October 15, 2018

Businesses should set their own staffing levels

On Nov. 6, Massachusetts voters will be tasked with deciding three ballot questions, but the one with the most reverberating impact on the Central Massachusetts economy is – by far – Question 1.

If passed, this ballot initiative would mandate healthcare providers meet certain required nurse-to-patient ratios in a complex system based on the situation: an emergency room nurse can only care for one critical patient at a time or five non-critical patients; in maternity, one active labor patients at a time or six postpartum, etc., etc.

While voters have heard a lot of comprehensive campaigning from both sides on costs vs. need for patient safety – with plenty of underlying motivations – the winning argument in this debate boils down to one fundamental truth: Businesses should set their own staffing levels.

Requiring hospitals and other healthcare providers with minimum nurse staffing ratios is an unfair burden on the healthcare industry and the type of government over-regulation attacking the very foundation of business principles. Police and fire departments don't have required staffing levels, and they aren't even businesses. Hospitals – whether they be for-profit or nonprofit – should not be held to a mandated standard.

The success or failure of a business ultimately will come down to how well it is run. A business spreading its workforce too thin will see quality suffer and client satisfaction and retention drop. A business putting too many labor resources toward one effort will never have enough margin to sustain itself long term. Staffing levels are a delicate balance of producing a quality product or service at a cost your business can afford to bear. Having mandated levels will throw off that balance, and businesses will suffer.

If patient safety had become a realistic concern in Massachusetts, then perhaps some kind of drastic action would be necessary. But it's not. In the latest safety ratings by Washington, D.C. nonprofit Leapfrog Group, three Central Massachusetts hospitals scored a "A" rating: Saint Vincent Hospital in Worcester, Heywood Hospital in Gardner and Leonard Morse Hospital in Natick. UMass Memorial Medical Center's Memorial Campus and University Campus in Worcester each received a "B." None of the region's hospitals scored lower than a "C."

At a time when healthcare costs are becoming more of a burden for individuals and businesses, now is not the time to saddle the industry with costly regulations. Both sides have their own predictions on the cost of mandated nurse staffing levels – no doubt influenced by their desire to win on Nov. 6 – but the numbers we trust come from the Massachusetts Health Policy Commission, the independent state agency charged with making data-driven decisions on healthcare reform. HPC says Question 1 will cost hospitals and other healthcare facilities $949 million annually. That's far too much.

An early October poll from UMass Lowell showed 51 percent of voters opposed Question 1 while 43 percent support it. When standing before your ballot on Nov. 6, you should side with this majority. Doing otherwise would place an undue burden on businesses throughout the commonwealth.


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