Visualizing The Health Care Reform

With our recently introduced category, Inside, we want to start a conversation around the processes and tools that information designers use. Following our introductory post, we’re happy to present you the first guest post in this category by our community member Marco Giannini. The work he presents here received a “best design” award in the GOOD Magazine competition.

The Story

GOOD is a well known periodical from the United States launched in 2006 and published in two different formats, both paper and internet. The magazine gives broad information on several topics like lifestyle, environment, education, business, politics and more. As part of the GOOD Magazine’s Transparency series they launched a contest in March 2010 about the new health care bill approved by the U.S. government.

The objective was to create an infographic explaining the health care reform based on existing research and relevant topics like whom the reform will benefit and whether it will save or waste money. Suggested data sources were the New York Times, the Washington PostCBS, and the U.S. Government.

The Creation

Health care in the United States is intransparent and overly complicated: There are so many different kinds of medical coverage that, before the reform, people were easily overwhelmed by legal ramifications and missed out on services they were entitled to have. This presented an interesting opportunity for me to apply my experience as a graphic designer – I have worked on both static and interactive infographics since 1996 – to visualize this interesting data from a citizen’s point of view in order to see what changes the reform would bring.

I started with splitting all the U.S. citizens into two groups: those who will and those who won’t be affected by the reform. In doing so, I realized that the reform will affect most of the citizens by 2014 – the real turning point – and I decided to split them into uninsured and insured. Apart from controversies over the reform during the period of congress approval, many different sources prove that a large amount of people in the U.S. are currently uninsured: around 90 million non-elderly people, according to the Census Bureau. As a next step I focused on the various kinds of insurance and split all the insured people into four categories:

  1. Self-initiated insurance at a private insurance company
  2. Insured by employer (lucky!)
  3. Insured by Medicare
  4. Insured by Medicaid

Currently Medicare and Medicaid support a large amount of poor and elderly people by providing them with therapy and health programs, supervision and personal assistance. But analyzing the numbers concerning this huge population stratum would miss the point, so I tried to concentrate on the more relevant part of the population: the uninsured. Because everyone should have an insurance by 2014, I decided to focus on solutions rather than the current situation, and, in order to get a similar grouping, split all uninsured people into four categories, too:

  1. People who have been refused insurance due to their health condition will be covered by a high risk pool (until 2014)
  2. People who will be insured by Medicaid due to their household income
  3. People who will get an insurance through the new government-run insurance marketplace (starts 2014)
  4. People who will be refused an insurance (because of penalties)

When looking for a visual representation to show the development of the health care reform over time, I decided on the subway map metaphor, grouping main categories by color. The labelled circles inside the map can be understood as subway stations, stopping at milestones as they progress downwards along the ten year reform timeline. The result is a flow that shows the starting and end points for both insured and uninsured citizens (whose situation hopefully improves) and clarifies the main applications of the reform:

  1. Changes in Medicare and Medicaid programs (columns A, B, C, D, L, M, X, Y and Z)
  2. Insurance Companies reforms (E, F, G, H, I, J)
  3. Government-run marketplaces (P, Q and R)
  4. Penalties (N and O)
  5. Other minor issues

Using this visualization, a reader can pause at each stop and read the corresponding bill. Some entries have been included without having a connection to a starting point because of their relevance.

Connections between stations, as well as multiple stations, were shown where possible. Enduring effects represent the duration of a bill over the years (some chapters of the reform stop in 2014, while others start then).

Then I added several facts and figures that I found interesting:

I also added a breakdown of the reform’s economic effect on the U.S. budget to clearly focus on the citizens and their future.

Finally I wanted to emphasize the fact that President Obama made health care for every American citizen a reality, something that several presidents tried but failed to achieve before him. So I added a timeline starting in 1912, showing the previous attempts. I used the historic coverage of Reuters as a source of information on this.

The Visualization

In the end, everything was combined into a poster, providing various levels of information. I added the human shape because I originally planned to create a list of all senators who voted against the reform on its back, but unfortunately, there was not enough time to do this.

The final infographic was published in the GOOD Magazine summer issue. You can also find a high resolution version on

What are your thoughts? We are very interested in your thoughts on the presented process and the final infographic, so please share them with us and comment below.

Visualizing The Health Care Reform Marco Giannini is a designer working at Infograficanimata, a branch of the service company Legomena located in Rome, Italy. Visit his portfolio if you want to see more of his work.

Wanna have your work featured here?
Submit a link!

Share this article

Subscribe for more

Give Feedback

  • Gavin Colborne

    Great work as ever guys.

  • Ulises Bolivar

    gracias por el aporte

  • Harold Blattie

    How can I get a printable copy of this in pdf format? LHB