By Ross Perez 2010/03/21

After much deliberation, fighting, infighting and some rather intense partisan antics, the House passed the health care reform bill Sunday. It is hard to think of a subject more controversial in American society today and the voting behind the bill proves it. If you have any interest in the subject, you can download the workbook and use the data to see the story from your own point of view.

Perhaps the most interesting story in the passing of the bill is illustrated in these two maps. The map on the left shows the percentage of people who do not have health insurance in each state; clearly the South and West are trailing the East and North. However, the map at the right shows that almost no representatives from the South and Midwest voted for the bill. In other words, representatives from the South were so strongly opposed to the bill that they voted against it, although their constituents would benefit the most (in theory). Similarly, Northeastern representatives voted for the bill though the vast majority of their constituents will gain little from the expanded coverage. It would seem that this vote (for both parties) was as much a statement of ideology as a vote for or against expanded health care.

What we like about this viz

Color: Two color scales can be confusing but these ones were chosen not to clash... and it works!

Tooltips (pop-ups): Detailed descriptions of fields help viewers understand without adding clutter.

Thanks to the Washington Post for the data.


And therein lies the greatest irony of the whole thing. If the federal government simply were to get the heck out of the whole business and let every state have full control over their own healthcare systems, each state could have the system they want and before long we would have a definitive answer as to what system works best.

Instead we get this mess.

"What's wrong with Kansas," as always. Those who voted against it will be the ones who most benefit. Unfortunately we aren't of a model where everyone gets only the government and benefits one votes for. Sometimes it's really tiring being a liberal...

"Those who voted against it will be the ones who most benefit."

Not necessarily. The West and South have the highest concentrations of uninsured because they have the highest concentrations of illegal immigrants. Amongst American citizens, the distribution of uninsured is distributed normally with the exception of Massachusetts which has more citizens covered but far fewer poor than many other states.

Illegal immigrants by and large do not buy health insurance, opting for emergency room care paid for by state tax payers.

The HCR bill does not resolve that problem so, as the HRC increases health care costs on all states equally (except the those who got the *special deals*) and does nothing to decrease the illegal immigrant cost burden of West and South states, those states will not see net increased costs and will not see the the most benefit.

Health care, immigration, deficits, welfare, taxes, military actions and all the "big" issues could be solved by dividing the country into the left and right. The left would end up in some form of socialism and the right would foster laisez faire capitalism. The middle would have to choose between the two. Guess which would come out better in, say, 25 years.

well, excessive capitalism almost brought the world to it's knees. I think most of the world is leaning to the left these days... we don't want to be a part of your world of reckless greed and selfishness.

The numbers are mildly interesting but don't shed much light on the question I keep asking myself. Who could possibly be against basic healthcare for ALL Americans or regulating the profiteering of the health insurance industry that kills 45,000 Americans every year and bankrupts many more. And yet there they stand, some 30 Democrats and EVERY Republican, each elected to Congress to serve the people. Amazing. America seems to have lost its way.

Let's be clear on one thing, the ppl that disagree with this bill do not hate HC reform. Both side painted this picture in a way that made it black or white when there is in fact middle ground. I for one am not for gov run industries and if you look at others, social sec, medicare/caid, post office, etc the gov never controls the spending and what is based on HELPING ppl ends up ruining lives, killing ppl(babies) and the well being of the country as a whole. So pls give ppl the curtiousy that they aren't monsters who hate regulations on the evil insurance co. They do want it, just do not want a takeover.

Big gov = debt / waste / less freedom

Simple math shows the utter folly of this bill. We cannot afford it without running up unsustainable debt. The purpose of the bill is to create dependent serfs who contribute next to nothing to the economy and but who do form a solid democrat voting block.

All polls show that 59-60% of the population opposed this abortion. Those opposing would be the people who work for a living instead of living on the government teat.

There was after all Bi-Partisan Support for the Healthcare Bill - OPPOSED TO IT... Democrats and Republicans voted NO while only the progressive, liberals voted yes.

You hit the nail on the head. Clearly Tableau (or this author) has a liberal, bankrupt the country bias here and it has no business being on a commercial site. Management should edit this post to either reflect the number of illegal immigrants or remove it.

Besides, those states CITIZENS who demanded their representatives kill this pile of bleep, don't want 'reform' in the form of this bill.

The strange thing is, the only people happy about this bill are Democrat politicians and the actual insurance companies who Obama spent the last year demonizing instead of working on the economy. That lack of focus alone has sealed the democrats doom in November.

Give me one example in history where any system other than Capitalism has been more successful than Capitalism.

By its very nature, capitalism has risk. There are no guarantees and people have been too stupid over the years to save for a rainy day and rather ran up huge personal debts (like our government except we can't print money)

There WILL be market crashes, there will be more in the future, but the overall average is lightyears ahead of the misery of Socialism/COmmunism. In its best economic years, countries like Venezuela, Cuba, The SOviet Union, even Western Europe and their hybrid socialism/capitalism have never had the GDP per capita approaching the US in our worst years since WWII.


The problem is your entire premise is completely false.

And if this bill actually solved this problems in a fiscally sound way, no sane person would vote against it.

Except the premise is completely wrong and your understanding of what this bill does and how its financed is completely wrong.

If this was a 'get the evil insurance companies' bill, like Obama has been stumping on for a year, than why have their stocks done nothing but risen as the bill moved toward reality and voted on? They get 35,000,000 new customers who will, by force of law, be required to buy their product. I bet Tableau wishes there were a law that all citizens must buy BI software...(This whole thing will likely get struck down by the Supreme Court because of this)

These numbers of americans that die because of lack of insurance claims are a joke. The assumption is if a 25 year kid is playing basketball who chooses to buy a new BMW 3 series instead of buy health insurance and he drops dead on the court because of a heart attack, that he died as a direct correlation to not having insurance.

There isn't a citizen (or illegal alien) in this country who if they need real medical care (not, I have the sniffels, please spend 30 minutes with me for free and prescribe an anti-biotic) they get it. It's been law for decades that nobody can be refused the emergency room,and we all already pay for that in our insurance.

If you are poor, you are eligible for Medicaid. If you are old, you are eligible for Medicare.

If you make $73,000.00/year and want to live in a nicer condo rather than buy health insurance, now its going to be my problem to subsidize your insurance premiums.

If you are healthy and don't want to buy insurance and find out you have cancer, now the insurance companies have to take you on at about $1,000/month premiums while shelling out $20,000 in medical care that all the rest of us pay for in higher premiums.

The health insurance companies have some of the net profit margins of any industry. I can guarantee you BI vendors take more to the bottom line as a percentage of revenue than they do.

If you took every ounce of profit the health insurance companies make and used it to provide healthcare for the United states, it would last less than 2 days of our annual costs.

Stop reading the NY Times, Newsweek or watching Rachel Maddow and MSNBC so you can start learning the truth

As a Texan and a person that disagrees with nationalized health care, I view this map differently than the comments lead people to read it. I see states that are subsidizing health care but can no longer afford it. So now they are willing to allow the federal government to subsidize their health care.

I also see that a third map is needed - a map showing which states have unbalanced budgets. We cannot afford to pay for nationalized health care.

Health care is overly regulated. Nationalization and regulation will increase cost for everyone. Law firms and health care related companies run by people with personal relationships with politicians will be the greatest benefactors. Low income people will still receive substandard health care in clinics that our representatives and senators would never enter seeking health care for themselves or their families. Middle income people will bear the majority of the cost directly and indirectly through diminishing salaries and a shrinking job market.

As a BI professional I can see how the presentation and omission of information can be misleading and misconstruing reality. This is a great example of how to use good data to represent what you “think” and not present truth and unbiased facts.

Please don’t drag Texas down with the rest of ya’ll. (And I use ya’ll proudly!).

Kudos to this comment. I couldn't agree more.

As a potential customer I found your email and post insulting.

The issues of the bill are so deeper than "who will benefit" - or whatever silly assumptions you have made.

Please keep your political lecturing out of my inbox.

What if I had a good job my whole life, paid taxes, always paid for health insurance thru an employee sponsored plan, now I am older and enjoying retirement, but not old enough for Medicare and I get cancer, and you want to cancel my health insurance?

You send money to help Haiti or Chili, but you do NOT want to allow all US children to be able to go to a doctor when they have colds, ear aches, high fevers, etc?

You oppose immigration reform, but you want every illegal immigrant to have free health care just by going to the emergency room?

First, this is an excellent demo of how to display data in an easily understood format.

Second, the passage of this bill is pure ideology at the expense of American citizens. There are no provisions to help contain health care costs, while in fact, having a bunch of previously uninsured people now in the market without any expansion of services, nor cost cutting elsewhere, will cause health care costs to balloon to the point of making the last ten years a fond memory.

My personal experience is that having lived around the globe, the best health care I've experienced was in my home country the Netherlands, followed by Switzerland, then the USA. England was abysmal, Canada and Australia both smelled bad but the UK takes the cake for rotten health care.

And what percent of health care is funded by the government in each of these countries?

Netherlands 6%
Switzerland 17%
USA 44%
Australia 62%
Canada 64%
UK 82%

So Mr. Obama wants the USA win the race to the bottom just so he can consolidate his power?

No Thank You! I'd take his miserable predecessor over Barack.

The states graph also demonstrates how the more urban, educated, and liberal states end up supporting the rural conservatives. Like HiHoSilver, I'd like to see this country split so we could get rid of the dead wood (y'all).
Those who wail about costs should hold their tongues for at least a little while--at least until we extricate ourselves from needless wars that have run up $1T of the bill. That's the money figure, BTW, my brother's prosthetic isn't included.
And complaining about insurance company profits is great sport when you get tired of complaining about the banks or big gas & oil, but you should have been behind the public option.

Still, I appreciate the graphs and wish they were published more broadly, say in the Post and Times.

Note that I am commenting on the format of the info being good, not what's in the data. Specifically illegal aliens being included in the non-insured group.

As a US citizen that legally immigrated here, I constantly see the abuse of including those here in the country illegally as US Citizens. I know the number of uninsured US citizens in several states in the West. These numbers clearly have illegal aliens included in that number.

"You hit the nail on the head. Clearly Tableau (or this author) has a liberal, bankrupt the country bias here and it has no business being on a commercial site.

You are absolutely correct. Tying to tie in Tableau's Business Analytics Software with a graph that shows how the voting for health care reform went down is not going to make people more likely to purchase Tableau's products (and selling their products is what they should concentrate on).

Tableau clearly falls into the same category as other companies such as GE. Their corporate leaders seem to see the need to inject their own political and ideological views directly on their customers. Regardless on what side of the health care issue you stand on, all fair minded Americans should reject this kind of corporate behavior.

Wow! Thank you all for your participation and comments; clearly our viz struck a chord.

First, I want to apologize if the post struck you as biased or adhering to a certain ideology. For example, in hindsight, I should have titled this something more along the lines of "Healthcare bill passed by representatives from states with lower un-insured rates".

However, with such a controversial bill, I doubt any visualization could be viewed by everyone as completely un-biased. I stand by my summation: "It would seem that this vote (for both parties) was as much a statement of ideology as a vote for or against expanded health care."

Luckily for those of you who felt strongly about this view, we live in a world of free data and open expression. At Tableau, we believe everyone should have the capability to find their own facts in public data. Download Tableau Public (or a Tableau Desktop Trial) for free, and use this workbook to make your own take on the view. Or, use your own data to create an alternate view.

Then, send it into me at and we will post it here (provided it uses accurate data, and is not profane or otherwise inappropriate). Or, post a link to a Tableau Public viz right here.

Thanks again and as always happy vizzing.


Every state can set up their own helthcare system and plan - Massachusetts. They don't, I understand because it is just too expensive for an entity smaller than full US or something large to handle. You probably picked that up from the Repubs who provided that to keep with their idea of 'States Rights'. That's another sorted story but suffice it to stay - that ain't going to work.

This is a really useful graph. Thanks, Tableau. But what's not so useful is all this name calling. Really, can we agree that reasonable people can have different opinions about this and that we don't have to call each other names to make a point?

Great visualization of information in a way that is easy to consume, no matter what one's politics this solution is a great way to illustrate the information. Looking forward to you covering more tops of political interest in the future.

The reason people who don't have insurance in the south is probably because they don't want insurance... ergo they don't want to be force to buy what they already don't want to buy....kinda like people who dont own guns would object to a law that mandates everyone to buy a gun and get free ammo....people didnt vote for health care for all.. they just want lower premiums for themselves and are willing to sacrifice everyones choice for it...

Unfortunately, tableau, GE, and all the major industry "don't get it". The future of their
vested interests depends on building out the next generation infrastructure for next generation
medical advancements, services, etc. Instead, they have been waiting on the sidelines, due
to the nominal stimulus money for electronic records. Sunday on NPR National Public Radio,
there was a program on how the space program was launched starting back in 1957.
As a comparison, you don't see industry promoting my message, nor the value of a major
"overhaul" of the medical system. That only proves that my projections from the Crystal Ball
Reports of 2002, are accurate. Technology will fall, big time starting in 2012. That report
is backed up by The Foundation for the Studies of Cycles- who see a severe double dip
recession starting in 2011.

What is noteworthy is the fact that the industry titans, the ones making the most money
have the weakest and most erroneous projections. So the word is- listen to the best, not
the profiteers. The best are the best. The richest are the very worst.

It just goes to show you, that in fact, their line, is not the leading edge. What this health care
bill tries to do, is funnel 800 billion plus into an outdated system. Luck has it, that already
12-14 states attorney generals are pressing charges on the grounds of it's unconstitutionality.

The really really sad part, is that technology/telecom- the very sector who can gain the most
from medical advancement, has no real opinion- even in the week of OFCNFOEC.

I would like to see some additional data. The actual amount and percent the federal government has NOT paid to doctors, hospitals, and insurance companies for every billing of services rendered. Ever since 1965, the federal government has paid only 70% to 80% of bills submitted (I have been an accountant in a doctors office). And this is the basic reason why health costs double every 5-10 years. If you want to see what federal health care REALLY looks like, just visit a clinic on a Native American reservation. It is criminal.

I'm actually sorry this graphic has turned into a political debate, but the following is true for graphic representation as well as politics; "What you focus on determines what you miss".

A guy from the south wrote:
"The reason people who don't have insurance in the south is probably because they don't want insurance"

This is nothing but an unsubstantiated assertion. There is no evidence to support it. I'm not going to try to make a counter claim as I don't have any facts myself. But I couldn't let it go by.

It also completely ignores the basic economics of the situation which is that if only sick people have health insurance it will cost FAR more than if everyone has it. If you require health insurance companies to cover people with pre-existing conditions and don't allow them to drop anyone, you must require everyone to have insurance. Otherwise people only start paying for health insurance when they get sick and stop as soon as they are better. That's like buying homeowners insurance after your house catches on fire, and dropping it as soon as your new house is built. There's a reason home policies don't work that way, and it has everything to do with free-market capitalism.

The gun analogy is also bogus. Unlike lack of gun ownership, lack of health insurance costs the rest of society, whether from emergency room visits, lost job productivity, unmanaged health issues resulting in unemployment and welfare, or catastrophic health issues bankrupting them and pushing them into the federal or state safety net. The better analogy is car insurance, which IS mandatory if you want to drive. Why? Because if you drive and injure someone else or damage their property, you are required to pay for it. Car insurance ensures that you can. Yes, you can choose not to drive, in which case you won't damage anyone's property with a car and you don't have to have the insurance.

The analog with health insurance would be choosing not to live. The only way you can be sure you won't get sick is if you are dead. Some states do allow you to make the choice to die if you are sick, but only in exceptional cases. And only if you see a couple of doctors first, which requires health insurance....

A trillion dollars to today's congress is all in a days work. They had the trillion dollar stimulus (worked real well, huh?) Trillion dollar healthcare bill, and want a trillion dollar 'cap and trade' program and they are only just getting warmed up.

Bush was a miser compared to these guys.

Downtown, If a state set's up their own healthcare (assuming equal distribution of population, which is irrelevent) than they have to deal with 1/50th of the expense so your argument doesn't hold water