All posts by Dr. Michael Forster

There’s a good chance the Supreme Court will rule that the “individual mandate” at the heart of the Patient Protection and Affordable Care Act (“Obamacare”) is unconstitutional.  Since the requirement that nearly everyone – healthy and unhealthy alike – buy health insurance is central to the insurance companies’ ability to expand coverage and to cover existing conditions, the ruling will likely mark the unraveling of the entire law.

What then?  Absolutely everyone agrees that the current system is disastrously unsustainable.  But Republican proposals – primarily focused on “voucherizing” Medicare, it seems – do nothing to address the key issues of coverage and cost containment.

So why not go the other way?  Why not expand Medicare to everyone?  There are at least two good reasons to consider doing so:

First, unlike Obamacare’s “individual mandate” to buy private insurance, there is absolutely no question about the constitutionality of taxing citizens for a public good.  We’re already doing it with both Medicare and Social Security.  And despite the passionate views of some that these programs too should be privatized, both Medicare and Social Security are immensely popular in their current form – payroll tax funded public programs.

Second, Medicare has greater potential for effective cost containment than any alternative on the political market.  It has a strikingly low administrative cost – 3% compared to a private health insurance industry average of 30% or more, and an 11% average for private plans under Medicare Advantage.  In addition, a universal Medicare could use the leverage of scale to negotiate lowered costs of pharmaceuticals and covered medical procedures.

If the Supreme Court effectively guts Obamacare by striking down the individual mandate, the smart move for the president and the Democrats will be to counter with a proposal to universalize Medicare.  As counterintuitive as it may sound at first, I think the vast majority of Americans – frustrated by both an out-of-control health care system and ineffective national leadership on the issue – would support the move.  And, presumably, so would the Supreme Court.

Last Thursday night the college presented nearly 100 achievement awards to some of our “best and brightest” students across the seven academic units. 

While the range of awards is extensive – from research recognition, to community service, to national dean’s list – the general theme of the event is scholarship and leadership excellence.  As I remarked in introduction, these students are the most academically successful, the most professionally dedicated, the hardest working, the leaders.  They are indeed our future, and the antidote to despair – energetic and gifted young women and men committed to service, leadership, and changing the world for the better, making it “healthier.”  What could be more important, or a better cause for celebration?

I’m sure the 500 in attendance – our largest turnout ever for this event, packing the Cochran Center ballrooms – would agree.

The Mississippi chapter of the National Association of Social Workers gathered Thursday and Friday of last week for its annual conference at the Natchez Convention Center.  March is Social Work Month nationally.  This year’s rallying theme is “Social Work Matters” – an important message in a time of severe and widespread cuts to social service programs and budgets, austerity measures causing much pain to many people.

Invited to offer a keynote address to the several hundred assembled, I did my best over 45 minutes with a captive audience to affirm the progressive, principle-centered, justice-oriented heritage of the profession, while attempting to scare everyone into action with the prospect of even meaner politics and social welfare back-sliding ahead.

On a happier note, the Southern Miss School of Social Work looked very, very good.  Attendees wearing black-and-gold “Southern Miss Alumnus” ribbons were ubiquitous throughout the Center and downtown Natchez.  Southern Miss faculty studded the program with high-attendance educational presentations.  An evening reception hosted by the school was “the” extra-curricular headliner.

Best of all, two former Gulf Coast faculty colleagues, Patricia Davis and Ray Scurfield, and a current Hattiesburg MSW student, Bethany Kent, received top honors.  Pat Davis was recognized for her induction into the national pantheon of “Social Work Pioneers,” an exclusive privilege indeed.  Professor Emeritus Ray Scurfield was presented with the chapter’s “Lifetime Achievement” award, reserved for only the most outstanding of lifelong contributors to the profession.  Delta native Bethany Kent received the state’s “MSW Student of the Year” award, in recognition of both her achievements to date and her promise as a professional and a leader.

Without doubt, 2012 should be remembered as a banner year for the school.

I just returned from an “International Health, Wellness, and Society” conference in Chicago, conveniently scheduled at the front end of spring break, where I presented a paper on the college’s efforts to confront Mississippi’s daunting health issues through a combination of collaboration and a decided shift toward a prevention/wellness perspective.

I learned much at the meetings I attended, but two impressions were particularly acute:

First, America’s ideological fixations strike many foreign colleagues as strangely self-inflicted damage.  Especially odd to many is our reluctance to use smart policy to encourage, if not compel, wellness-oriented behavior, or to invest in evidence-based interventions that ensure saving money (and suffering) in the long run.

Second, Mississippi and its bottom-rung status on so many health indicators “sell.”  Colleagues are intrigued, strongly curious to learn about the combination of historical-political-cultural factors that seem to keep Mississippi in headlines – some of them worldwide – concerning health bad news. 

One telling question that I got after speaking: “Is it true that other poorly performing states like to say ‘thank God for Mississippi’?”  Anybody from the Magnolia State knows that the answer is, sadly, “yes.”

Energetic efforts by a coalition dedicated to making Mississippi “smoke free” fell short, as state legislative leaders failed to bring bills forward for discussion by the required deadline.  Too bad.  Mississippi has many, many health challenges, but if there’s any single thing we might do to help our health profile, it’s cutting down on tobacco use.  (And yes, Mississippians are relatively heavy users of tobacco.)  It’s not just a matter of what I do to myself when I smoke, it’s the damage I do to others with my “second hand” smoke.

It’s time to start asserting the right of everyone to live and work in a healthy environment.  As Kimberly Hughes, Government Relations Director for the American Cancer Society Mid South Division, put it in reacting to the end of this year’s legislative effort: “Every Mississippian deserves to breathe clean indoor air. No business has a constitutional right to harm their employees or customers.”

Here’s hoping that the smoke free Mississippi coalition does indeed remain dedicated to the fight, and comes back even stronger next year.