CALIFORNIA, USA — California's Proposition 29 is the third election in a row where people will be casting a vote regarding dialysis clinics.
The proposition requires a doctor or nurse to be available at each dialysis clinic at least through telehealth. It would also require clinics to disclose ownership information and report infection rates.
What would Prop 29 do?
This measure would require kidney dialysis clinics to have at least one physician, nurse practitioner or physician assistant with six months of relevant experience available on site or, in some cases, via telehealth. It also requires that clinics report infection data to the state, as well as publicly list physicians who have ownership interest of 5% or more in a clinic. The measure also prohibits clinics from closing or reducing services without state approval and from refusing treatment to people based on their insurance type.
Why is it on the ballot?
This is the third time a labor union, Service Employees International Union-United Healthcare Workers West, goes after dialysis clinics via the ballot process. The union says it wants to reform the booming industry and increase transparency, while dialysis companies that spent millions to defeat the two prior measures say it’s a union ploy to pressure clinics and organize dialysis workers.
There are about 650 dialysis clinics across the state and about 80,000 Californians receive the life-saving treatment. State analysts estimate that the clinics have total revenue of about $3.5 billion a year and that two private, for-profit companies — DaVita Inc. and Fresenius Medical Care — own or operate three-fourths of the clinics.
Arguments
For: Supporters argue that dialysis companies do not invest enough in patient care and safety despite being highly profitable. The hours-long process of removing blood, filtering it and returning it to the body is a physically draining process that leaves patients vulnerable to medical complications. Having a physician or nurse practitioner, in addition to current staff, available at all times could help reduce hospitalizations, proponents say. Meanwhile, adding reporting requirements would increase transparency in the dialysis business.
Against: Opponents say that this measure is unnecessary as clinics already provide quality care and have the needed staff to treat and monitor people. Patients may also reach their nephrologists via telemedicine if needed. Plus, opponents say, clinics already report infection data to the federal government. The opposition warns that these new requirements could result in dangerous consequences — adding physicians would increase costs for clinics, pushing some to potentially reduce hours or close.
This is an abridged version of the full story, which is available at CALmatters.org—a nonprofit, nonpartisan media venture explaining California policies and politics.
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