What’s best for the patient? That is the question that defines the standard guiding competent and qualified medical professionals as they treat illness and injury and save lives. It is also the standard that should be used to examine Question 1, the Nov. 6 election ballot measure limiting how many patients can be assigned to registered nurses in Massachusetts hospitals and some other health facilities.
The Coalition to Protect Patient Safety, which opposes ratios, tacked an $880 million annual price tag on the cost of nurse staffing ratios and warned that price tag will drive up healthcare costs for families across Massachusetts.
In addition, the Executive Office of Administration and Finance estimates ratios will cost state-owned hospitals $69 million to $75 million a year to implement. Enforcing ratios throughout the state will cost another $1.3 million.
The Massachusetts Nursing Association and other supporters say studies have shown that the quality of care delivered in hospitals declines when nurses are assigned too many patients. Opponents, meanwhile, point to a nurse-patient ratio as an oversimplified and rigid approach to patient care that imposes strict ratios “at all times” and ignores the complex realities of modern healthcare. The state’s health policy commission found that there was no improvement in quality outcomes after the passage of ratios in California.
We believe the best way for the voter to analyze Question 1 is by keeping the patient-comes-first standard in mind while asking some broad-ranging questions about healthcare in general and the nurse-patient ratio proposal. What is the real cost of implementing ratios? Why is there such strong disagreement over whether ratios do or don’t work? How feasible is the Jan. 1, 2019, implementation date for the question?
In our view, a “no” vote on Question 1 will ensure the healthcare system provides what is best for patients — and nurses.
Question 2 on the ballot takes aim at a subject that historically has been the focus of Massachusetts ballot initiatives: political campaign financing.
Question 2 asks voters to approve creating a citizens commission to participate in what supporters hope will be a nationwide effort to shore up, in their view, an erosion in the U.S. Constitution’s First Amendment’s free speech protections.
The 15-member, all-volunteer commission appointed by the governor and other top state officials wouldn’t actually draft any campaign finance reforms and it wouldn’t have any power to enact reforms. The commission would join similar commissions across the country in drafting a new amendment to the U.S. Constitution, as defined by the ballot question language, “to restore the First Amendment … “
At the center of Question 2 supporters’ proverbial crosshairs is Citizens United v. Federal Election Commission, the Supreme Court decision that backers say eroded the First Amendment by treating corporations like people when it comes to campaign spending.
Campaign finance reformers have traditionally taken aim at corporate and political action committee spending on elections. Treating corporations like people in the eyes of the law makes it even more difficult to make campaign spending a level playing field, say Question 2 supporters.
The commission would spend 2019 studying the scope and focus of the new amendment and pass recommendations for its language to the state Legislature. Opponents warn that delving too deep into the corporations-as-people debate opens a Pandora’s box of legalistic problems that could have negative implications for nonprofit corporations, labor unions and a host of other groups of individuals organized legally under a specific title.
We invite voters to view Question 2 as an invitation to examine their perspectives on campaign finance reform and ask themselves how urgently it needs to be undertaken. That examination, we hope, will result in a “yes” vote on Question 2.
Freedom and individual rights are protections enshrined in the Massachusetts and United States Constitution, and Question 3 on the ballot seeks to uphold those rights.
A “yes” vote on Question 3 ensures that gender identity is one of the prohibited grounds for discrimination in places of public accommodation listed in the law passed by the state Legislature in 2014 and signed by Gov. Charlie Baker in 2016.
Question 3 opponents derisively call it the “bathroom law,” but prohibiting discrimination is a paramount value in a democracy. Transgender residents of Massachusetts fought to be accepted, valued, and safe under the law. They represent Massachusetts residents from all walks of life, ethnicities and social backgrounds. The Legislature agreed and passed the law.
Endorsements in favor of Question 3 clearly outweigh opponents’ arguments about unproven public safety dangers posed by Question 3 and unfounded proprietor liability obligations. We believe a “yes” vote on Question 3 stands for doing the right thing in the name of individual rights and freedoms.