Talk:Universal health care/Archive 3
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Hong Kong
for me it seems that the article about Hong Kong talk more of medicine in Hong Kong than the health care system. if somebody believe it so, please make the necesary changes (if he knows about the health care system). —Preceding unsigned comment added by Cedy 30 (talk • contribs) 05:48, 28 June 2009 (UTC)
top
How do you edit to add? The Austrian Health System should be covered since there is a great article on it from the JAMA. I am not a Wiki editor, but thought someone who knows how to do this editing should read and write an Austrian section.
Charles L. Bennett; Bernhard Schwarz; Michael Marberger Health Care in Austria: Universal Access, National Health Insurance, and Private Health Care JAMA, Jun 1993; 269: 2789 - 2794.
(67.184.121.92 (talk) 23:31, 11 August 2009 (UTC)).
Does Turkey have universal health care?
On July 8, an IP address added to the lead that Turkey doesn't have universal health care ([1]). I reverted that edit, because the original text that asserts that the US is the only wealthy, industrialized nation not to have uhc, was cited to two different sources supporting that assertion, whilst the new text was not supported by those two sources nor did the IP address add its own source(s) to support its assertion. I have asked the address to point out some sources that say Turkey doesn't have uhc, but I thought to bring this query to this talk page; does Turkey have uhc, and if not should we adjust the text in the lead accordingly? Otumba (talk) 14:58, 12 July 2009 (UTC)
- Turkey is a very big and poulous country but it is neither heavily industialized (its still 30% agricultural) nor particularly wealthy. Its per capita GDP is 92nd in the world putting it between Mauritius and Belarus. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004rank.html?countryName=Turkey&countryCode=tu®ionCode=me&rank=92#tu --Hauskalainen (talk) 11:06, 28 July 2009 (UTC)
IP Comments
Not only in the US section, but the entire article is 100% pro socialized healthcare. There is no talk about rationing bodies in the UK and Canada, and the "facts" stating that life expectancy is the lowest in the US in completely false. There is also no mention that most Americans are satisfied with health care especially at the beginning of 2008 before we were told there was a "crisis" with our system. Also no mention that of the 47 mil that dont have insurance in the US, 50% arent even citizens and another 10 mil make 75k or more and chose not to purchase it. And finally there is no mention of the millions of people from other countries who come here because their systems either wont spend the money to heal them or that our care is superior. The American health system as it is, is one of the best in the world. We provide inovation and the latest equipment to the entire world. —Preceding unsigned comment added by 136.160.191.18 (talk) 17:49, 24 July 2009 (UTC)
I tried to make this a little more fair in the respect that the entire article glorifies universal health care, but reading the replies to everyone else i understand now why it is so liberal in the first place. Dont try and make this article seem like universal is the way to go by supporting it with entirely liberal sources. This isnt the huffington post its supposed to be a biased online encyclopedia. If our system is so bad, why do millions flock here every year to see our doctors? exaclty. —Preceding unsigned comment added by 136.160.191.18 (talk) 19:00, 24 July 2009 (UTC)
- Wikipedia is supposed to be unbiased (not biased).
There is also no mention that most Americans are satisfied with health care especially at the beginning of 2008 before we were told there was a "crisis" with our system.
- Under the United States heading under Politics: "Most Americans report satisfaction with their own personal health care."
- Your edits were reverted due to their violation of WP:V
--Jorfer (talk) 06:34, 28 July 2009 (UTC)
- Realise that any article talking about peoples access to medical attention is going to come across like having access to medical attention is a good thing 92.2.108.233 (talk) 06:57, 30 July 2009 (UTC)
Realise that the problem in America is not peoples access to medicine; hosptials are legally required to treat any patient that enters. The problem is the cost to some people, especially those with pre-existing conditions. All Obama has to do is regulate prices.
It also seems like nobody has updated the info on this page, like for instance the fact that more americans are now opposed to the president's proposed bill, and even more are happy with their current plan. There is no evidence that a government run health plan is any better than a free market anywhere in the world. It may be cheaper for the individual, but seniors recieve less coverage, long waits for ordinary procedures are unavoidable, and quality of care and innovation drop dramatically, and these things can NOT be argued. Please, in the name of journalism and unbiased info sources, make this article less bias. —Preceding unsigned comment added by 136.160.191.18 (talk) 19:50, 19 August 2009 (UTC)
- I'm still not sure how single-payer *insurance* reduces innovation in any way, I'd like to see some verified information on that. I could see how a public *healthcare* system would reduce innovation. —Preceding unsigned comment added by 74.166.240.133 (talk) 18:46, 26 August 2009 (UTC)
I've read through the article and it's pretty damn well unacceptable as is. I'll be making sourced edits this weekend to improve arguments against healthcare, because a number of arguments were skimmed and removed. --170.97.167.61 (talk) 19:31, 27 August 2009 (UTC)
Article for Deletion proposal Shona Holmes
Editors to this article may wish to know that the article Shona Holmes (who has appeared in advertsements and in congress campaiging against health care reform and especially against single payer) has been nominated for deletion here http://wiki.riteme.site/wiki/Wikipedia:Articles_for_deletion/Shona_Holmes_(3rd_nomination)#Shona_Holmes Please feel free to add your comments about this proposed deletion as you see fit. --Hauskalainen (talk) 22:39, 22 September 2009 (UTC)
Cuba?
There should be a section on Cuba (main article: Healthcare in Cuba). They have one of the best health care systems in the world, despite economic hardships.--87.162.34.82 (talk) 17:38, 26 September 2009 (UTC)
- Feel free to start one. DJ Clayworth (talk) 18:25, 5 October 2009 (UTC)
Politics Section - Merge with Health care reform in the United States
The politics section begins by waffling about far reaching changes being necessary to health care systems globally. This is, surely, disputable. The document it quotes does not even appear to be in the public domain. I suspect the main reason for this preamble is to justify the sections that follow, which re-iterate all the arguments going on in the United States. The fact is that most health care systems around the world with UHC do not seem to have the same problems that the US has.
Because the U.S. does not actually have a UHC system and the political issues being played out in the U.S. are covered in other articles, I would argue that most of this politics section does not belong in this article. It should be merged into Health care reform in the United States with a reference to this main article being put in its place. Comments please. --Hauskalainen (talk) 00:22, 26 October 2009 (UTC)
- The standard for for sourcing is WP:RS which does not indicate any preference toward public domain sourcing over sources not in the public domain. As for the location of the section, there has been a consensus established that it should be here (see Talk:Health care in the United States#Debate section should be deleted or moved.), but that may have changed over time of course.--Jorfer (talk) 00:45, 26 October 2009 (UTC)
- But also has to be verifiable and I cannot see how it can be verified. And as for the suggestion that it be moved here - I think you misread the section. It referred to a section on pros and cons in that article and not an addition here. I'm going to be WP:BOLD and delete the section. There are better articles carrying this stuff.--Hauskalainen (talk) 22:25, 26 October 2009 (UTC)
- The section is verifiable as arguments (see Wikipedia:Reliable sources#Statements of opinion), which is why no one has raised this as an issue with it. This section has a long history. User:Wikidea said on Talk:Health care#Merging Universal health care into Health care: "...the debate on universal health care, which is now found under the politics section of Health care in the United States because it's a very US specific debate." This merge proposition is part of a temporary mess that was caused by a bold move to redirect Universal Health Care to Health Care. It was originally here and was moved to Health care in the United States in the merge. Since the merge ultimately failed, I took the suggestion it be relocated back, as reflecting the consensus the merge was a bad idea.--Jorfer (talk) 16:10, 27 October 2009 (UTC)
Actually Hauskalainen you're being a WP:ASSHOLE. That was a good section and now I can't get ANY of the references. If there's a way to restore the hard work that was put into that, and possibly suspend Hauskalainen, I would greatly appreciate it. —Preceding unsigned comment added by 192.250.175.26 (talk) 12:38, 27 October 2009
I stand by my argument. The United States of America does not have Universal Health Care but many countries do have it. It is crazy to have such a large section devoted to politics in the United States and say nothing about health care politics in the countries that actually DO have Universal Health Care. I wouldn't mind if the politics in the U.S. actually reflected political debate about health care in the countries which have Universal Health Care, but as far as I can see, it simply does not. There are places in Wikipedia for texts such as these such Health care in the United States for example, and even that other article Health care reform in the United States (which is highly biased in what it includes and especially what it omits - see my recent on its talk page. Other editors are welcome to try and fix it or get it deleted, nut I for one will no longer edit it). But the text I deleted certainly does not belong here. If you need the references you can easily get them from history but most of the text has been culled from other articles en bloc. --Hauskalainen (talk) 23:37, 28 October 2009 (UTC)
- This article is certainly not an appropriate place for a discussion of US health care politics. Fact is, the US doesn't have a universal health care system. This version, as rewritten by Huskalainian, with minor follow-ups by The Squicks and myself, is adequate and appropriate for this topic. ... Kenosis (talk) 15:00, 30 October 2009 (UTC)
- Please note that much of this material discussed above is already in Health care reform in the United States. I've reverted the recent insertion of this disorganized block of material from Health care in the United States. Speaking as just one WP user, I have no objection to inserting the rest of it into either Health care reform in the United States or Health care reform debate in the United States. ... Kenosis (talk) 22:28, 30 October 2009 (UTC)
- I was going off Hausk suggestion without realizing that the Health Care in the United States article is more organized than is used to be, the section was there for a while, and the debate section is a summary. My mistake. The text is now available at User:Jorfer/Sandbox if you want to try to incorporate the information that is not already in the reform article.--Jorfer (talk) 02:03, 31 October 2009 (UTC)
- No problem. Thanks for saving it for potential future use of its various components. The bullet-list of pro and con arguments remains in Health care reform in the United States#Common_arguments_for_and_against_health_care_reform, and at some point in time will likely need to be cleaned up as well. ... Kenosis (talk) 19:48, 31 October 2009 (UTC)
- I was going off Hausk suggestion without realizing that the Health Care in the United States article is more organized than is used to be, the section was there for a while, and the debate section is a summary. My mistake. The text is now available at User:Jorfer/Sandbox if you want to try to incorporate the information that is not already in the reform article.--Jorfer (talk) 02:03, 31 October 2009 (UTC)
I come back to this article every few months - it is much improved from a few months ago! Good stuff --Nmcclana (talk) 09:15, 3 November 2009 (UTC)
Conservatives statement
OK we obviously disagree on this paragraph:
Conservatives can favor universal health care, because in countries with universal health care, the government spends less tax money per person on health care than the U.S. For example, in France, the government spends $569 less per person on health care than in the United States. This would allow the U.S. to adopt universal health care, while simultaneously cutting government spending and cutting taxes.
Reference: A Conservative Case for Universal Health Coverage, Randall Hoven, December 12, 2007
Not just is conservatives ability to favor universal health care being listed in that section an Ad hominem argument against non-conservatives (conservatives can support it, so Universal Health Care should be approved), but it is a statement that takes a very diverse group of people and concludes a common attribute...that needs more sourcing than an editorial. That wording also reads like and advertisement.--Jorfer (talk) 04:20, 12 September 2009 (UTC)
- I completely agree with you (That we can disagree on the paragraph). Conservatives disagree with universal healthcare not just for cost factors, which will more likely increase than decrease if Romneycare is any sort of measuring stick, but for quality and the fact that the private insurance mandate is not constitutional as well. —Preceding unsigned comment added by 76.28.204.79 (talk • contribs) 03:06, December 26, 2009
No offense, but you don't seem to know what Ad hominem means. The argument that conservatives can support it for the reasons listed in that section IS an argument in favor of UHC, not only for the reasons listed, but because it shows it's possible to get conservative support. And it doesn't say all conservatives support it (obviously) but that there are good reasons that align with traditional conservative interests that would allow conservatives to support it.
Also it would be possible to both cut spending and cut taxes. Mystylplx (talk) 05:16, 12 September 2009 (UTC)
- I tend to agree with Mystylplx here. The viewpoint was specifically the reasons why conservatives should support UHC. So just presenting the argument supporting the premise wihout mentioning the premise itself is not doing the reader any favors.--Hauskalainen (talk) 07:01, 12 September 2009 (UTC)
- An argument is an argument regardless of who it persuades. To say that one one person's support is more important than another person's support is definitely Ad hominem (if conservatives support it than I should support it). The ability to get conservative support is an argument to pursue Universal Health Care but not one for Universal Health Care itself. As it is written, it implies all conservatives. If it wasn't for the mentioned problem, "many conservatives" and "should be" would have to be used to clarify and make clear that it is speculation.--Jorfer (talk) 20:13, 12 September 2009 (UTC)
- There's nothing ad hominem about it. There's no personal attacks and it is not saying "if conservatives support it then I should." That's not what it's saying at all. It's giving reasons why conservatives can support it. That's all.
- Your point that this is an argument to pursue UHC but not an argument for UHC is, I think, an accurate distinction, but too fine a distinction to make any difference. Mystylplx (talk) 20:33, 12 September 2009 (UTC)
- Again I agre ewith Mystylplx. The "ad hominem" argument makes no sense and must be a misunderstanding of the term. The simple matter is that the article espoused why conservatives should support the bill. The argument is of cource not irrelevant but the issue was a philopsophical one about whether Action A or Action B is better. You can agree or diagree with the argument but you cannot pretend the argument has not been made or rhat it cannot be discussed encylopediacally (if tht word exists). —Preceding unsigned comment added by Hauskalainen (talk • contribs) September 12, 2009
- The distinction may seem subtle, but it makes a big difference. Conservatives are part of a systematic (that of the government) argument in determining the fruitfulness of pursuing Universal Health Care since conservatives are a part of the system, but are not an aspect of the Universal Health Care system itself. Thus conservatives are irrelevant in the second case. Also, to say that conservatives can support something is a psychological estimation, which is much more difficult to prove than to state something like "is compatible with conservative principles such as" and thus would require better sourcing. It would be an argument from definition if conservatism was defined strictly enough and thus would not require much sourcing, but it is not.--Jorfer (talk) 22:28, 12 September 2009 (UTC)
- I'd say "is compatible with conservative principles" is actually better wording, and is also supported (maybe even more supported) by the cited source. I would not be opposed to changing it to that.
- Let's put this into perspective--the section is about arguments that have been made, for and against, UHC. It's not our job as writers/editors for an encyclopedia to make judgments about the quality of those arguments (WP:OR), but merely to faithfully summarize those arguments as they have been made. The cited source for that particular argument is all about why conservatives can support UHC, or alternative wording, how UHC is compatible with conservative principles. Both, the arguments in isolation, as well as the point that they are in alignment with conservative principles, (conservatives being most often the chief opponents of UHC) are arguments in favor (of pursuing, or otherwise) of UHC. Does that make sense to you? Mystylplx (talk) 22:41, 12 September 2009 (UTC)
Well if the argument is wholly wrong and one can prove it then it is fair game to challenge it. For example one might accept that UHC based on single payer could lower costs but this has to be balanced against potential issues of choice (for example, will the single payer system pay for the branded medicine I have always used or do I have to switch to a cheaper generic? If that trade off had to be made and you felt choice of medicine was more important tham cost, a conervative might not go for the cheaper option.--Hausk —Preceding unsigned comment added by Hauskalainen (talk • contribs) September 12, 2009
- Only if the challenge can be backed up by reliable sources. And in this case the section is 'arguments for and against' so the challenge would have to be that the arguments have not been made rather than that the arguments are faulty. If the arguments have been put forth by reliable sources then they deserve inclusion in that section, whether we agree with them or not.Mystylplx (talk) 02:01, 13 September 2009 (UTC)
- WP:OR applies to the actual content. It does not apply to the determination of the inclusion or copyediting as policies like WP:V and WP:NPOV restrict what content comes in and how it is to be presented. It also does not apply to the analysis of the reliability of an article even if it from a reliable source as you can see in Talk:Accelerated Christian Education#Third opinion starting at "Rspeer said that I made no suggestion on how to fix the problem...".--Jorfer (talk) 00:37, 13 September 2009 (UTC)
- As far as the content and how it's presented, I'd say the current version does a pretty good job of presenting the content from the citation, though I really do like your suggestion of "compatible with conservative principles" better. As far as the reliability of the article, I'd say it's a reliable enough source to count in the section in question. Again, the section in question is merely a listing of arguments that have been made, both for and against. By it's very nature this is not Wikipedia making these arguments, but simply detailing the arguments that are 'out there.' That doesn't mean we have to include any nutjob who thinks UHC is mandated by the alien overlords, or conversely, will destroy the planet, but any argument in a reliable source deserves mention in that section. Mystylplx (talk) 02:01, 13 September 2009 (UTC)
It should not be used as a source at all, as it a man's personal opinion. And he even admits, in the piece, that it is -not- compatible with conservative principles. The crux of his case is that that the only thing compatible with very conservative, or his own librertatioan principles, would be for the government to stop interfering all together- but since the government is interferring, he thinks we should get our money's worth. This piece, being pure opinion, and not that of any historical figure or person of note regarding health care, should not be used - and it does not make a convincing case nor a support for a conservative platform for universal healthcare, so it is extremely misleading. —Preceding unsigned comment added by 76.28.204.79 (talk) 06:57, 26 December 2009 (UTC)
By the way, all this source says is that -one- conservative is supporting it for certain reasons. It is not claiming that 'many conservatives are supporting universal health care for these reasons' or 'some conservatives feel they can support government run health care for this reason' it is saying 'I now support universal health care for this reason.' So at most you could say in the article 'One conservative supported Universal Health Care in 2007 for these reasons' and cite this source. You would likely have to ask the author of the article if he still feels the same way to cite that he feels that way now, since this is his most current article dealing with health care: http://www.americanthinker.com/2009/12/merry_christmas_from_harry.html It might be interesting to ask him how his theory that American universal health care would be great turned into a battle against it. —Preceding unsigned comment added by 76.28.204.79 (talk) 07:14, 26 December 2009 (UTC)
Italy and Greece have Single Payer systems, not compulsory insurance systems
The map suggests that Italy and Greece have compulsory insurance systems, like the systems of central and eastern europe, when in fact they don't and have publicly owned systems.
Alpha-ZX (talk) 11:51, 10 February 2010 (UTC)
Greenland The map indicates no health system in Greenland, however the text describes a Greenland healthcare system.
Also, should not the Greenland discussion be integrated with mother country Denmark? gerenr (talk) 12:29, 25 February 2010 (UTC)
The map on the article
Shouldn't the USA be green now? —Preceding unsigned comment added by 67.67.91.83 (talk) 03:37, 22 March 2010 (UTC)
Nope, The USA Health Care Reform Bill does not technically conform to the global definition of "Universal Healthcare" as defined by the World Health Organisation.
Unfortunately, there is a reason it's called "HCR" not "UHC"
121.203.38.39 (talk) 07:35, 22 March 2010 (UTC)
It's "UHC", they just don't call it that because of the political opponents. —Preceding unsigned comment added by 67.67.91.83 (talk) 13:32, 22 March 2010 (UTC)
I just returned from Egypt, where I learned that there is Universal access to some level of health care . Is this enough to give that country some color on the map???
23-march-2010 —Preceding unsigned comment added by 140.247.109.18 (talk) 16:32, 23 March 2010 (UTC)
THE US SHOULD BE GREEN! —Preceding unsigned comment added by 68.89.165.93 (talk) 14:09, 24 March 2010 (UTC)
- Let's wait until 2014, when the mandate goes into effect. And remember, even by 2016 only 95% will have coverage. --Jatkins (talk - contribs) 18:16, 24 March 2010 (UTC)
Well even in some countries with UHC not everyone is covered, but those are usually illegal immigrants. —Preceding unsigned comment added by 68.89.165.93 (talk) 21:30, 24 March 2010 (UTC)
- I'm not saying the map shouldn't be changed, but let's at least wait until the mandate reaches its maximum coverage, sometime around 2016. --Jatkins (talk - contribs) 12:22, 27 March 2010 (UTC)
Ok. I have updated the map: added Egypt and some other countries that I was able to find an article from reliable source that proves it has a universal healthcare. Please let me know if anything I have missed. About US: as I understand, the map is "As of March,2010". That mean at the current moment we here in US still do not have a universal healthcare (I live in US, so I know). Lets wait until 2014, then I with pleasure color US blue (if nothing stops the reform). May be I should add color like "yellow" for "reform in transition"? Let me know if anybody object. Innab (talk) 15:43, 1 April 2010 (UTC)
- Changed US color to "lime" because yellow visualy blend into white space Innab (talk) 14:25, 2 April 2010 (UTC)
Island, Austria, Sweden
It is quite surprising that some of the most successfull - according to many surveys - healthcare systems are not mentioned. Could someone add these. —Preceding unsigned comment added by 80.121.34.207 (talk) 14:38, 31 March 2010 (UTC)
- Provide us a text, please. Or just go ahead and add it yourself to the article. 131.252.134.228 (talk) 19:59, 2 April 2010 (UTC)
France
I don't know enough about this topic to write one myself, but there is no section on France, where universal health care exists. —Preceding unsigned comment added by 194.83.68.114 (talk) 08:02, 29 June 2010 (UTC)
Definition of universal health care
This article needs a more rigorous definition of universal health care provided by an outside source. Recent debate in the US shows that what different people mean when they say "universal health care" is not consistent.
I haven't been able to find an organization that attempts to classify health care systems around the world as coarsely as this article does, as either universal or not. Not surprisingly the grouping of countries in this article is not applied uniformly. This is inevitable--to take the US as an example, one can find sources that say the new system will be universal and sources that say it won't be. Some say the current US system is universal, through a combination of private insurance, Medicare, Medicaid, free clinics, or that fact that ERs can't turn people away, all of which is subsidized by the government.
Without a single source to rely on, or a clearer definition of what comprises universal health care, all of the classification done in this article is original research. We either need a better definition, or to remove the map and the attempt to determine whether every country's health care is universal. Mforg (talk) 15:34, 3 April 2010 (UTC)
- I would propose definition: a national health insurance program in many countries that is mostly financed by taxes and administered by the government to provide comprehensive health care that is accessible to all citizens of that nation.184.76.31.145 (talk) 00:28, 4 April 2010 (UTC)
- That sounds more like a definition of single-payer health care and excludes systems with a mandate for private insurance. I don't see why the source of financing should be relevant or who runs the system. The question is simply if all legal residents of a country have access to pre-catastrophic health care. That is true for countries with a single-payer system as well as those with mandates or combinations of both. --EnOreg (talk) 20:22, 5 April 2010 (UTC)
- Single-payer it is when goverment pays 100% for the coverage with goverment approved providers accesible to all citizens, that why it single to goverment-only as payer. Many countries have system of susidized insurance, where peoples still have to pay a small portion for the care, however goverment pays for most of the coverage making it accessible to all citizens. US reform is moving that way, if you look at the last page of this CBO document [2], you will see that after 2014 the government will pay 95% for health care premiums for peoples up to 150% FPL (i.e 36K/yr for family of 4), 83% for 200% FPL, 72% for 250% and so on. Eventually this makes health care accesible to all citizens. Innab (talk) 21:10, 5 April 2010 (UTC)
- I have come late to this thread having only just seen it for the first time today. The definition in the article that I read and deleted the other day was completely wrong and was indeed the definition of Single Payer health care. I too had severe problems with the map and its not a personal dispute. It is, to put it simply, both WP:OR and WP:Bias. It views UHC through the lens of the US health care debate and whether the method of achieving it is Single Payer or a plurality of payers. It imples that most of Europe is a plurality of payers and that is comlpetely false. Only tiny Switzerland and relatively small Holland have a market based insurance system. That in many countries the old trade union based health care financing schemes have continued post reform is merely a matter of history. There is no plurality or competition in most countries for health insurance. Though there may be several payers they operate along the same lines and the divisions between them are purely administrative. Rather as if each US state had its own single payer fund. Would you then say the U.S. had a single payer system or a multiple payer system? This is why the misleading map had to be removed. You cannot simplify a complex issue of health care finance into whether it fits a buzz word or not.--Hauskalainen (talk) 12:27, 15 April 2010 (UTC)
removal of the map
I removed the map for several reasons.
- Primarily, it is an example of Original Research.
- There is no sourcing at all, and even if there was, it is likely to be multiple giving rise to issues of choice.
- It implies that there is some meaningfulness in the distinction between Single payer systems and other means. i.e. one insurer or many. There is not (IMHO)
- It implies that most of Western Europe has a plural financing system with a choice of multiple insurers. That is misleading (IMHO). Take France for example. There, one insurer covers something like 86% of the population. The remainder are in smaller insurance schemes permitted by law according to their profession. Your insurance fund is determined largely by your profession and there is little choice of insurer.
- Even in Holland where the government insists that people buy their insurance from a private provider, there is an equalization fund operated by government which distributes finance according to risk experience between funds, essentially making a large single fund with only a proportion of risks carried by the individual insurers.
- Secondly, it is totally biased towards a U.S. perspective.
- The term "Single payer" is one that has arisen in the U.S. to describe the system in Canada where multiple insurers were replaced with a single government insurer. It simply has no meaning to observers outside of the United States.
- Universal Health care is a globally recognized term and should not be described in terms couched in U.S. terminology which has no relevance to the subject matter. That the debate in the U.S. has been focused on reform in finance matters it is wrong to expect the rest of the world to view this subject through a U.S. lens.
- Besides, the issue relates soley to finance. Universal health care systems are about the PLANNED PROVISION of health care service as well as issues of how to finance is (ASSURED FINANCING for all).--Hauskalainen (talk) 01:22, 15 April 2010 (UTC)
creation of a list/table?
The article has great potential, but seems to be in need of a re-design in order to reach the next level.
How about drafting an attached "List of Countries by Health Care Delivery System?" and a discussion on what should be in such a table? If the table were designed appropriately, a map could represent that compilation. One or more of the critiques (noted just above) of the map could then be resolved - as the table could include reference citations, and be designed to be globally applicable (rather than favouring a single national point of view).
I am the creator of the Human Security Index, and could really see benefit from a table that was (1) globally comprehensive (e.g. listed all the countries/states covered in the CIA World Factbook at a minimum), and (2) had columns for, say, (a) universal health coverage in effect?, (b) universal health coverage legislated and in process of implementation?, (c) type of coverage (e.g. single-payer, multi-tier, mandated insurance (with gaps covered by government or other service), (d) other (whatever might be agreed to), (3) year(s) of implementation/revision, and (4) reference citation(s) documenting the country's universal health coverage or lack of same. It might be better to have separate columns "checked off" for type of coverage, as some countries combine more than one aspect. It might also be worth considering where state, non-profit private sector, profit-making private sector modalities are in play, and whether people can lose coverage or financial benefit by technicalities (e.g. by ringing 999 for an ambulance, and getting one that your provider will not reimburse).
With such a table, and a map based thereon, the article itself could go deeper into the issue. It could do deeper analysis on successes and challenges of each methodology, and discuss (perhaps in a separate article, or on country-specific articles perhaps hyperlinked from the List_of_countries_by_health_care_delivery_system) situations in individual countries/states.
I have been working on such a table (but not in a Wiki environment). It now seems to have over 130 countries/states with universal health care by various means. It is far from "publication-ready" but suggests that a few more eyes doing design and peer review might lead to a useful compilation. 192.153.129.137 (talk) 17:10, 28 May 2010 (UTC)Hastings
The problem you would have is that the topic is multidemensional and there would not be agreement on how to break out the analysis, how label the data or get data that was compiled in the same way to get comparable. Most countries have a mix of private and public services but the content of each public service would be radically different as would be the methods of funding, reimbursement, etc. By all means think about further and bring your ideas back but I suspect it will be hard to get even near unanimity from the editing community. --Hauskalainen (talk) 23:17, 29 May 2010 (UTC)
Ahhh, your points imply (rightly, IMHO) that the discussion seeking to partially agree on how to break out the analysis, etc. are part of the point. This would not be research per se, but design of the presentation. The draft table that I have now lists SP (Beveridge "single payer"), IM (Bismarckian "insurance mandate"), MSM (Modified Semashko - which seems to be evolving toward IM with some multi-tier aspects in several countries), and TT (two-tier but maybe should be reworded MT for multi-tier), with blends allowed (as they occur in various administrations). I am grinding through WHO and other documents, country by country - but unfortunately they are not fully consistent in their presentations in the documents that I find on the Web. After discussing issues with others, I get the impression that qualifying modalities could involve subsidy, non-profit, or profit (but not "profiteering") by financial mechanisms (ministries, tax and health administrations, or "insurance providers") or service providers (clinics, others). An additional thought - agreement on what constituted universal health care would not be necessary in the table. The goal of the table would be to provide information on health delivery mechanisms in countries - which the reader could use to help determine what constitutes universal coverage. And, of course, we're talking Wiki - something that would hopefully encourage others to be more complete, up-to-date, or otherwise better than anything that I or anyone else might initially draft. 192.153.129.137 (talk) 17:10, 21 June 2010 (UTC)Hastings
Error in description under Canada heading.
There is a sentence using the word 'medicare' when describing the health care coverage in Canada. That is inaccurate, as medicare does not exist it Canada. 68.247.32.156 (talk) 05:11, 29 July 2011 (UTC)chitniss
Incorrect Citation: Cost savings associated with improving..
"probably because of the 40% cost savings associated with universal preventive care" I read this and thought wow that's amazing so I read the source and found it is unfortunately not applied correctly and is very misleading.
It is important to note that not once did this study mention "universal preventive care".
The source says: "On a yearly basis the net cost saving to the government is $191,733 per year (2003 $Can) equating to $3,687 per physician or $63,911 per facilitator, an estimated return on intervention investment and delivery of appropriate preventive care of 40%."
In the Discussion section of the report: "The significant reduction in inappropriate testing and increase in appropriate testing resulted in net savings of $191,733 per year in 2003 dollars to the government or a return on investment of 40%. "
This is based on the single study shown, which does not apply to all of heath care.
Unfortunately the study is based on: "The Prevention Facilitator intervention involved Health Service Organizations (HSOs) in Ontario. HSOs are community primary care practices that have a payment system based primarily on capitation and not fee-for-service"
and
" rates of delivery for preventive screening tests were from a randomized controlled trial in a HSO setting. Therefore, caution must be used when generalizing the potential cost savings to other settings."
And accordingly: " However, this study involved HSO physicians who may not be representative of all family physicians and research has demonstrated that the intervention does not work in chaotic practices "
Believing in good faith I believe this article was misunderstood. Though it is important to note that not once did the article mention "universal preventive care" or even the word "universal".
This is why I made the change. 67.183.129.200 (talk) 00:03, 23 October 2011 (UTC)
This article is totally biased countries like China by no means have universal health.
Someone should mark this article to put it at the concern of as many users as can be, so it gets reviewed letter by letter. A good way to improve it is to add a spreadsheet putting very clear which countries really have universal health, and some kind of scoring system borrowed from some ngo. If China is there then im pretty sure there are lot of countries that should not be there. And economics section is a joke, that wikipedia is not a dictionary does not mean you are not supposed to search word universal and look what it actually means.
This article is defenitively biased by some megalomaniac company and needs to be under close surveillance. Preceding unsigned comment added by Userwords (talk • contribs) 19:05, 22 December 2011 (UTC)
Proposed revision (March 2012)
Hi, would like to propose a major revision to this article, towards the following new outline:
- History: Use existing language. Potentially add new text.
- Terminology: One paragraph
- This paragraph will address the terminology issues e.g. universal health coverage, universal care, universal health care coverage as well as provide a clear definition of universal health coverage and key terms sources from the WHO report.
- Goals: One paragraph
- This section will outline the intended outcomes of UHC e.g. improved access to health care, financial protection, and improved health outcomes. Use WHO report to develop language.
- Funding Models: Outline the various funding models for UHC
- Countries pursuing UHC: Add a short paragraph to introduce the section, then link out to the separate page with UHC snippets on a per-country basis.
The biggest change will be to remove the country-specific descriptions of UHC to a separate page (for example, Universal health coverage by country or Health financing by country, which would mirror the Health systems by country article but focus on short paras for each country that detail the financing arrangements in that country, and then link out to the main health system#financing link for each country. I suggest this because for now the country-specific descriptions take up the bulk of the article, and the broader definitional and generic issues around UHC are not covered well. Please share your thoughts on the above proposal.--Karl.brown (talk) 20:37, 23 March 2012 (UTC)
- Note - this was partially done; country-specifics were moved to Universal health coverage by country. --KarlB (talk) 15:10, 3 July 2012 (UTC)
Clarification Iraq and Afghan Health Care Status
The map rather confusingly lists Iraq and Afghanistan as having their "health care coverage provided by the United States war funding." I know of some commitments by the US military to provide medical attention to civilians injured as a by-product of American military action, but no universal health care. Could someone clarify? --Indolering (talk) 19:20, 30 March 2012 (UTC)
- The map was redone, and these notations re: Iraq and Afghanistan removed. --KarlB (talk) 15:57, 18 July 2012 (UTC)
Constitutional Health Care Guarantee
Most countries have constitutional guarantees for universal health care. I think we need to add another color to the map indicating these countries. — Preceding unsigned comment added by 24.128.221.196 (talk) 00:12, 30 July 2012 (UTC)
- There is a color for legislated mandate for UHC; if you see the referenced paper, you can see the methodology they used. If you can find other papers that use the same (or similar) methodology to capture UHC constitutional guarantees then it could be added; in any case it is probably better to have this discussionat the talk page of the image as it's used on several different articles.--Obi-Wan Kenobi (talk) 00:35, 30 July 2012 (UTC)
- Mexico, Peru, Turkey, Lebanon, India, Pakistan, Bangladesh, Cambodia, Malta, Kenya, and Ethiopia to name a few are all countries that have legislated mandates for UHC. — Preceding unsigned comment added by 63.117.69.3 (talk) 18:09, 29 August 2012 (UTC)
Addition(s) to the article: Funding models
Hello,
I read the article and thought it would be nice to see more information included about the history and different funding models. I have included sources in my proposal.
Could there be a comparison made between the funding models? Possibly the implementation issues? http://www.healthpaconline.net/universal-health-care.htm
http://www.who.int/bulletin/volumes/86/11/07-049387/en/index.html
Under the funding models section in the Social health insurance sub-section there did not appear to be much information. If Social Health Insurance is too dissimilar to be elaborated on in this article could there be an inclusion of a link to another wiki article and/or website that goes in depth about social health insurance? "Social health insurance:Key factors affecting the transition towards universal coverage" by Guy Carrin and Chris James for the World Health Organization Geneva.
http://www.euro.who.int/__data/assets/pdf_file/0010/98443/E84968.pdf
Also the community-based health insurance sub-section was lacking too in information. There are countries that are implementing this funding model and it would be interesting to see them included in the article.
http://heapol.oxfordjournals.org/content/19/3/147.full.pdf
http://apps.who.int/iris/bitstream/10665/69023/1/EIP_FER_DP.E_03.1.pdf
Thank you.
--D wing200 (talk) 22:34, 17 September 2012 (UTC)
Should U. S. be classified as a "Nation attempting to obtain universal health care"?
If yes, File:Universal health care.svg should be updated accordingly. Dodoïste (talk) 08:36, 1 July 2012 (UTC)
- Since one of the stated goals of the ACA is to give everybody access to affordable healthcare, I think the US should fall under the category of "attempting."Cite error: There are
<ref>
tags on this page without content in them (see the help page). — Preceding Wikipedia:Signatures comment added by 98.220.38.52 (talk) 13:16, 1 July 2012 (UTC)- Thanks for your comment. I've updated the file accordingly.
- Now the file was removed for discussion, as it is not based on factual sources. That's another issue. I hope it will be solved, as I find this map useful. Dodoïste (talk) 09:55, 3 July 2012 (UTC)
- Thanks; there is a discussion going on here File_talk:Universal_health_care.svg about how this graph is made. The problem is, many countries are attempting to improve their health coverage, but there isn't a clear metric on when a country has achieved universal health coverage. So yes, the US is attempting to improve, but so is Canada and England. Please join the discussion - what is most needed are 3rd party sources which make some sort of differentiation between levels of UHC. --KarlB (talk) 12:17, 3 July 2012 (UTC)
- The more you think about the notion of "universal health care" the less it means. From moving between different countries I've found that US residents have better access than in other developed countries. For example, in Europe or Australia an expensive medication may be difficult to get because it's too expensive, but in the US the pharmacutical company will give it to you at the copay price or free. This is something I've found from direct experience. — Preceding unsigned comment added by 2001:DA8:D800:107:E1BB:43D5:78EA:8E71 (talk) 09:04, 1 January 2013 (UTC)
- Thanks; there is a discussion going on here File_talk:Universal_health_care.svg about how this graph is made. The problem is, many countries are attempting to improve their health coverage, but there isn't a clear metric on when a country has achieved universal health coverage. So yes, the US is attempting to improve, but so is Canada and England. Please join the discussion - what is most needed are 3rd party sources which make some sort of differentiation between levels of UHC. --KarlB (talk) 12:17, 3 July 2012 (UTC)
- graph has been revised; further discussion re: graph should ideally be here File_talk:Universal_health_care.svg; in any case, the US is now listed as a country which has legislation in place for UHC.--KarlB (talk) 15:58, 18 July 2012 (UTC)
Universal health care in Poland
According to Health care in Poland Poland has universal health coverage, which is not reflected on the map. — Preceding unsigned comment added by 168.28.2.98 (talk) 20:33, 18 March 2013 (UTC)
- Plz see ongoing discussion here: commons:File_talk:Universal_health_care.svg#Map_based_on_unreliable_ILO_source. The paper cited to develop the map did not list Poland as having achieved UHC, which is proposed as a combination of legislative mandate, effective insurance coverage, and effective service delivery (proxied as 90% skilled birth attendance). So they likely failed one of those criteria, based on the 2009 data of the paper. The best way to solve this is to find another paper which defines UHC as 'X' and then says 'Poland has achieved it'. --Obi-Wan Kenobi (talk) 21:34, 18 March 2013 (UTC)
Russian Federation
According to the map Russian Federation is not country with UHC. Document provided as a proof does not contain proof itself (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) 06:47, 20 January 2013 (UTC)
- I agree. It is also ridiculous that the USA and China where establishment of UHC is just under process are marked as countries with UHC while Russia where 100% health care coverage has been existing for decades is marked as a country with actually unexisting UHC. — Preceding unsigned comment added by Vornoff (talk • contribs) 12 May 2013
- I'm not sure what map you're looking at - Russia is marked as having a legislated mandate but not yet achieved threshholds of 90% social protection and 90% attended births - that was the proxy for UHC laid out in the source. China is not marked as all. The problem here is we have to follow sources - it would be great to find a newer source that (a) defines what is UHC and (b) defines which countries have met the threshold. Otherwise, it just becomes an argument of people saying "country X has it" and "country Y doesn't" - we need to go by sources. Please contribute here, where the discussion about this map should be centralized commons:File_talk:Universal_health_care.svg --Obi-Wan Kenobi (talk) 13:13, 12 May 2013 (UTC)
- See for example http://www.ilo.org/dyn/ilossi/ssimain.viewScheme?p_lang=fr&p_scheme_id=3104&p_geoaid=643 which clearly says that "All Russian citizens, foreigners and refugees living in the Russian Federation are insured in the framework of the mandatory health insurance". I would daresay "all" and "are" mean 100% or close to 100% actual coverage by mandatory health insurance. — Preceding unsigned comment added by Vornoff (talk • contribs) 14:37, 12 May 2013 (UTC)
- Yes; however, UHC is not defined by the paper as just 100% insurance coverage - access is also measured, and legislative intent (access measured through proxy of skilled birth attendance). Again, I didn't write the paper, I'm just going by sources, if you can find another more recent source that says "this is what UHC is, and by such definition, the following countries meet the threshhold" we'll be in business. It's just there aren't many papers which have actually drawn a line in the sand to say this country has UHC and this one doesn't, but there was discontent when the map was removed, so users want *some* sort of map here.--Obi-Wan Kenobi (talk) 14:49, 12 May 2013 (UTC)
- See for example http://www.ilo.org/dyn/ilossi/ssimain.viewScheme?p_lang=fr&p_scheme_id=3104&p_geoaid=643 which clearly says that "All Russian citizens, foreigners and refugees living in the Russian Federation are insured in the framework of the mandatory health insurance". I would daresay "all" and "are" mean 100% or close to 100% actual coverage by mandatory health insurance. — Preceding unsigned comment added by Vornoff (talk • contribs) 14:37, 12 May 2013 (UTC)
- I'm not sure what map you're looking at - Russia is marked as having a legislated mandate but not yet achieved threshholds of 90% social protection and 90% attended births - that was the proxy for UHC laid out in the source. China is not marked as all. The problem here is we have to follow sources - it would be great to find a newer source that (a) defines what is UHC and (b) defines which countries have met the threshold. Otherwise, it just becomes an argument of people saying "country X has it" and "country Y doesn't" - we need to go by sources. Please contribute here, where the discussion about this map should be centralized commons:File_talk:Universal_health_care.svg --Obi-Wan Kenobi (talk) 13:13, 12 May 2013 (UTC)
POV tag regarding "Social health protection (SHP)" map
I've tagged the section of the article that contains this map as it doesn't belong in this article. According to the source, "Social health protection is defined by the ILO as a series of public or publicly organized and mandated private measures against social distress and economic loss caused by the reduction of productivity, stoppage or reduction of earnings, or the cost of necessary treatment that can result from ill health." In other words, SHP doesn't necessarily involve health care, which is only a component of SHP. It's also not synonymous with "Compulsory insurance" so having it in that section doesn't make sense. What it does do is paint the U.S. in a flattering light, even though the U.S. doesn't have universal health care. User:Obiwankenobi created the graphic in 2012 and appears steadfast on it remaining in this article. Somedifferentstuff (talk) 09:51, 14 July 2013 (UTC)
- I created the graph based on an ILO source; the map is an exact copy. Secondly, you may want to read this article more carefully, which is titled Social Health Protection. An ILO strategy towards universal access to health care. For example, they state that "Virtually all countries have established systems based on multiple financing mechanisms that combine two or more of the mentioned sources of funding - and the ILO explicitly and pragmatically recognizes the pluralistic nature of national health protection systems. The ILO advises the promotion of systemic combinations of national financing systems that provide: (a) universal and equitable access to health services; (b) financial protection in case of sickness; and (c) overall efficient and effective delivery of health services." Also, it seems you may consider "universal health care" to be *only* about health care, but it is not - this concept is also explicitly about financial protection from loss as a result of health care expenditures. Finally, its inclusion in this article is warranted because the definition we are using in the first graph above for UHC relies on the ILO social health protection as one of three measures of universal health care; countries need to score at least 90% on the ILO social health protection metric in order to be considered to have "universal health care". I'm still not sure what POV you believe is being promoted here, but it's certainly not to paint the US (or any other country) in a positive light; the intent is rather to share a different slice of the data than the very first graph, which paints a more stark picture (has, doesn't quite have, doesn't have), with a more granular view of social health protection, which is the way a major international organization views this topic. We could probably create a separate section to discuss social health protection and house the graph there, I'd be fine with that of course. The bottom line is, different organizations in this space view this issue in a slightly different light - the WHO prefers to call it "Universal health coverage", American media calls it "Universal health care", the ILO and GIZ uses the term "Social Health Protection", etc. They don't all have EXACTLY the same meaning, but they are all close enough that a single article is sufficient with redirects for now. --Obi-Wan Kenobi (talk) 16:06, 14 July 2013 (UTC)
- There is absolutely NO consensus whatsoever for the inclusion of this misleading, WP:NPOV-violating, blatantly erroneous map in this or ANY OTHER Wikipeida article. Apatens (talk) 23:42, 14 July 2013 (UTC)
- you seem really passionate about this issue, do you have any sources which back up *your* claims that the ILO paper is inaccurate? Otherwise this is original research. I don't think they are making the claim that 100% of the US population has health insurance, that's not what social health protection means. In any case, if you have issues with the numbers you publish, I'd suggest taking it up with them. I've seen the ILo data replicated in multiple papers (for example the one used for the first map), so other scholars don't seem to dispute those figures. Again, if you have other sources that say "Ilo data is terrible and not to be trusted" bring them forth. --Obi-Wan Kenobi (talk) 02:09, 15 July 2013 (UTC)
- I agree with the user above that the Social health protection map doesn't belong in this article. Obiwankenobi, I will respond to your post but I don't have the necessary time right now. Somedifferentstuff (talk) 17:30, 16 July 2013 (UTC)
- There is absolutely NO consensus whatsoever for the inclusion of this misleading, WP:NPOV-violating, blatantly erroneous map in this or ANY OTHER Wikipeida article. Apatens (talk) 23:42, 14 July 2013 (UTC)
- Since user:Apatens didn't explain his position, you and I should try to arrive at some consensus. When you reverted this edit[3] of mine, you created a contradictory article. I'll explain. When a reader comes to this article they see a map of countries with Universal health care (the United States is not on the map because they don't have Universal health care)[4]; but now, with your revert, when they read the first sentence of the lead they see: Universal health care — sometimes referred to as universal health coverage, universal coverage, universal care or social health protection. -- So if they scroll down to your Social Health Protection map they may think, "oh, maybe the U.S. does have Universal health care", because of what is stated in that first sentence combined with what is shown on your map; but the U.S. doesn't and UHC and SHP are not interchangeable. Somedifferentstuff (talk) 23:51, 22 July 2013 (UTC)
- There are multiple, contested definitions of what exactly UHC is - and even harder is finding a source that says "this country has UHC, and this one doesn't" - I found one source which did, and which I used to develop the map. The map that was there previously was based on, well, nothing at all as far as I could tell - but people want to see some map. That's the problem we're dealing with. SHP is, to some, UHC - read this source, for example: Universal coverage in Mexico is synonymous with social protection of health, you can find many others, including much from ILO, GIZ, and other european organizations. I don't think we're harming the users by presenting the ILO data in that way. I admit that it may be flawed (for example, Moldova numbers), so I'd be happy to update the map accordingly - better yet would be to get fresher data from ILO, as it now dates to ~2008. I also don't agree with your revert of the addition of "countries with legislation" addition to the map - while the source doesn't have such a map in the paper itself, they did detail in a web appendix which I have all of the countries which have legislation, and highlight legislation aspect several times, so I think it's useful to the reader to see that additional classification of countries and useful to see that several countries do have policies in place for UHC but haven't yet reached the threshhold definition - this can also serve to disarm people who come and say "Why isn't X on the map colored green, it's a law that UHC exists in X" - we could even add more nuance to the main graph. Wikipedia is chock full of chloropleth maps reproduced solely from data (where the maps weren't in the original sources), there's no prohibition against this. If you want to clear up the language around social health protection and even have a separate section devoted to it to make things clear for the reader, that would be fine and I'd be happy to help. Finally, your assertion that the US doesn't have universal health care doesn't hold water - according to some definitions, it does - since anyone can show up at an emergency room, and if unable to afford the cost, be covered for basic emergency care. There are some countries - many in fact - where this isn't the case. The WHO report is the best one I know, which defines UHC along a spectrum with 3 dimensions. How far do you have to be on each dimension (population coverage, services coverage, OOP payments) before you have UHC? Is UHC defined solely by policy, by financial protection, or is access also important? By most standards, Japan has UHC, but patients sometimes still have to cover a significant out of pocket payment.--Obi-Wan Kenobi (talk) 00:29, 23 July 2013 (UTC)
- This article is about universal health care and the lead map should reflect this. If you want to create another map showing countries with pending legislation that should go in another section; and I didn't revert you, another user did but I agree with him. And the United States doesn't have Universal health care.[5][6][7] I assume you don't have personal experience with UHC because your emergency room example was not a good one. Lastly, what is your proposal to fix the current contradiction in the article which appeared after you reverted me. Please be more concise with your next comment. Somedifferentstuff (talk) 01:12, 23 July 2013 (UTC)
- seriously, you quote me that Atlantic blog?? Do you know where they got that map in the first place?? WIKIPEDIA! That blog was one of the things that inspired me to make a better graph - that graph is complete **** ... - and that Atlantic article is lazy journalism at it's finest - making deductions about UHC based on a wikipedia map that itself HAD NO SOURCES. I don't even know where to start.
- I *know* that by most definitions the US does not qualify as having UHC, but by the definition of the ILO, they do have 99%+ social health protection.
- Again, I don't think there is a contradiction. We should simply call out SHP in a separate section, explain what it means and introduce the graph there.--Obi-Wan Kenobi (talk) 01:50, 23 July 2013 (UTC)
- Seriously, you attack a source without providing any proof that anything in the article is inaccurate? Did you even bother to look at these 2 links within the article.[8][9]. The United States is unlike every other country because it maintains so many separate systems for separate classes of people.
- The reason the US doesn't have Universal health care by most definitions is because the US doesn't actually have UHC.
- There is a clear contradiction as I explained above.
- I've removed the material again from the lead as it doesn't belong there. I'll explain. Universal health care and Social health protection are not equivalent; see the source you provided in your earlier edit summary for clarification. The fact of the matter is that the term Social health protection does not have anything to do with the amount of people covered, which is precisely what the term universal is used for. Social health protection is defined as a series of public or publicly organized and mandated private measures against... etc.; whether they cover 5% of the population or 100% is another matter.
- There is something we agree on. That the SHP map should be in its own section. Somedifferentstuff (talk) 17:03, 23 July 2013 (UTC)
- Sigh. The MAP, which was presumably used as their basis of argument, was from WIKIPEDIA - a map which was built based on no sources whatsoever. Here's one particularly egregious portion:"What's astonishing is how cleanly the green and grey separate the developed nations from the developing, almost categorically. " - so the author is concluding, based on a map in wikipedia based on zero sources, that no "developing" countries have UHC. What about Thailand, or Mexico - neither of which is shown on that map! I don't want to talk about the Atlantic piece anymore, it's really quite poor. Again, that material in the lede is restored, I've provided multiple citations showing how major organizations in this space equate those terms. You have to provide a source which says "these things are totally different" if you really want to remove it from the lede. Also please read what it says - it doesn't say "UHC is a synonym for SHP" - it says "sometimes referred to as" - because, again, there are many contested and overlapping definitions for all of these terms. As long as we're clear in the lede that they are not synonyms, but closely related and sometimes used one for the other, we are helping not hindering the reader. In any case, those are all redirects, so they should still remain in the lede. I'd suggest you start by writing up a SHP section, and we work on that together.--Obi-Wan Kenobi (talk) 17:12, 23 July 2013 (UTC)
- Here's another source from the WHO [10], with the following juicy quote: "In this report, both universal coverage and social health protection are used synonymously and the term 'universal coverage' is employed to reflect both." Thus, stating that UHC is *sometimes* called SHP is reasonable, even in the lede. I've cited other sources elsewhere. Have you brought any sources to the table asserting your POV?--Obi-Wan Kenobi (talk) 17:29, 23 July 2013 (UTC)
- Sigh. The MAP, which was presumably used as their basis of argument, was from WIKIPEDIA - a map which was built based on no sources whatsoever. Here's one particularly egregious portion:"What's astonishing is how cleanly the green and grey separate the developed nations from the developing, almost categorically. " - so the author is concluding, based on a map in wikipedia based on zero sources, that no "developing" countries have UHC. What about Thailand, or Mexico - neither of which is shown on that map! I don't want to talk about the Atlantic piece anymore, it's really quite poor. Again, that material in the lede is restored, I've provided multiple citations showing how major organizations in this space equate those terms. You have to provide a source which says "these things are totally different" if you really want to remove it from the lede. Also please read what it says - it doesn't say "UHC is a synonym for SHP" - it says "sometimes referred to as" - because, again, there are many contested and overlapping definitions for all of these terms. As long as we're clear in the lede that they are not synonyms, but closely related and sometimes used one for the other, we are helping not hindering the reader. In any case, those are all redirects, so they should still remain in the lede. I'd suggest you start by writing up a SHP section, and we work on that together.--Obi-Wan Kenobi (talk) 17:12, 23 July 2013 (UTC)
- This article is about universal health care and the lead map should reflect this. If you want to create another map showing countries with pending legislation that should go in another section; and I didn't revert you, another user did but I agree with him. And the United States doesn't have Universal health care.[5][6][7] I assume you don't have personal experience with UHC because your emergency room example was not a good one. Lastly, what is your proposal to fix the current contradiction in the article which appeared after you reverted me. Please be more concise with your next comment. Somedifferentstuff (talk) 01:12, 23 July 2013 (UTC)
- There are multiple, contested definitions of what exactly UHC is - and even harder is finding a source that says "this country has UHC, and this one doesn't" - I found one source which did, and which I used to develop the map. The map that was there previously was based on, well, nothing at all as far as I could tell - but people want to see some map. That's the problem we're dealing with. SHP is, to some, UHC - read this source, for example: Universal coverage in Mexico is synonymous with social protection of health, you can find many others, including much from ILO, GIZ, and other european organizations. I don't think we're harming the users by presenting the ILO data in that way. I admit that it may be flawed (for example, Moldova numbers), so I'd be happy to update the map accordingly - better yet would be to get fresher data from ILO, as it now dates to ~2008. I also don't agree with your revert of the addition of "countries with legislation" addition to the map - while the source doesn't have such a map in the paper itself, they did detail in a web appendix which I have all of the countries which have legislation, and highlight legislation aspect several times, so I think it's useful to the reader to see that additional classification of countries and useful to see that several countries do have policies in place for UHC but haven't yet reached the threshhold definition - this can also serve to disarm people who come and say "Why isn't X on the map colored green, it's a law that UHC exists in X" - we could even add more nuance to the main graph. Wikipedia is chock full of chloropleth maps reproduced solely from data (where the maps weren't in the original sources), there's no prohibition against this. If you want to clear up the language around social health protection and even have a separate section devoted to it to make things clear for the reader, that would be fine and I'd be happy to help. Finally, your assertion that the US doesn't have universal health care doesn't hold water - according to some definitions, it does - since anyone can show up at an emergency room, and if unable to afford the cost, be covered for basic emergency care. There are some countries - many in fact - where this isn't the case. The WHO report is the best one I know, which defines UHC along a spectrum with 3 dimensions. How far do you have to be on each dimension (population coverage, services coverage, OOP payments) before you have UHC? Is UHC defined solely by policy, by financial protection, or is access also important? By most standards, Japan has UHC, but patients sometimes still have to cover a significant out of pocket payment.--Obi-Wan Kenobi (talk) 00:29, 23 July 2013 (UTC)
- Since user:Apatens didn't explain his position, you and I should try to arrive at some consensus. When you reverted this edit[3] of mine, you created a contradictory article. I'll explain. When a reader comes to this article they see a map of countries with Universal health care (the United States is not on the map because they don't have Universal health care)[4]; but now, with your revert, when they read the first sentence of the lead they see: Universal health care — sometimes referred to as universal health coverage, universal coverage, universal care or social health protection. -- So if they scroll down to your Social Health Protection map they may think, "oh, maybe the U.S. does have Universal health care", because of what is stated in that first sentence combined with what is shown on your map; but the U.S. doesn't and UHC and SHP are not interchangeable. Somedifferentstuff (talk) 23:51, 22 July 2013 (UTC)
I also find it really ironic that this SHP map is being attacked. One of the main reasons I added it was to balance the initial graph, which is partially based on this data, but also sets thresholds for service delivery. As a result, many countries which have very high levels of insurance coverage were *not* considered to have UHC. Thus, I felt, adding the map to demonstrate that there are many countries with high levels of SHP - even if they don't meet service delivery threshholds, would inform the reader. This is a complex subject, and it's not black and white (e.g. X has it, Y doesn't) - each country is at a different point along a multi-dimensional spectrum. One of APatens original critiques about the map was that it highlighted countries with legislation but poor coverage, while not highlighting those with good coverage, perhaps no formal legislation, and not meeting service threshholds. The ILO map was intended to help show a different side of the story. I admit that not creating a SHP section was my fault, so rather than keep arguing, lets just work together on that.--Obi-Wan Kenobi (talk) 17:32, 23 July 2013 (UTC)
- You haven't refuted the contradiction present in your version of the article nor have you appropriately addressed my explanation of why the term doesn't belong in the lead. Did you even bother to understand the new source you provided??? It states "universal coverage and social health protection", not Universal health care, which I discussed previously had you taken the time to digest it. Let me be very clear. You have not provided one source that equates those terms. Look at your sources again, thoroughly this time. Somedifferentstuff (talk) 17:48, 23 July 2013 (UTC)
- I suggest you read the WHO reference I provided - I'll copy it here: " Full social health protection corresponds to the term “universal coverage” which is used in the WHO concept of health for all and primary health care. Universal coverage of health care is defined as effective access to appropriate essential quality health services at an affordable cost. Universal coverage implies equity of access and financial risk protection. It is also based on the notion of equity in financing - people contribute to the system on the basis of capacity to pay." The WHO's preferred term is Universal coverage, Universal health coverage, or (above), Universal coverage of health care - but they are all basically the same term. Why are you arguing so strenuously over this. The other WHO source I provided above makes the same association. The TOPIC of the article is at play here, not the title. You need to get that into your head - an article can only be at one title, but it covers a TOPIC which may have multiple names. Providing them in the lede helps the user, and is sourced to two SEPARATE WHO-based sources; the ILO paper can be similarly sources, or the paper used for the graph - all associate SHP with UHC. Please stop your aggressive behavior here.--Obi-Wan Kenobi (talk) 18:10, 23 July 2013 (UTC)
- I added some sources to the lede linking with SHP. Would welcome your help in expanding a section on social health protection, I will start it.--Obi-Wan Kenobi (talk) 18:39, 24 July 2013 (UTC)
- Apatens has reverted, but has not joined the discussion here. The inclusion of SHP in the lede is appropriately sourced with 4 separate RS that equate SHP with the topic of this page. In addition, the existence of a special section on SHP, and placing the map within, was agreed between the two editors discussing here. I have thus reverted those changes, and invite Apatens to join the discussion here and share why this section should not exist, why the map should not exist, and why SHP shouldn't be mentioned.--Obi-Wan Kenobi (talk) 21:32, 26 July 2013 (UTC)
- I suggest you read the WHO reference I provided - I'll copy it here: " Full social health protection corresponds to the term “universal coverage” which is used in the WHO concept of health for all and primary health care. Universal coverage of health care is defined as effective access to appropriate essential quality health services at an affordable cost. Universal coverage implies equity of access and financial risk protection. It is also based on the notion of equity in financing - people contribute to the system on the basis of capacity to pay." The WHO's preferred term is Universal coverage, Universal health coverage, or (above), Universal coverage of health care - but they are all basically the same term. Why are you arguing so strenuously over this. The other WHO source I provided above makes the same association. The TOPIC of the article is at play here, not the title. You need to get that into your head - an article can only be at one title, but it covers a TOPIC which may have multiple names. Providing them in the lede helps the user, and is sourced to two SEPARATE WHO-based sources; the ILO paper can be similarly sources, or the paper used for the graph - all associate SHP with UHC. Please stop your aggressive behavior here.--Obi-Wan Kenobi (talk) 18:10, 23 July 2013 (UTC)
Universal health care and Social health protection maps
I removed the Universal health care map File:Universal_health_care.svg added on July 17, 2012 and the Social health protection map File:Social_health_protection.svg added on August 1, 2012 by Karl.brown/Obiwankenobi (talk | contribs) because they were inaccurate and misleading and their sources were not reliable.
The Universal health care map File:Universal_health_care.svg was sourced to:
- 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.
The Social health protection map File:Social_health_protection.svg was sourced to:
- International Labour Organization (November 16, 2010). World Social Security Report 2010/11: Providing coverage in times of crisis and beyond. Geneva: International Labour Office. ISBN 9789221232698.
Both sources used 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 article's Universal health care map File:Universal_health_care.svg 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 article's Universal health care map File:Universal_health_care.svg 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) 17:13, 14 March 2013 (UTC)
I reverted the readdition of misleading, inaccurate maps based on an unreliable ILO source by IP-hopping anonymous editor 88.232.225.122/88.232.227.246/81.213.226.125/88.224.21.194, who has reintroduced misleading, inaccurate maps without reliable sources to this article four times without consensus, talk page discussion, or edit summaries. Apatens (talk)
I re-added the two maps. I have moved the discussion to the talk pages of the maps in question, in order to centralize the discussion.--Obi-Wan Kenobi (talk) 20:31, 18 March 2013 (UTC)
Social health protection map based on unreliable ILO source
The Social_health_protection.svg map created by Karl.brown/Obiwankenobi (talk | contribs) on August 1, 2012 is inaccurate and misleading and its source is not reliable:
- International Labour Organization (November 16, 2010). World Social Security Report 2010/11: Providing coverage in times of crisis and beyond. Geneva: International Labour Office. ISBN 9789221232698.
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.
Apatens (talk) 16:56, 14 March 2013 (UTC)
- Having read the above carefully, I'm still not sure I understand the issue. We have 2003 statistics by one agency (OECD) that don't map with 2008 statistics by a different agency. Well, 5 years have passed, and there is likely a new or different methodology at play here. So, it is natural that the numbers are different. I can't see any reason to dispute that the ILO numbers are indeed the ILO numbers, which is all this map ever claimed. In fact, the graph shown simply replicates a figure from the paper, using the same exact divisions (e.g. <10%, 10-40%, etc): [11] (see figure 3.7), but converting it to an easily zoomable svg form w/o copyright issues. Do you really have any evidence, that the ILO is publishing figures which are wildly inaccurate - and do you have published sources which back up this assertion? I know some disagree with the ILO methodology, but calling it misleading/inaccurate/unreliable is not backed up by anything as far as I can tell.--obiwankenobi (talk) 21:27, 18 March 2013 (UTC)
You misunderstood. It is one set of data—misused by the International Labour Office.
The U.S. Census Bureau data on U.S. health insurance coverage in 2003—was used by the OECD for their statistics about U.S. health insurance coverage in 2003—which was published by the OECD in 2006—and was misused by the International Labour Office in Table A2.2 of their 2008 "Social health protection" paper to produce the absurd result that:
- 100% of the United States population has health insurance coverage!!!
This ridiculous claim was then replicated in the ILO's 2010 World Social Security Report, where it was used as the basis for its Figure 3.7 map, which was used as the basis for Obiwankenobi's Social_health_protection.svg map used in this Wikipedia article.
It is not valid to add the population percentage of Medicare beneficiaries and the population percentage eligible for Medicaid (ignoring the duplication of "dual eligibles" who receive Medicare and Medicaid) to the population percentage with private health insurance (ignoring the duplication of including complementary private health insurance—which most Medicare beneficiaries have to cover some of their cost sharing), as is made apparent by the absurd result that:
• 100% of the United States population has health insurance coverage!!!
Table A2.2 of the 2008 ILO "Social health protection" paper contains other errors, e.g.: miscopying OECD health insurance data for Israel (substituting 9.0% for 100%) and an error copying Mexico's 78.6% total insurance coverage to the following line for Moldova, instead of using Moldova's 100% social health insurance coverage.
Per WP:EXCEPTIONAL: Any exceptional claim requires multiple independent high-quality sources.
The following are exceptional claims made by the Obiwankenobi's Social_health_protection.svg map based on the ILO's 2010 World Social Security Report:
- 100% of the United States' population has health insurance coverage!!!
- 9.0% of Israel's population has health insurance coverage.
- 78.6% of Moldova's population has health insurance coverage.
The above are blatant errors from "Table A2.2. Formal coverage in social health protection" on pages 83–90 of Appendix II in:
- International Labour Office (2008). Social health protection: An ILO strategy towards universal access to health care. Social security policy briefings, Paper 1. Geneva: ILO.
A map based on misinformation and making exceptional claims SHOULD NOT be re-added to this or any other Wikipedia articles without consensus and multiple independent high-quality sources. Apatens (talk) 23:38, 14 July 2013 (UTC)
- SHP is not the same thing as health insurance coverage. Please read the sources carefully. I admit there may be errors in the dataset that you have identified, so we could easily correct Israel's and Moldova's figure in the graph and you can find a source that says Israel has x% SHP.--Obi-Wan Kenobi (talk) 21:34, 26 July 2013 (UTC)