I'll be insured for Christmas

What state has the highest rate of people who are uninsured?

Uninsured Rate by State[Source: U.S. Census Bureau]
  1. How accurate was your crummy prediction?

  2. What geographical patterns or trends do you see in the map above?

  3. How do you explain that pattern or trend?

  4. What is one consequence of this pattern?

  5. Make a connection between the data in the map and the concept of federalism.

  6. If we had a unitary system of government in the United States, how many colors would we have on this map?

  7. Make a claim about whether having a unitary system instead of a federal one would be a good or a bad thing:

  8. 8.8% of Americans are uninsured, a historic low. What claim would an American liberal make about this information?

  9. What claim would an American conservative make about this?

  10. What claim would someone who supported the idea of universal health coverage (a system where every person in the country has access to health care - for example: Canada, Sweden, or Spain, Germany, Denmark, Japan, South Korea, New Zealand, Australia, Italy, Finland, Portugal, Austria, France, Luxembourg, the Netherlands, Belgium, and Norway - just to name a few) make about the American system.

  11. Texas has the highest rate of uninsured people of any American state. Explain why you think that is. (For example, did the people of Texas demanded from their legislatures that their state have a super-high rate of uninsured people? Is health care more expensive in Texas? Do people in Texas just not want insurance?)

  12. One way to decrease the number of uninsured citizens of each state is for each state to pass Medicaid expansion (right now, states only have to pay 10% of the cost of Medicaid expansion - the federal government pays the rest). 37 states have expanded Medicaid and lowered the rate of uninsured people in their state (here’s a great explanation of all the health and economic benefits of Medicaid expansion) 14 have not. Why do you think some states have decided to lower their rate of uninsured while others have not?

  13. Looking at the map of the states who have expanded Medicaid, what patterns do you see in the data and how do those patterns connect to what you know about the political ideology and party affiliation by state?*

  14. They say that federalism allows people to “vote with their feet.” If you lived in Colorado (which thanks to their Medicaid expansion has a very low rate of uninsured people) versus next-door-neighbor Wyoming (which thanks to their refusal to expand Medicaid) has more than double the rate of uninsured people, explain how likely you would be to move?

Visual Extension*

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Learning Extension

Check out this interactive map from the Kaiser Family Foundation about insurance rates in each state.

Action Extension

Contact a member of your state legislature and ask them if they voted to expand Medicaid. Let them know whether you believe your state should expand Medicaid or not.

Therapy Animals in Airplanes Extension

This is totally real!

This is totally real!

Health Care ROI

The U.S. spends way more money on health care per person than any other country. How do you think our infant mortality rate compares to other wealthy countries?

  1. How accurate was your prediction?

  2. In a recent infographic (below) we learned about the high cost of US health care spending. Does this information from today's chart surprise you?

  3. What is the big story from this chart?

  4. What do you think causes the US infant mortality rate to be so high (bad) relative to other OECD (rich) countries?

  5. Is there anything a government can do to reduce infant mortality rates?

  6. Is there anything about the US health care system that causes such abysmally bad infant mortality rates?

  7. Why do you think Iceland has such better health care outcomes than the US?

  8. Why doesn't the US adopt more of the health care policies of countries like Sweden, Norway, Korea, and Japan?

  9. What questions do you have about this information?

  10. Besides infant mortality rates, what would be some other ways to measure the return on investment of our health care dollars?

  11. In the comments section, imagine the average American learned about this information. What do you think they would say?


Learning Extension

Did you know that “If Alabama were a country, its rate of 8.7 infant deaths per 1,000 would place it slightly behind Lebanon in the world rankings,” Christopher Ingraham recently noted in The Washington Post, while “Mississippi, with its 9.6 deaths, would be somewhere between Botswana and Bahrain.” Read this entire Atlantic article about the horribly high U.S. infant mortality rate.


Action Extension

Post online or on the wall the recent Health Care Investment chart (below) next to today's Health Care ROI chart along with a space for commentary.

Health Care Spending Gone Wild

¿How do you think U.S. per capita spending on health care compares to other wealthy countries?

  1. How accurate was your prediction?

  2. What most surprised you about this chart?

  3. What does the chart tell you about health care spending across the wealthy world?

  4. Why do you think the US spends so much more than other countries?

  5. What is one consequence of the US spending so much on health care per capita?

  6. What would be some good ways to measure the success of US health care?*

  7. Let's play the metaphor game. Based on health care spending, what kind of car is the US health care system?

  8. What do you think the US government could do to lower health care costs?

  9. Based on our high per capita spending, what expectations would you have about the health care outcomes in the US compared to other wealthy countries? Leave your response in the comments section:


Learning Extension

Read this fascinating PBS interview about why US health care costs are so much higher than other members of the OECD**.


Action Extension

Read this report by the Commonwealth Fund about ways to lower American health care costs and contact President Barack Obama with suggestions of what the US government can do to make the US health care system better OR find out what the leading presidential candidates (below) have to say about health care and contact them with your suggestions about lowering health care costs:




*We'll learn in later infographics about US health care outcomes, relative to other wealthy countries.

**The OECD is the Organization for Economic Cooperation and Development - a group of the world's most economically advanced nations.

Life Expectancy at Home & Abroad

¿Overall, is life expectancy higher in Europe or in the US?

  1. How accurate was your prediction?

  2. What story do these maps tell?

  3. In which areas of Europe and the US are life expectancy rates most similar?

  4. The part of the US with the highest life expectancy is similar to what part of Europe?

  5. Why do Europeans live, on average, so much longer than Americans?

  6. Based solely on this map, what part of the US would you definitely not want to move to?

  7. Do you think most Americans are aware of this information?

  8. What do you think most Americans would do if they learned that Europeans* (see bonus map), who spend much less money per person on health care, outlive Americans by so much?

  9. In the comments section, if you were an adviser to the president of the US what advice about health and life expectancy would you give them?

Action extension

Do some research to find the exact life expectancy of people who live in your state and then list three other countries (in Europe or elsewhere) that have similar life expectancy rates.

Bonus Map on per capita health care spending.*