Rising health insurance costs and harsh social stigmas ---- many employers to overlook workers’ mental health needs, but ignoring the problem ---- more than addressing it.

A) will cause / had cost

B) cause / will have cost

C) are causing / may have cost

D) caused / has cost

E) have caused / should have cost


Hi Native Speakers,

The one above is taken from a recent English Proficiency Exam. "C" is the given answer as is issued in the Official Key. I acclaim that "may have" is much too stilted and disorganizes the course of events in the sentence. Apparantly, regardless of an appropriate tailoring, the question herementioned is axtracted from the following paragraph in which the original option is "MAY"

Employers who provide for mental health care may cultivate a better balance sheet as well as a happier lunch room. Rising health insurance costs and harsh social stigmas cause many employers to overlook workers' mental health needs, but ignoring the problem may cost more than addressing it.

Researchers at the Johns Hopkins School of Medicine recently reviewed 103 studies covering mental health and factors such as health care dollars spent; worker productivity, retention and absenteeism; and workplace morale. Certain studies showed that health insurance claims of workers with both mental and physical disorders were 1.7 times higher than those of workers with physical disorders alone

What's your view of it. Do you have any sound grounds to justify the validity of the question.We think a "may" rather than a "may have" option is the correct wording.
>I acclaim that
I claim that

The original text puts the emphasis on what may happen in the future (in the 2nd part of the sentence) in terms of cost.

The text for the exam puts the emphasis on what may have happened in the past in terms of costs. The 2nd part of their pairs shows that.

Both are correct, but not the same, of course.
Their version and their answer is appropriate for the past.
C does appear to be the best answer, regardless of what the question might have been in different circumstances.. are causing is present tense, and may means it is possible that ..., which is also present. Both present and present perfect are "present-point-of-view" tenses, so everything seems to match all right.

X and Y are causing employers to ..., but it is possible that ignoring the problem has (already) cost more than addressing it.