In my essay about how voters “should” decide on Question One I recommended that voters use the same basic methodology that their elected representatives use to decide how they will vote on issues because it is both an effective and efficient method that is far superior to unrealistic attempts to make “objective” or “non-partisan” judgments on public policy questions. Some readers took me to task for suggesting that voters who try to assess the “substantive” arguments on both sides, because they assume that one side or the other has the better objective argument, are kidding themselves.
In truth, both sides have arguments that are logical and reasonable from their particular perspective. The “NO on One” side is arguing that statutory nurse staffing ratios would produce a number of cost increases that would lead to service cuts. These claims are based entirely on the economic assumptions of hospital executives and the staffing and service assumptions of hospital administrators and managers (including “nurse” managers). The “YES on One” side denies that these costs and cuts would be (or need to be) as severe as claimed and that the mandated ratios would improve patient care and the working conditions of bedside nurses. These claims are based entirely on the economic assumptions of organized labor and the staffing and service assumptions of unionized nurses.
The independent studies highlighted by both sides are legitimate scientific studies. The reason why two studies can be both independent and valid despite arriving at different conclusions (especially economic impact studies) is that every study’s validity is determined in part by how well its chosen assumptions fit with its conclusions. The studies on either side of Question One were based on different assumptions. While trained economists might (and I mean might) be able to hash out which side’s assumptions are more likely to prove accurate, neither average voters nor the advocates and opponents of Question One have the time, inclination, or knowledge and training to do so. If you don’t evaluate and parse scientific studies very often, don’t kid yourself into thinking you can adequately determine which side’s studies are objectively superior.
What does all this mean for average voters?
It means that voters’ choices on this question at the ballot box will also be based on what comes down to either conservative economic and management assumptions or liberal economic and management assumptions. So, should voters be researching and weighing each specific claim and counter claim on this issue? Absolutely not! Reasonable voters should consult their own general economic and management assumptions and then choose the side of Question One with which their own assumptions are most consistent.
What about voters who are not in touch with their own economic and management assumptions? How should they decide?
Frankly, few voters are precisely aware of their economic and management assumptions, but they need not be even arm chair economists thanks to our remarkably stable political party system. Our two major political parties are very conveniently situated. One supports conservative economic and management philosophy and policy and the other supports liberal economic and management philosophy and policy. The elected representatives of each party, also quite conveniently, take positions on policy questions. In the case of Question One on this year’s Massachusetts ballot, the positions of the two political parties and of the most prominent elected officials in each one, are very clear. Republican governor Charlie Baker, whose conservative economic and management assumptions are most consistent with those on the “NO on One” side, has signaled his opposition to Question One. Democratic U.S. Senators, Elizabeth Warren and Edward Markey, whose liberal economic and management assumptions are most consistent with those on the “Yes on One” side, have signaled their support for Question One.
Therefore, the average Massachusetts voter has more than enough guidance, without serious personal research or debate, to identify which side’s arguments on Question One are more consistent with their own relevant assumptions. For those who will protest here that smart folks do not always make assumptions that complement their personal or political interests; that smart folks often “put the public interest above their own interests,” I say that may be true in a number of specific contexts but that as a general matter and in the context of a policy question decided by voters at the ballot box, that is not true.
This seemingly high-minded pushback against my argument fails on at least two counts. First, it is entirely inconsistent with what we now know about human rationality and decision making, and second, it relies on a caricature, rather than a fair characterization, of the roles and functions of political parties.
Human beings do not have access to objective truth uncolored by their personal (or group) perspective. John Rawls’ “original position” is a really cool concept and a great way to think about democratic justice, but it’s not a position from which living, breathing human beings can make decisions about what is and is not in the public’s best interest. The best real live human beings can do in this regard is to equate the public interests with the interests of the primary groups in society of which they are members, or with which they most empathize. In other words, conscientious voters trying to look “objectively” at a public policy dispute with the goal of choosing the side most likely to better serve the public interest, are in truth (because they possess only the “bounded rationality” of humans) subconsciously equating the public’s perspective with that of specific social, economic, cultural, or political population sub-groups.
Almost everyone wrongly understands the roles and functions of political parties in American politics. Parties are seen as groups whose purpose is the acquisition and maintenance of power without regard for the public’s “real” interests. This very popular perception of political parties is reinforced EVERYWHERE and by EVERYONE, including partisans themselves. This is, unfortunately, an unavoidable consequence of high stakes partisan political competition. The reality, however, is actually quite a bit less depressing. The two major parties represent groups. Each one operates with an overarching philosophy of government that connects to both their policy preferences AND to the types of people and groups whose interests would be best served by such policy. The ideological assumptions of political parties are the closest things to a true vision of the real “public interest” as you can get.
The Democratic and Republican Parties compete for the public’s support on all manner of public policy. The Democrats bring a liberal philosophy of government to policy issues and the Republicans bring a conservative philosophy of government to policy issues. Because partisanship has come to be seen as entirely unprincipled and poisoned by ignoble biases, voters have wrongly discounted the value of the substantive and very useful cues that parties were designed to provide for average voters. You don’t even have to abandon your contempt for ugly partisanship to understand this. Despite the hype and despicable rhetoric, Republicans support policies consistent with conservative ideological assumptions and Democrats support policies consistent with liberal ideological assumptions. The rest, especially on an up or down ballot question to settle a labor-management policy dispute, is all noise! A voter taking partisan cues is actually using a decision making method that is amazingly well insulated from all the noise, nonsense, and dishonesty that has come to dominate political debate (partisan and otherwise). Partisan cues are MORE not less “substantive” than the poll-tested arguments and rhetoric of campaign advertising. This means that the voter who dismisses partisan arguments in favor of the “objective” claims of both sides on an issue like that of Question One is actually choosing to rely on self-interested political spin that may or may not align with their conception of the public interest, rather than on information or cues that provide the kind of deeper and more meaningful information that is much more in sync with that voter’s interests and principles.
So at the end of the day up or down ballot questions are not necessarily as complicated or confusing as they are often portrayed to be. Question One is definitely not as complicated or confusing as it is often portrayed to be. Voters who understand their own relevant philosophical assumptions can very easily use cues from the contestants in any political dispute that pits Democrats against Republicans, or liberals against conservatives, in their decisions about how to vote. Popular misconceptions about partisanship and the fact that neither the contestants nor the news media have provided an accurate picture of whose interests and principles are actually served by voting one way or the other are why so many voters are expressing confusion about Question One.
Both the advocates and opponents of Question One decided that average voters would choose whatever side they thought nurses were on. Unfortunately for the proponents, “nurses” is too large a category to evoke the intended group sympathy among voters. Had they understood the issue as a conventional dispute between labor and management, they would have realized that the principles and interests advanced by nurse staffing ratios are of hospital bedside nurses (i.e. labor), but not necessarily the principles and interests of nurse managers or nurses who work in settings or facilities where bedside nurses (especially non-unionized bedside nurses) are not severely hampered by patient assignment overloads. The opponents of Question One are hospital executives and nurse managers (i.e. management) and they have been able to exploit the public’s ignorance about the nursing profession to disguise the clear cleavage on Question One. Opponents understand it’s a labor- management dispute and that average voters would assume that “nurses” are on the side of labor. Since nurse-managers and other types of nurses are not labor, but are, in fact, management, the “No on One” side has had the luxury of making it look like the laborers in this labor-management dispute are not united in support of Question One, signaling that the law being proposed may not be aligned with the interests and principles of labor.
Sadly, the news media has been all too willing to play along, reporting routinely that “nurses are divided on Question One.” This story line has the virtue of being technically true, but the vice of being highly imprecise and unintentionally dishonest. Reporters, of course, are in a very tough spot. They are trying to report newsworthy stories and many know no more about the nursing profession than average voters [consider the confusion over whether or not the ANA is a union], which is to say that they too were taken in by the clever rhetorical sleights of hand employed by the opponents of Question One.
The highly relevant distinctions between different types of nurses went largely un-examined in the coverage of Question One until this week when a WBUR/MassInc poll of registered nurses in the state was published. In surveying the opinions of “nurses” on Question One the MassInc poll separates out the opinions of many different types of nurses working in many different types of settings. The poll results illustrate very nicely the differences between the opinions of nurse managers and bedside nurses and between unionized nurses and non-unionized nurses. The poll results confirm what any voter who understands Question One as a labor-management dispute would have assumed about the opinions of nurses. Unfortunately, the title of the article in which the polling data is introduced and discussed is “Nurse’s Are Split On Staffing Ratio Ballot Question, WBUR Poll Finds.” In today’s communications environment, the titles of news stories tend to be all that sticks, even when the content provides crucial precision and context.
Armed with all this manufactured confusion and plenty of evidence and arguments that employ management assumptions about statutory nurse staffing ratios, opponents of Question One are in a pretty good position to defeat a proposal that almost certainly aligns with the interests and principles of average voters in deep blue Massachusetts.