For the third time in three elections, California voters are being asked to demand changes in the operation of dialysis clinics that provide life-saving care to 80,000 people with kidney failure.
Proposition 29 on the November ballot would require a physician, nurse or physician assistant to be present during treatment at the state’s 600 outpatient dialysis facilities.
Dialysis clinic companies say the mandate would require between two and three doctors at each facility because most are open at least 16 hours a day, creating a financial burden that could lead to some clinics closing.
Supporters insist that dialysis patients need more thorough care during regular visits.
This is the third consecutive general election in which Californians have been asked to vote on dialysis regulations. It is one of the most expensive ballot issues in state history. Both parties have spent more than $90 million combined this year, according to state figures.
All three were supported by unions representing healthcare workers. Two previous measures failed.
To stay alive, dialysis patients typically undergo four-hour treatments at least three times a week, during which machines remove blood from the patient’s body, filter out toxins, and then return the blood, essentially performing the function of the kidneys temporarily. but out of body.
DaVita Inc. and Fresenius Medical Care — the nation’s two largest for-profit dialysis companies — operate about three-quarters of California’s clinics.
Opponents of Prop. 29 say most clinics already offer high-quality care and are regulated by federal and state authorities. They also point out that all patients already have a nephrologist — a kidney specialist — overseeing their care and that nephrologists also direct every clinic in California. They say the initiatives are part of a tactic to pressure dialysis companies to allow workers to unionize.
“This unnecessary requirement would cost hundreds of millions across the state, forcing California dialysis clinics to reduce services or close, making it harder for patients to access their treatments – putting their lives at risk,” the No On 29 campaign said.
Supporters say it’s a safety issue.
“Most dialysis patients are medically fragile and often have other health problems,” a statement from Yes On 29 said. .”
In 2018, the union-backed Proposition 8 sought to limit the profits of dialysis clinics and force them to invest more of their profits in patient care. Voters rejected the measure, but not before it became the most expensive initiative on the 2018 ballot, generating more than $130 million in campaign spending — more than $111 million from dialysis companies to kill the initiative and about $19 million from unions who supported her.
Two years later, voters rejected Proposition 23, which would have made mandates similar to this year’s measure.