The author cites what is wrong with the state of the current healthcare system and what could be done to fix it. Whether the author is irrational would be an opinion of the material presented, but not the author’s voice. The passage draws too many references to fault, rendering it very partial. There is no information to support a moral platform. The passage refrains from both mocking sneering, never intonating sardonicism.

All Americans are affected by the healthcare system provided they live in the country. Therefore, it could not be limited to any of the other choices, as it would be all-inclusive.

The author reports the Institute of Medicine findings after much research in the first half of the passage and then delivers the possible solutions in the second half. There is no counterpoint, so the answer is not choice a. The Institute of Medicine isn’t presenting a hypothesis, making choice b incorrect. There isn’t a comparison being drawn, so choice d is incorrect. Attacking denotes violence, an emotional response far more drastic than this passage ever suggests, rendering choice e incorrect.