The previous post on health care had some confusing and contradictory statistics. Without getting in to details of those, one can say that there is enough evidence (anectodal or otherwise) to show that the number of immigrants without insurance is not insubstantial. And yet its a moot point to say how much of that contributes to the lack of “affordable health care” in the U.S. In other words, there are many more factors that contribute to the health care problem than immigration alone.

As an aside, in my opinion, immigrants shoud not expect the host country to bear the burden of subsidizing or providing free health care. Any such expectation is sure to muddle the issue of how much they are part of the health care problem.

Just now realized that the term “affordable health care” is such a loaded one that its sure to open more cans of worms!

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In response to the previous post, Uninsured in America - Certainly, there are many variables we could map to explore the issue of health care reform and access to insurance. Percents, levels, rates and different indicators – Each will tell a different aspect of the story and in whole, will provide a richer understanding of the issue. The list of related datasets in Geocommons that I am providing on my weekly Wednesday post is designed to allow anyone to go about this type exploration.

The idea to map percentages comes from an article I read last week that talks about a study that was just released by the Commonwealth Fund on health care in America (Aiming Higher: Results from a State Scoreboard on Health System Performance). They rank states based on 20 or so variables (one being percent uninsured). What caught my attention is that Texas ranks the highest in terms of percent uninsured. I was curious about this and what a more fine-grained geographical analysis would show and indeed the results of my mapping were consistent with the findings of the Commonwealth Fund study, at least in terms of the percent who are uninsured. The areas of the country where there are high percentages of individuals without health insurance are in the south and southwest.

When I initially created the map, it sparked another wave of curiosity. Are these immigrants who are the uninsured? What I found is that access to health care insurance is very much tied to immigration and the Hispanic population. Here are some of the statistics I found through the U.S. Census: 1. Immigrants (including naturalized citizens) comprise roughly 26% of the uninsured 2. Foreign borns are 2.5 more likely to not have insurance than native Americans 3. A little over 43% of non-citizens are without insurance and 4. Hispanics, the largest minority group in America, are 3 times more likely than non-Hispanic to have health insurance.

The map in the previous post, showing the numbers of uninsured by county sparked yet another wave of curiosity. I wondered if those counties that ranked high in terms of the numbers were also counties with high concentrations of immigrants and/or Hispanics. When I took a look at some numbers from the Census, I found that indeed, this is the case. A map of the number of uninsured immigrants by county would be an interesting next step in the exploration process!

And there’s the value of sharing analysis and maps online in a collaborative forum – I learned something. It looks like the debate on health care reform is very much tied to the debate on immigration.

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In my opinion, percentages (in this case percentage of uninsured by county) tell a point of view that shows the non-native (immigrant) population along the U.S.-Mexico border is a major contributing factor to the problem of uninsured. In reality, nearly 45 million or so uninsured are scattered across major population centers in the U.S. When ranked by uninsured population, the top ten counties are:

1. Los Angeles Co., CA 2. Cook Co., IL 3. Harris Co., TX 4. Maricopa Co., AZ 5. Kings Co., NY 6. Orange Co., CA 7. San Diego Co., CA 8. Queens Co., NY 9. Dallas Co., TX 10. San Bernandino Co., CA

Nearly 10.5 million (23%) uninsured live in just 25 counties out of total 3,108 counties/jurisdictions in the lower 48. As part of disclosure, let me say this: I am a little skeptical about the whole issue of "Universal Health Care," especially with federal govt playing the role of a mother hen. However, if there is going to be a political debate about the issue, then as a start, it would help to identify concentrations of uninsured based on actual numbers. The map below shows just that, pan around and explore the world of the uninsured.

I would not wish this on anybody, however, it would be interesting to explore spatial distribution of the unfortunate subset from the world of the insured who have gone bankrupt due to escalating health care cost when faced with life threatening diseases in their families. But that would have to wait for another post another day when such data is compiled!

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Following the 2008 Presidential Election? Starting today, I will be posting a regular weekly blog on the election and the issues at the heart of the political debates. For each issue, you will be able to interact with a map to find out more about the problem, find out what the candidates are saying and where they stand on the issue, weigh in on your own opinion and see immediately how others around the country feel about the issue. So, stop by every Wednesday and get to know the issues and the candidates! Today’s focus is on health care reform.

Issue: Should the U.S. government ensure universal access to health care?

Looks like Michael Moore is at it again - This time attacking the U.S. health care system. His latest film, SICKO, takes jabs at the large, profit driven insurance companies and illustrates through a series of satirical vignettes how the United States, as one of the wealthiest nations in the world, has a health care system that is far from accessible to many. Not surprising, this issue has been central to the recent political debates.

One aspect of this problem that people are talking about is access to health insurance. As Michael Moore and many others have recently noted, nearly 45 million people in the U.S. do not have health insurance. That’s roughly 15% of the population.

Here's a little more insight on the problem. The map below plots the percentage of individuals with no health insurance by county, using 2000 data from the U.S. Census, Current Population Survey. One can see that the real area of concern is in portions of the South and most prominently, along the U.S. - Mexico border. In fact, in Hudspeth County, along the border, nearly 40% are without health insurance.

How are the candidates weighing in on the issue? Here are some revealing quotes from some of the recent presidential debates:

Hillary Clinton: “What's important and what I learned in the previous effort is you've got to have the political will… standing firm when the inevitable attacks come from the insurance companies and the pharmaceutical companies…”

John Edwards: “I'm proud of the fact that I was the first person to come out with a specific, truly universal health care plan…I'd pay for it by getting rid of Bush's tax cuts for people who make $200,000 a year.”

Rudy Giuliani: “The problem with our health insurance is it's government and employer-dominated. People don't make individual choices. It's your health; you should own your health insurance."

John McCain “Another one I think is important is a $3,000 tax credit for people to be able to purchase health insurance, so low- income Americans will have access to health care…”

Barack Obama: “My belief is that most families want health care but they can't afford it. And so my emphasis is on driving down the costs, taking on the insurance companies, making sure that they are limited in the ability to extract profits and deny coverage…”

Mitt Romney: “The market can work to solve our health care needs, and that’s the great, exciting news.

How do you weigh in on the issue?

Want to find out more about the issue of health reform in the United States? Use the key word "health" in geocommons to find a variety of data on different aspects of the issue - e.g., access to physicians, hospice care, health insurance coverage for immigrants and mortality and incidence rates for a range of diseases and disorders.

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A few weeks ago James Fee wrote a blog post about a debate he had with Steven Citron-Pousty concerning the usefulness of GeoCommons. From a high level the argument came down to the GIS vs. Neogeogrpahy debate. There were great quotes on both sides like “freaking sweet” in support and “pretty worthless” in the bashing category. Over all we were excited to see that GeoCommons had started a debate in the GIS community. The intent of GeoCommons had originally not been to provide a resource to the GIS community, but to provide access to GIS data and a few tools to the rest of the world. The GIS community always had access to the data and the tools, so I had figured GeoCommons would not even pop up on the radar. In hindsight I think we should be providing mutual resources to each other, so with that in mind here are few thoughts on the topic.

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