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Difficulty: HardStrengthening Arguments

To reduce emergency room overcrowding, a city's health department opened several free outpatient clinics in low-income neighborhoods. Six months later, emergency room visits among low-income residents had increased by 12 percent. Consequently, municipal auditors concluded that the clinic program failed to reduce emergency room usage. Health administrators maintain, however, that the program is effectively accomplishing its intended goal.

Which of the following, if true, provides the strongest support for the health administrators' position?

  1. A
    Staff at the new outpatient clinics routinely referred patients presenting with minor, non-emergency conditions to local hospital emergency rooms due to clinic scheduling backlogs.
  2. B
    The city expended a larger portion of its annual municipal healthcare budget on operating the new clinics than it originally allocated during the planning phase.
  3. During the same six-month period, an unusually severe flu outbreak caused emergency room visits to surge by 35 percent among residents in comparable neighborhoods lacking free clinics.Answer
  4. D
    Surveyed low-income residents reported that emergency rooms were preferable to outpatient clinics because emergency departments operate continuously 24 hours a day.
  5. E
    Prior to the opening of the new clinics, hospital emergency room overcrowding had been identified by municipal leaders as the city's most urgent healthcare priority.

Answer

The statement showing that emergency room visits surged by 35 percent in comparable neighborhoods without free clinics provides the strongest support for the administrators' position.
The option citing a 35 percent surge in emergency room visits in comparable neighborhoods without clinics establishes a critical counterfactual baseline. It demonstrates that a widespread external event (the severe flu outbreak) naturally increased emergency room reliance across the city. Because emergency room usage in neighborhoods with clinics only increased by 12 percent, the clinics successfully mitigated what would have been a much higher increase, thereby validating the administrators' claim of efficacy.

Step-by-Step Solution

1
Deconstruct the argument structure
Premise 1: Clinics were opened to reduce emergency room usage. Premise 2: Emergency room visits increased by 12 percent after six months. Auditors' Conclusion: The program failed. Administrators' Conclusion: The program is effectively accomplishing its goal.
Identifying the disagreement between the auditors and administrators isolates what needs to be strengthened.
2
Identify the logical gap in the administrators' claim
The administrators must explain why a 12 percent increase in emergency room visits does not mean the program failed to reduce emergency room usage.
Strengthening an apparently contradictory claim requires establishing an unobserved baseline (what would have happened without the clinics).
3
Evaluate the choices for counterfactual support
Showing that visits rose by 35 percent in neighborhoods without clinics proves that the clinics held the increase to only 12 percent despite a major external surge factor (the flu outbreak).
Ruling out alternative explanations and establishing that the outcome would have been far worse without the intervention strongly supports efficacy.

Key Concept

Strengthening Arguments via Counterfactual Baseline Analysis
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Topics

Strengthening Arguments

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