Thread by @nickmmark

Instead of proposals to cap RN pay I’d love to see legislation that:
1️⃣mandates safe RN staffing ratios nationwide
2️⃣enacts a “50 state medical license” w/ straightforward reciprocity
3️⃣imposes limits on executive compensation for any hospital/org that bills CMS

For those doubting these reforms are possible. A couple points:

There already is a federal law calling for “adequate numbers of licensed RNs” 42CFR 482.23(b) The issue is that this is too vague.

15 states have passed laws that go further. CA & MA explicitly stipulate RN ratios

The CA law, enacted in 2004, mandates 1 RN to 5 med/surg patients & 1:2 for ICU patients.

After implementation RNs cared for one fewer patient on average. There was a decrease in hospital mortality & increased RN job satisfaction. ncbi.nlm.nih.gov/pmc/articles/P…

In the decade after the CA law was passed RN occupational injuries decreased by a massive 31.6%.
link.springer.com/article/10.100…

Regarding 2️⃣, there are some occupations (like pilots and other aviation professionals) that have national instead of state based licensing.

Also many professions (EMTs, paramedics) have streamlined the reciprocity process.

We ought to do this for ALL health professional jobs.

As for 3️⃣, we know it’s possible to limit executive compensation because we just did this with the 2020CARES act.

Under the law any airline getting bailed out had to limit executive compensation. It worked.

crsreports.congress.gov/product/pdf/IN…

We can & should do the same for hospitals