We've witnessed the transformation of health care in the Commonwealth over the last several decades into a risky business. Starting in the late eighties, hospital administrators began importing job reengineering consultants, leading to widespread deskilling of bedside nursing. In 1991, Chapter 495 deregulated hospital finance, thus putting the commercial health insurance industry in the driver's seat and leading to the megamergers that so destabilized community hospitals and made life so difficult for so many patients. Then came the heavy penetration of managed care, with patients admitted sicker and discharged quicker. For-profit acute-care hospital chains for the first time found Massachusetts a fertile field to plow for profits. (Each state experienced a similar transformation, although it came more swiftly and intensely here.) Frontline nurses took note and launched a campaign to reverse this trend. Later on, the Institute of Medicine published a report in 2002 stating that 98,000 patients died unnecessarily in US hospitals each year. Around that time, Linda Aiken of the University of Pennsylvania published her findings in the Journal of the American Medical Association to the effect that, for every patient a bedside nurse cared for over four at a time, there was a seven percent increase in the mortality rate after thirty days. There have been many studies since then corroborating the fact that a lack of adequate professional nursing care, with appropriate support staff, leads to increased infections, falls and "failure to rescue" (patients being found dead and cold, too late to save). The Commonwealth of Massachusetts several years ago published a report that 2000 patients died unnecessarily each year in this state. That translates into six patients per day on average. The industry has responded with such cosmetic changes as an inaccurate web site to which patients and families are encouraged to go to find out just how great the staffing on a particular unit is. When you or a loved one is hospitalized, you need to ask how many patients you or your loved one is sharing your nurse with. Those who ridicule the struggle that organized nursing has been undertaking, right across the country, for an enforceable limit on the number of patients cared for at one time by a nurse have not been exposed to the situation. By the way, for the record, MNA strongly supported Question 5 on the 2000 ballot and the move to amend the state constitution to make access to comprehensive health insurance a right of all who dwell here. We support the real solution to the multifaceted crisis in health care, Medicare for All, HR.676. Elected and appointed officials at the federal and local level need to start paying attention to the people in the communities and not the corporate lobbyists, who buzz at least as thickly on Beacon Hill as they do on Capitol Hill. MNA has a track record of vigorously supporting such uncorrupted officials and candidates, and opposing those who have betrayed the public trust. - Sandy Eaton, RN, Blue Mass Group, June 26, 2009