Union members tend to become more militant during contract negotiations, and Minnesota nurses are no exception. To promote their contract goals, they held a one-day strike June 10 against Twin Cities hospitals. Then on July 12, they sponsored informational picketing in Duluth, contending hospital staffing is not sufficient. Away from the bargaining table, they are seeking direct legislation to set nurse-patient ratios.

Are their pleas simply negotiation rhetoric, legitimate concerns, or do they reflect a little of both? From the outside, it’s hard to tell.

It’s fair to say, however, that healthcare institutions, practitioners and patients continue to be challenged by a reimbursement system that’s shrouded by the same people who created it. Very few details are known about the reform package approved by Congress and signed by President Barack Obama. It was largely debated behind closed doors, which led to the inevitable explosion of misinformation and disinformation.

At this juncture, labor and management are negotiating in an information vacuum. So it’s logical to assume nurses will seek higher staffing levels, expecting much from reform, and hospitals will lean toward being conservative, fearing provisions of the reform bill might leave them unable to meet their expenses.

It didn’t have to be this way.

• Congress could have operated with complete transparency. Details of the reform bill could have been formulated in public instead of written in private by agency bureaucrats.

• News organizations could have focused on reform details instead of partisan rhetoric. By reporting the side show instead of the main event, they leaned closer than ever to replacing news with shoddy entertainment.

• Americans could have demanded accountability from their elected officials and the media. Instead, they wrote off the debate as Comedy Night at the Capitol.

For now, it’s impossible for labor, management or patients to know what’s been created in Washington. And for that reason, all should respond cautiously. We need to know exactly where healthcare reform will take us before committing ourselves to a dream that may not bear fruit.

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