Rep Atkins (DFL-52B) is not a doctor, or a nurse, or even a trained hospital administrator. Nevertheless, he thinks that the right thing to do is to write into law a requirement for hospitals to track and report on the "nursing personnel to patient activity ratio" in their hospitals. (see House File 200) These reports will require extra effort by both nurses and hospital administrators to produce. This will raise the cost of care for every patient, while reducing the resources available to care for patients.
Why on earth is this a good idea? What urgent problem forces Rep. Atkins into legislative micromanagement of nursing?
The nurse's union has been lobbying for control of staffing levels for years, and has been very supportive of Rep Atkins. The reports mandated in this legislation will be a potent tool for the union to compel administrators to increase staffing levels.
This is not to say that Rep. Atkins is simply pandering to supporters. I'm sure Rep Atkins believes in what he does. I have no doubt that Rep Atkins thinks legislative and/or union oversight of the number of nurses on duty at a given time is a Good Thing. I believe he is proposing this because he has fully swallowed the idea that the law is the ultimate tool to make things better. If there is a problem, pass a law.
This is easy for a legislator. Legislatures love to give voters what they want. Address every injustice with a law. Attack every inequality. Use the power of the state to the benefit of your supporters. Praise the benefits. Bury the costs. Kick the can through bonding. Let the grandkids pay.
It is easy to love just about anything if you ignore the costs.
F. A. Hayek called this the Fatal Conceit. It is the idea that man, through compulsion and law, can "perfect" society. Unfortunately, this does not lead to utopia, but to a police state. More laws mean more state power, and a society built on fear and compulsion rather than voluntary action, mutual respect and freedom.
Rep Atkins thinks he is helping. He thinks he is correcting a flaw, but in fact he is piling on yet another injustice by allowing one group (the MNA) to use the power of the state to force another group (hospital administrators) to do what it wants. Injustice begets injustice, and we lose our civility, and our freedom, step by step, inch by inch, law by law.
Our constitutions - federal and state - were built to prevent men from ruling other men. In 1776 it was royalty ruling colonists, but it is just as bad when neighbor rules neighbor, and a majority uses the power of the state to get take it wants.
In America, we solve our problems by walking across the street and talking to our neighbors, not by whining to legislators to pass laws to force our neighbors to do what we want.
Nurses, hospitals, patients and insurance companies are fully capable of working out their differences. HF200 will raise costs, pointlessly complicate nurse staffing and raise calls for more legislation to mandate similar reports for other situations. These costs are subtle, but very real.
The state of Minnesota has no business micromanaging the internal affairs of hospitals.
Rep. Atkins should withdraw HF 200.