Newspapers across California are urging their readers to vote no on Proposition 29, a November ballot measure that would require dialysis clinics to maintain, at the dialysis clinic’s expense, at least one licensed physician, nurse practitioner or physician assistant on site during all times that in-center dialysis patients are being treated.
Prop. 29 Would Increase Health Care Costs
Proposition 29 mandates chronic dialysis clinics to:
• Require that on-site physicians, nurse practitioners, or physician assistants have at least six months of experience providing care to patients with end-stage renal disease.
• Prepare a quarterly report regarding that clinic’s health care associated infection data which will then be published by the State.
• Disclose to patients all physicians with clinic ownership interests of 5% or more.
Under this measure, clinics would also be prohibited from closing or substantially reducing services without state approval.
The California Chamber of Commerce opposes Proposition 29 because the physician on-site requirement is unnecessary given that dialysis treatment is prescribed by a patient’s personal physician and administered by specially trained nephrology nurses and patient care technicians. Moreover, the initiative would increase costs dramatically.
A nearly identical initiative was proposed in 2018 (Proposition 8) and 2020 (Proposition 23). Both were widely rejected by voters.
A study by the Berkeley Research Group found that Proposition 23’s physician requirement would increase dialysis treatment costs by $320 million every year. According to the independent, non-partisan Legislative Analyst’s Office, this provision would result in “Increased state and local health care costs…resulting from increased dialysis treatment costs.”
These increased costs will be passed on to all Californians in the form of higher insurance premiums and higher taxes for government-sponsored health care.
Read why California newspapers are urging readers to vote no on Prop. 29:
Inland Valley Daily Bulletin, Los Angeles Daily Breeze, Los Angeles Daily News, The Orange County Register, Pasadena Star-News, Long Beach Press-Telegram, Redlands Daily Facts, Riverside Press-Enterprise, San Bernardino Sun, San Gabriel Valley Tribune, Whittier Daily News:
“There is no medical reason for this request. There is zero evidence that California dialysis clinics are unsafe. To the contrary, they are literally life-savers. This is another ploy by one union, SEIU-UHW West, which has made a practice of harassing clinics around the nation because its leadership wants more power over how such clinics are run.”
“This measure isn’t really about patient care. Even the labor-friendly Legislature has refused to pass similar legislation. Furthermore, it’s a tactic the union has used before to pressure healthcare facilities, most recently in Los Angeles and other cities, where the SEIU-UHW has qualified local ballot measures to force private health facilities, including dialysis centers, to pay workers at least $25 an hour.”
“The extra costs would be especially harmful to clinics operating close to the margins (think those in rural, lower-income communities). We’d hate to see any of those clinics close, forcing some of our most vulnerable Californians to travel farther for care.”
“Instead of threatening clinics, frightening patients and harassing voters, SEIU should try to organize workers the old-fashioned way: by meeting with them and making the case for membership. Misusing the initiative process to advance unionization by other means, let alone to propose detailed policy on specialized health care for a small number of vulnerable Californians, is nonsensical and irresponsible. Californians should defeat Proposition 29 as decisively as they did its predecessors.”
“…the Legislative Analyst’s Office says the requirement would sharply increase clinic costs, which could lead to clinic closures — which would be dangerous for kidney patients in remote areas. The rule would also damage health care overall in California by exacerbating the state’s acute shortage of health care workers. We shouldn’t have to keep voting on dialysis. Why are we?”
“Regulation of the industry is complex and best suited for the Legislature rather than the ballot box. If changes are needed, lawmakers should hear from experts in the field, thoroughly vet any new laws and be open to alterations dictated by sound medical advice. The California Medical Association understands that, which is why it steadfastly opposes Prop. 29.”
“The union behind the measure continues to assert that these new medical supervision requirements will improve patient care. Clinic operators — including nonprofits — still say these staffing requirements are arbitrary, expensive and unnecessary, and will put the financial health of smaller and rural clinics in jeopardy. Dialysis facilities are already required to employ a physician medical director and keep a registered nurse on site.”
“Doctors, including the California Medical Association, disagree on the need, and the Legislative Analyst’s Office warns, as it did with the previous ballot measures, that the requirement would increase a clinic’s costs by several hundred thousand dollars annually on average, potentially forcing some clinics to close or operate at a loss. That could be devastating to patients, who could be forced to travel longer distances to receive treatments….Voters have rejected the two previous kidney dialysis ballot measures for good reason. They should do so again and vote no on Prop. 29.”
“…we believe an initiative is the wrong way to regulate a specialized medical procedure that literally is a matter of life and death for people suffering from serious kidney disease. Without advanced medical knowledge, even the most diligent voter would be hard-pressed to determine the best approach to delivering kidney dialysis. If new rules are needed, the job should be handled by the Legislature and the state Department of Public Health Services in consultation with medical experts.”