You have probably seen TV commercials defending both sides of the debate on Question 1. This ballot question proposes strict nurse staffing ratios at all Massachusetts hospitals and will be decided on election day on Nov. 6. We all want appropriate and safe nurse staffing, but we do not believe the proposed regulation is the correct approach. A one-size-fits-all approach would tie the hands of all health care professionals.

We appreciate that this is a difficult and hotly debated topic. This is not about our nurses. We are proud of our incredible nurses and celebrate them every day. This is about arbitrary, expensive, bureaucratic policies that will significantly raise costs and cause devastating harm to the Massachusetts health care system without improving your care. Below are some of the reasons why the Martha’s Vineyard Hospital and Windemere board of trustees have joined every other hospital in Massachusetts in opposing this ballot initiative.

Passage of Question 1 would:

• Impose rigid government-mandated nurse staffing ratios in every unit of every hospital — large or small, teaching or community — across the state, every hour of every day. Patients have different care needs. These mandated ratios would not take the individual needs of patients into consideration.

• Take decisions out of the hands of experienced nurses at the bedside and put them in the hands of the government.

• Dramatically increase emergency room wait times and delay services throughout the hospital, including those that are time-sensitive and life-saving whenever we do not have the mandated nurse-patient ratio in place. Imagine our busiest months in the summer when beds are full, and all emergency room bays are in use. This could put you, your families and your friends at risk. There is no other hospital on the Island for you to seek care from.

• Reduce access to critically needed psychiatric beds in all of Massachusetts. It is estimated that 1,000 behavioral health beds across the state would need to close. This will affect access to these off-Island facilities for Island residents.

If Question 1 passes, it could force the Martha’s Vineyard Hospital to close beds, which would limit access to our services for you, our community members to whom we have pledged to serve. Some hospitals in the state would be forced to close altogether.

It could impact Windermere by luring away nursing staff to acute care hospitals off Island where, due to an increased demand for nurses, pay will be higher. Without enough nurses, we may need to close beds.

It would cost the Martha’s Vineyard Hospital up to $2.6 million per year. The state of Massachusetts estimates that the proposal would cost Massachusetts more than $900 million per year.

California is the only state currently with mandated nurse-to-patient ratios. Government-mandated ratios in that state have had no beneficial effect on the quality of health care. Without government-mandated nurse staffing, Massachusetts consistently ranks among the best states in the U.S. on hospital quality and patient outcome measures and has earned national acclaim including from the Commonwealth Fund’s State Health System Performance, placing second overall in the nation, versus California’s 14th place finish.

Our staffing supports the Island’s unique swings in seasonal volume and allows us the flexibility to provide quality care despite our isolated geography. This flexibility is crucial to our success and would be eliminated under the proposed mandates in Question 1. The future of our hospitals is at stake. Let’s keep staffing decisions in the hands of our nurses. On Nov. 6, please join us and vote no on ballot question 1.

Earl (Sandy) Ray is chairman of the board of trustees for the Martha’s Vineyard Hospital and Windemere Nursing and Rehabilitation.