File talk:Universal health care.svg

Move discussions to commons

Going forward, for simplicity, let's move all discussion to here, since this map is used in several different wikis:

Moved to commons:File_talk:Universal_health_care.svg

 – Discussion on the UHC map is moved here. Please continue this discussion there. Obi-Wan Kenobi (talk) 20:30, 18 March 2013 (UTC)

Mandate for Universal Health Coverage

Most countries have a constitutional mandate requiring universal health care, or designating health care as a right, and a lot of these on the map have not been colored orange/pink including: Mexico, Peru, China, Libya, Egypt, Kenya, Ethiopia, South Africa, India, Pakistan, Indonesia, Malaysia, Iraq, Honduras, Guatemala, El Salvador, Nicaragua, Democratic Republic of the Congo, and Kazakhstan to name a few. All these countries have a legislated mandate for health care. ZacharyGeorgeNN (talk) 00:58, 20 October 2012 (UTC)

Turkey

Turkey does have a universal healthcare system 94.123.194.206 (talk) 13:58, 9 April 2012 (UTC)

So does China. --GuyWithoutAUsername (talk) 22:15, 25 May 2012 (UTC)

After reviewing the information shared at This WHO report, the WP Article Universal health coverage by country and the information provided by the National Health Insurance Fund of Bulgaria I came to the conclusion that Bulgaria, at least according to its laws and statutes, has an universal health insurance. --dimi_z (talk) 10:14, 29 June 2012 (UTC)

Colours

Algeria, Azerbaijan, Bahrain, Barbados, Belarus, Bhutan, Bulgaria, China (including Hong Kong and Macau), Colombia, Costa Rica, Cyprus, Egypt, Georgia, Ghana, India, Iran, Jordan, Kazakhstan, Kuwait, Libya, Malaysia, Malta, Mexico, Mongolia, Morocco, North Korea, Pakistan, Panama, Peru, Serbia, Seychelles, Singapore, South Africa, Syria, Thailand, Trinidad and Tobago, Tunisia, Turkey, Turkmenistan, the United Arab Emirates, and Venezuela should also be coloured orange because they have some type of universal health care as well.

User:Djodjo666 (talk) 18:56, July 5, 2012 (UTC)

Difference

that's the rub; what are we trying to say with this diagram; what is the diff between 'has some type of' and 'attempting to achieve'? I'd rather we define some firm metrics and define the image based on those vs these vague terms we have now. --KarlB (talk) 18:10, 2 July 2012 (UTC)

Ok, let me clear up these "vague terms" for you: places that "have some type of" universal health care already have universal health care and places that are "attempting to achieve" universal health care don't have universal health care yet but are considering getting it. Whoever the hell you are, please try to think of the answers to questions like these yourself before bothering other people about them. I feel like I'm teaching a 2-year-old when I'm answering these questions because the answers are just so obvious that anyone who isn't completely brain dead can figure them out. I thank you for attempting to achieve knowledge like that because it means that at least you're interested in not being a clued-out idiot.

User:Djodjo666 (talk) 14:45, July 2, 2012 (UTC)

Thanks for your comment. Please remember to be civil. The definition of having 'UHC' is under debate; for example, some sources (like ILO) claim the US has UHC b/c anyone can access care in an emergency room; others claim our medicare/medicaid is a form of UHC. So it depends on which definition you are using, and the extent of the coverage offered - does UHC mean access to care, access to affordable care, is it access covered via social health insurance, or through other government mechanisms? How broad does the reach have to be before it is considered universal? 60%? 95%? Is Thailand's UHC equivalent to that of Finland? Is their package comparable? What happens if the package is only available to those in the formal sector? Or what happens if the co-pays are too expensive for the poor? UHC is a journey, not a destination; if you read the recent WHO report it will perhaps shed some light on this area for you. [1] But attempting to achieve can be used to describe many countries, but it's very vague and has no sources behind it; nor does "have some type of". If we said something like countries which have a social health insurance programme in place covering at least 80% of the population with a basic package of primary care + xxx, then we're starting to talk about real indicators; and when we say "attempting to achieve" if that was turned into an indicator like "national government has passed laws with a target of increasing coverage for population up to x% by year z", demonstrating some sort of credible political commitment then you have something. But again as framed, this is currently way too vague and potentially OR. This graph is an important one, and needs to be based on sources, not just claims by some government that they "have" UHC; and thus far, due to the diversity of these programmes, it has not been commonly done to build a map - we need to tread carefully. --KarlB (talk) 19:20, 2 July 2012 (UTC)

Very well then, you've shown me that you're more intelligent than my first impression of you made me believe. You've brought up some very good points here and I can tell you've done a lot of research. While explaining universal health care around the world in a detailed way such as you've suggested would be good for the article, the information presented on a diagram such as this map can only be so complex, so thus it must be heavily simplified as there isn't room on the map to go into great detail about each country's health care system.

Djodjo666, 2:56, July 3, 2012 (UTC)

I agree, we can't go into all of those details; but it seems there is interest in having some sort of levels in the graph (as opposed to a binary "has UHC" and "doesn't have UHC") so what we really need are sources that somehow differentiate between different levels of coverage in the health system. ILO and WHO are probably the best places to start to look. For an explanation of why this current graph is a bad idea, it has now been replicated all over the web by lazy journalists and bloggers (without reflection), and it shows Thailand as attempting to get UHC, while Thailand today has about 99.9% coverage of its population, so it certainly qualifies as having achieved universal health coverage; but the graph didn't say so; mexico is also listed as attempting, but they reached 98% coverage in 2011: [2]. One potential way of doing this graph would be based on buckets of coverage, so looking at the percentage of the population covered - 100-80%, 79-60%, 59-40%, etc. but even those numbers aren't easy to get.--KarlB (talk) 12:25, 3 July 2012 (UTC)

I've also seen journalist reuse this map without much care. But one updated the US, and classified it as "attempting". I was wondering wether he bothered to update the original file at commons, I found he did not. That's how I got here, and updated myself. That's it for my story.

Now, I am saddened by the removal of this map. In spite of its inherent lack of precision and detail, I find it very useful to have a general idea of UHC thorough the world. The main reason why journalist reused it is because it is interesting.

I believe the main issue with this map is a lack of update. The mistakes your are pointing out about Mexico and Thailand are only due to a lack of update. This map was created in 2009, and I believe it was fairly accurate at the time. No one bothered to updated it since then, of course we can find mistakes in it.

The only solution is to write a warning under the image, that says : "This map was not updated since 2009, and only meant to give a rough idea of UHC thorough the world. Read the article for more rigorous information." Or something like it. Dodoïste (talk) 15:04, 3 July 2012 (UTC)

I think the problem is not just that the map is out of date, but that it's not even clear what sources were used to build the map. If we color a country as having UHC, what does that mean? And what 3rd party source has said so? I agree it is useful to have such an image, but it needs to be built carefully and from 3rd party sources. We are making very strong statements, for example saying that some country is a "nations with no universal health care" - what does that mean? That's why I think a level of coverage metric would be better. Look at this: [3] - I think this was taken from wikipedia and tweaked - you'll notice Mexico is not colored in, nor Ghana, nor Rwanda, etc. And no, the map was not accurate in 2009; Thailand claims to have achieved universal coverage in 2002...--KarlB (talk) 15:18, 3 July 2012 (UTC)

Here is a 3rd party source we could use: [4] - the authors did a metaliterature review of all the different definitions of UHC, then generated 58 countries which have both legislation in place and health services available for 90% of population. It is relatively recent (c. 2010), so could serve as a starting point. We could even make the graph with two levels - level 1 = UHC legislation in place (~78 countries); level 2 = over 90% health services coverage achieved (~58 countries) --KarlB (talk) 18:48, 3 July 2012 (UTC)

Sounds great, thanks for your efforts. I trust you to find reputable and useful sources, and decide on the classification of countries. You're better at doing this than me.

As for me, I know how to make such a map using SVG graphics and Inkscape so I could take care of this part of the job. It's fairly easy with an awesome starting map such as File:BlankMap-World6.svg. Cheers, Dodoïste (talk) 19:12, 3 July 2012 (UTC)

Ok, I'll try to validate that source, then send you the link so you can create the new file. I think I need a bit more info. Will probably take a couple of days. Cheers. --KarlB (talk) 19:17, 3 July 2012 (UTC)

Cool. In the meantime, might I add six countries said to have UHC in the 2009 map from the pdf source you chose (pacifichealthsummit.org)? From left to right, there is Venezuela, Tunisia, Botswana, United Arab Emirates, Mongolia, Thailand. It will take 5 minutes. Or we can wait until we have all we need for the new map. Dodoïste (talk) 22:47, 3 July 2012 (UTC)

The file has been updated, based on the paper: [5]. This paper provides a 3rd party classification of UHC, based on legislation and achievement of coverage metrics. If additional sources are found to demonstrate that additional countries meet these criteria, or if we want to add a refinement to the map (for example, listing all countries that have achieved 80% coverage of insurance or birth attendance), that should be considered.--KarlB (talk) 21:16, 17 July 2012 (UTC)

Good job ! :-) Dodoïste (talk) 22:12, 17 July 2012 (UTC)

Thanks. I note that one advantage of this method is that it uses a 3rd party source; thus no significant original research is needed to build the graph. One disadvantage is that it is now out of date, as Mexico would definitely qualify. So we need to find a way to balance updating this map with the need to rely on published sources of information.--KarlB (talk) 23:08, 17 July 2012 (UTC)

According to this doc, Russian Federation is not country with UHC, but it does not contain proof inside and only has short statement (page 15) telling that "Russia did not have healthcare insurance among more than 90% of population", which is ridiculous as long as permanent health insurance is given for all and everywhere any time and the only actual reason for denial can be if you lost your passport. According to The Federal Fund for Mandatory Medical Insurance (Rus), 141,4 million are insured 2.92.144.127 (talk) 06:39, 20 January 2013 (UTC)

Map based on unreliable ILO source

The map created by Karl.brown/Obiwankenobi (talk | contribs) on July 17, 2012 is inaccurate and misleading and its source is not reliable:

• Stuckler, David; Feigl, Andrea B.; Basu, Sanjay; McKee, Martin (November 2010)."The political economy of universal health coverage. Background paper for the First Global Symposium on Health Systems Research, 16–19 November 2010, Montreaux, Switzerland". Pacific Health Summit Seattle: National Bureau of Asian Research.

Which uses health insurance coverage percentages from Table A2.2. Formal coverage in social health protection on pages 83–90 of Appendix II in:

• International Labour Organization (2008). Social health protection: An ILO strategy towards universal access to health care. Social security policy briefings, Paper 1. Geneva: International Labour Office. ISBN 9789221211617.

Which for OECD countries is based on 2003 statistics in:

• OECD (October 10, 2006). OECD Health Data 2006 (Update October 2006). Paris: IRDES (Institut de Recherche et Documentation en Economie de la Santé), OECD.

But major discrepancies/errors are found in Table A2.2 of the 2008 ILO paper vs. OECD Total public and primary private health insurance coverage statistics for 2003 for Chile (96.0% vs. 66.1%), Israel (9.0% vs. 100%), Mexico (78.6% vs. 46.5%), United States (100% vs. 85.0%), making all ILO-based health insurance coverage data (and world maps based on it) unreliable.

In addition to being based on unreliable ILO health insurance coverage data, the 2010 Stuckler et al. symposium background paper has other problems:

• it equates 90% health insurance coverage with universal (100%) health insurance coverage
• it erroneously says that United States is among 75 countries that have passed health legislation that explicitly states that the entire population is covered by a health plan that grants them access to a core set of services
• it says that the United States will achieve >90% health insurance coverage by 2014

This Wikipedia map was altered from the 2010 Stuckler et al. paper map to include an additional 17 countries that the paper (dubiously) says have passed health legislation that explicitly states that the entire population is covered by a health plan that grants them access to a core set of services, but have not achieved >90% skilled birth attendance (4 countries) or >90% health insurance coverage (12 countries + the United States which the ILO says has achieved 100% health insurance coverage but has not). This Wikipedia map highlights these 17 additional countries as: "Nations with legislated mandate for Universal health coverage, but which have not yet reached thresholds above." It is not credible to highlight El Salvador (ILO 59.6%), Bolivia (ILO 66.9%), and the Congo (ILO …%) as being closer to providing universal health care than Poland (OECD 97.5%), Lithuania (ILO …%), and Lebanon (ILO 95.1%).
Apatens (talk) 16:58, 14 March 2013 (UTC)

Moved to commons:File_talk:Universal_health_care.svg#Map_based_on_unreliable_ILO_source

 – Discussion on the UHC map is moved here. Please continue this discussion there. Obi-Wan Kenobi (talk) 20:30, 18 March 2013 (UTC)

Mexico

Mexico more or less has a universal health care system, as most hospitals, etc in urban areas are generally free/subsidized. --HappyStumpy (talk) 00:57, 15 August 2013 (UTC)

Isle of Man

The Isle of Man should be coloured green too (the small grey dot in the middle of the British Isles. It has the Isle of Man Health Service (https://www.gov.im/dhss/) which offers universal coverage on the island and has reciprical health agreements with over 30 other countries including the UK and Ireland.--XANIA - ЗAНИA^{Wikipedia talk | Wikibooks talk} 21:07, 3 January 2015 (UTC)

Jersey and Guernsey too. Has this really been wrong for over a year now? 31.52.231.172 (talk) 07:25, 13 May 2016 (UTC)