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Posted by (name unknown) on Mar 6th, 2014 9:57am

The latest event in the nurse staffing ratios and hospital margins/executive compensation ballot issue occurred Monday, when testimony on both proposed legislation and the union's ballot initiatives was heard by the Joint Committee on Healthcare Financing at the State House.

I'm proud to have been among the many members of the hospital and nursing communities who testified in opposition to the proposals. Any and all of them would significantly set back the progress we have made with healthcare reform in Massachusetts.

There can be no doubt that care starts with the actual needs of every patient. And while registered nurses are invaluable members of the caregiving team, that doesn't mean others on the team should not be valued, too. There are cases where more registered nurses can improve care, but not in every case. Sometimes the best patient care calls for the skills and talents of others on the team, as well as other resources including technology. Ratios have been a bad idea for years. They're still a bad idea. And The Boston Herald agrees – the paper issued this editorial in strong opposition to nurse staffing ratios the day of the hearing.

There's also a proposal before the committee that calls for caps on hospital operating margins and executive compensation. This proposal certainly appears to be more about politics than sound policy. Under state and federal reform, hospital financials are already transparent. The "transparency" provisions called for in this proposal are duplicative. As for the proposed caps – operating margins alone are inadequate measures of hospital financial well-being. They are snapshots that often fail to illustrate true fiscal health. Operating margins may be positive one year and negative the next, and they do not reflect the debt a hospital may be carrying or its difficulties in accessing capital needed for critical investment in facilities and equipment. As the saying goes, a hospital will have an operating margin until the day it closes. This week's announcement by North Adams Regional Hospital that it's shuttering its doors at the end of this week is stark proof of that.

Simply put, the proposals under review by the Joint Committee on Healthcare Financing would be harmful to the state's healthcare system and patient care. For a state known for innovation and progressive thinking, adopting or advancing any of these proposals would be a clear step back.


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