic increase in premium (200%) is not justified for marginal improvement (10% improvement) in healthcare. therefore it should not be included in the plan. 
we have to find out the option which is required assumption for conclusion 2
No let us look on the answer choices one by one

(A) Insurance companies should not value the saving of lives more than they value corporate profits.-- lets negate this--- insurance company should value the saving lives more than they value corporate  profit. 
-- Irrevlevant the conclusion does not talk about profit it is talking about increased  premium or cost. 
(B) New treatments should only be included in insurance plans if they increase positive patient outcomes at a higher percentage than they increase costs.--  tempting one:- but this is not neccessary, please look on the word   ONLY.   The insurance company may include the new treatment even if it sees 70 to 80 % improvement with 200% increase in cost we never know

(C) There is no affordable test to determine which patients' lives would be more likely saved by the new treatment than by the old treatment- Correct Answer:-  Lets negate this. There are some affordable test to determine which patients lives would be more likely saved- this means that those who know that their life will be more likely to be saved will pay 200% to increase their chances of survival (of course by some greater margin than 10%) while others can keep on paying the lower premium, and therefore this gives a reason why insurance company should include it in its plan.
 
(D) No other insurance companies offer the new cancer treatment in their insurance plans.--  irrelevant

(E) The pancreatic cancer treatments currently offered by the insurer's plans will not become more effective over time.---  irelevant

kunalcvrce · Answer

(A) Insurance companies should not value the saving of lives more than they value corporate profits.: Incorrect-topic doesnt insurance companies values.

(B) New treatments should only be included in insurance plans if they increase positive patient outcomes at a higher percentage than they increase costs.: Correct

(C) There is no affordable test to determine which patients' lives would be more likely saved by the new treatment than by the old treatment.: Incorrect-topic doesnt talk about test.

(D) No other insurance companies offer the new cancer treatment in their insurance plans.: Incorrect-topic doesnt talk about other insurance companies

(E) The pancreatic cancer treatments currently offered by the insurer's plans will not become more effective over time: Incorrect-  Since topic doesnt discuss about insurers plan.

AshutoshB · Answer

IMO Answer should be: C

A) WE cannot say this based on the premise

B) What suspicious about this is"  Only " & " Higher percentage than they increase costs  this is too trong to be an assumption

c)  CORRECT  If there are some ways to determine that those patients whose rate of survival would increase by this new treatment
 Then only those patients would bare extra 200% cost and this will save other from paying extra, So this way Insurer Argument will be hurt

D) Irrelevant

E) Irrelevant

AshutoshB · Answer

IMO Answer should be: C

A) WE cannot say this based on the premise

B) What suspicious about this is" Only" & "Higher percentage than they increase costs this is too trong to be an assumption

c) CORRECT If there are some ways to determine that those patients whose rate of survival would increase by this new treatment
Then only those patients would bare extra 200% cost and this will save other from paying extra, So this way Insurer Argument will be hurt

D) Irrelevant

E) Irrelevant[/quote]
The problem with C is that we don't know which percentage of all patients should be treated with the new method. Let's assume that 80% can be treated. In this case premiums would rise dramatically for everyone because there are not individual rates. Hence, the insurer's argument would make sense.

In contrary, if only 10% of patients could be treated with the new method, premiums would only rise slightly. In this case, the insurer's argument wouldn't make sense.[/quote]

As we know a medical insurance can have multiple options and riders and premium varies accordingly. If someone knows he can be treated by the new method he can afford to pay the higher premium (200%) but if there are no test available that can Identify people who have high likelihood of cure then it wont make sense to include this new method because it will increase the premium for everyone (since nobody knows the likelihood by what percent mortality will reduce)[/quote]

Exactly this is my point

Nightmare007 · Answer

*Edited the color of my explanation of why E is wrong.

Hi  abhimahna  , 
Can you please explain me where am missing.
Thank you in advance.

abhimahna · Answer

Hey  Nightmare007  ,

Insurer said "Hey, your plan is very costly. Since it saves only 10% of the people, I don't think there will be much benefit of increasing the premium."

I can very well say that the author is assuming everyone is going to buy the plan or there isn't any way to understand who should be the real receiver of the plan before the plan can actually be assigned. Hence, option C is correct.

Now, you need to understand that the key words to solve this question are " Including the new treatment in our plans would increase premiums while providing only marginally better care.". Meaning not beneficial for all.

Does that make sense?

Mavisdu1017 · Answer

Hi expert,
I was stuck between C and E. If negate E ---> The new treatments currently offered will become more effective over time, thus can weaken the conclusion "providing only marginally better care", so I can E is correct too. 
Any expert would like to shed some light? Thanks

Afn24 · Answer

I am not an expert and it took me more than 5 mins to get the correct answer C.
B - Is incorrect coz even if you do the calculations: the percentage increase in Cost Suppose (20k to 45k) = 125%
 and Suppose if earlier 7 people were saved and now 8 people are saved (as per 10% improvement), then percentage improvement = 
 (8-7/7) X100 = 14.28%, which is way less than 125% increase in cost. In other words, this isn't possible.

C - is correct, Coz if there is a cheaper way to find out which patient will survive the new treatment, the company will include the treatment and ask the patient to pay a higher premium, therefore making more profit and not having to pay the insurance claim in case the patient doesn't survive the new treatment.

gullyboy09 · Answer

Hi  MartyMurray ,  KarishmaB , can you please help me with the below Q, maybe my understanding is not 100% correct here.

My issue with option C is that it talks about determining which patient will more likely be saved by the new treatment. Now if the person is "already" a "patient", then why would insurance company sell an insurance to him? If they do, then they need to pay 100% everytime, as person is already a patient. So even if there is a test available to see which method will suit a patient, but it's after someone is diagnosed with cancer!