BOSTON (CBS) – Question 1 in Massachusetts is the proposal that would require strict nurse-to-patient ratios in Massachusetts hospitals.

A ‘Yes’ vote would limit the number of patients that could be assigned to one registered nurse in hospitals and certain other healthcare facilities.

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A ‘No’ vote would make no change.

WBZ-TV’s Lisa Hughes sat down with WBZ colleagues, Dr. Mallika Marshall and political analyst Jon Keller, to break down what Question 1 would mean for patient access.

(WBZ-TV graphic)

Marshall, a longtime physician, said the vast majority of doctors and hospitals oppose Question 1.

“If this passes, hospitals are going to be mandated to keep certain ratios and if they fail to do so, they are going to be fined exorbitant amounts of money,” Marshall said. “And that means that there’s some community hospitals that may be at risk of closing down, even at some of the larger hospitals, some units may have to close down, and that’s because they’re going to have to reshuffle nurses so they might have to bring nurses up from the emergency room or bring nurses in from outpatient programs in order to comply with the mandate.”

If hospitals don’t comply with the mandate, Marshall said, “they’re going to lose a lot of money, and that means less access to care for patients. outpatient programs, longer waits in the emergency rooms, substance use disorder programs, mental health beds — all of these things that were already busting at the seams to try to accommodate and greater expense that is going to trickle down to the patient, unfortunately.”

While it sounds good in theory and compelling ads make it sound like Question 1 is in a patient’s best interest, “in my humble opinion, I think you should vote, ‘No,'” Marshall said.

(Photo by Christopher Furlong/Getty Images)

And it isn’t just the medical community that is split on Question 1.

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Boston Mayor Marty Walsh and U.S. Senators Elizabeth Warren and Ed Markey say they will vote ‘Yes’ on Question 1, while Massachusetts Gov. Charlie Baker opposes nurse staffing mandates in Massachusetts hospitals.

Keller, in his analysis, said Question 1 “should be a blowout in the polls, but it’s not.”

“From a straight political viewpoint, this should be a slam dunk. Who doesn’t love nurses?” Keller said. “I worship the ground these nurses walk on, male and female nurses. They’re wonderful. They’re your lifeline.”

Question 1 “is being promoted by the Massachusetts Nurses Association, the largest nurses’s union in Massachusetts,” Keller said. “I believe less than 25 percent of the working nurses in the state belong to this union. And that message has gotten around. And there’s been resistance in this state in recent years, to the political muscle that unions manifest.”

“I think in this case, there may well be some resistance to the idea that a complex issue is going to be litigated or mandated through the blunt instrument of a ballot question, because this was before the legislature in the form of a bill for years, and they rejected it,” Keller said. “They wouldn’t go for this. That’s why it would up on the ballot. I think there’s a lot of people skeptical of union clout, and skeptical of this way of legislating.”

UMass Lowell-Boston Globe poll released earlier this month shows 51-percent of likely voters will vote “no” on Question 1 regarding nurse-patient limits, while 43-percent plan to vote “yes.”

Marshall said a statewide mandate isn’t the best way to address nursing issues.

“There are problems. There are nurses that are out there that are overworked, that are overwhelmed, but the fixes need to be in those particular places, in those particular units, hospitals, urgent cares, emergency rooms, whatever it is,” Marshall said. “This should not be a statewide mandate because it can’t apply to every place where we take care of patients. And as a fierce defender of patient access to care, I am just so fearful that this means patients are even going to have even less access, when we already have patients out there who can’t find primary care providers, who are waiting for hours in ERs to be seen. I just think it’s going to make a bad situation worse.”

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For more information on Question 1, here’s a link.