BOSTON (CBS) – By now you’ve surely seen the dueling TV ads on ballot question 1 in Massachusetts, the proposal to limit the number of patients that can be assigned to a nurse.

“Patient limits mean more time with your nurse,” says a nurse in one of the Yes on One ads, which emphasize the promise of better care.

“At the end of the day if this ballot question passes, patients would be put at risk,” warns the No on One campaign, which stresses the negative effects of costly over-regulation of hospitals.

On Wednesday, the state’s Health Care Policy Commission released its own study siding with the industry’s forecast of massive new costs imposed by passage of the question, up to $900 million a year on a system already struggling with cost control.

Outside the meeting room after the release, union leader Julie Pinkham of the Massachusetts Nurses Association angrily denounced the study, charging the commission with over-reliance on industry data, and accusing them of failing to address a “growing patient safety crisis…. If I have four patients and you put on your call button, I can get to you,” she said. “If I have eight you wait. What happens when you wait? Sometimes something bad happens.”

But John Nash, CEO of Franciscan Children’s Hospital, a small, non-profit post-acute-care facility in Brighton, says “I’m not so sure the nurse’s union considered Franciscan Children’s when they put this on the ballot. What we would have to do in order to comply with the regulation is to cut back about one-third of our beds, which would mean for us a $2.5 million revenue loss on our bottom line, and we’re a break-even charitable organization.”

Insists Pinkham: “The one thing that this does different is it really for the first time gives a vote to people and puts them in control of health care.”

Both sides have featured nurses in their ads, adding to voter confusion over this complicated question and highlighting the fact that less than a quarter of nurses in the state belong to the union promoting a yes vote.

Whatever the outcome, question 1 may be remembered, as an example of how ballot questions can sometimes be blunt, unwieldy instruments for change.

For those willing to try, here’s a link to more information.

Jon Keller

Comments (2)
  1. Theodore Oule says:

    The question here revolves around the legitimate interests in government in setting health care standards and the interests of both government and consumer in keeping the costs low.

    While staffing and patient responsibility levels are important elements of quality healthcare, so to is the ever-rising costs of maintaining a healthcare system that actually delivers on its promises of quality care for the patient.

    My wife recently had a scary experience in a skilled nursing facility were her call button went unanswered for more than 2-1/2 hours. And, while the call was not of an emergency nature, the fact that NO ONE stuck their head in her room for that period of time FOR ANY REASON left her feeling that in a real emergency she would be in trouble.

    As I went about trying to talk to people about this, I found that there were gaggles of nurses on the floor discussing everything but their patients, and generally ignoring anyone that was standing at the nurses’ station trying to get someone’s attention.

    This is a complex issue with no easy solutions. But the starting place should neither be more staff or more money or both.

    The starting place should be the Bill Belichick philosophy of playing on his team: “Do your job”.

    In my professional career, I often found that jobs not done frequently had a great deal to do with people helping others do the others’ jobs for them.

    I set a rule…No excuses of not getting YOUR job done BEFORE helping someone else do theirs.

    It was amazing how efficient and less error prone our team became. Things got done on time. People had plenty of time to socialize…with my full permission…as long as the work was done. And over the years, were were able to free up people to do other work, saving us both time and money as well as having some of the best morale in the company.

    I’m going to vote FOR staffing mandates. But I am also going to insist on a higher standard of care for the additional cost that I am going to have to bear.

    The fortunes of the patient are for more important than the fortunes of either the hospital owners or the nurses. And, the state has a legitimate role to play in the discussion.

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