Proposition 29, the Third Time in Three Elections, Asks Californians to Require Dialysis Clinics to Have a Doctor on Site
The measure would require kidney dialysis clinics to get state consent before closing or reducing patient services. It would also force clinics to have a physician or nurse practitioner on site during treatment hours.
Proponents argue that this will improve patients’ lives. But critics say it’s a union tactic to bully the industry into unionization.
This measure would require dialysis clinics to have a doctor, nurse practitioner or physician assistant on premises during treatment hours. It’s backed by labor union SEIU-UHW and opposed by two private for-profit dialysis companies. Both are national out-of-state businesses that own or operate about three-quarters of the state’s dialysis centers.
Both sides are spending millions in the campaign. As of August 1, the committee to support the proposition has raised more than $7 million. The committee to oppose the measure has spent nearly $8.1 million.
Supporters argue that the measure will improve patient safety by requiring clinics to have doctors, nurses and nurse practitioners on site during treatments. Opponents say it will drive up costs for patients, forcing some centers to close or reduce hours and limiting access to lifesaving treatment. They also argue that the proposal doesn’t address California’s shortage of medical professionals.
Having spent months watching both sides spend millions on advertising for and against Proposition 29, the 2022 California ballot measure that would require dialysis clinics to have physicians on-site or available virtually during treatment, it’s clear to KQED’s Prop Fest that many people oppose the bill. Opponents of the measure claim it will lead to higher costs and force some clinics to scale back or close altogether because they won’t be able to afford the new staffing requirements. They also believe it would exacerbate a healthcare provider shortage in the state.
The top funders of the ballot measure committee opposing Proposition 29 are DaVita and Fresenius Medical Care, which own 80% of California’s dialysis clinics. Those companies and other dialysis providers argue that keeping a physician on-site is unnecessary. In addition, they say the measure would force them to add jobs that aren’t needed and pass those costs on to patients. They say the initiative system was created to solve problems that elected officials couldn’t, but it shouldn’t be weaponized like this.
For the third time in three election cycles, California voters are being asked to impose new rules on kidney dialysis clinics. This year, the measure is called Proposition 29. It would require a physician, nurse practitioner or physician’s assistant to be present (either in person or via telehealth) during treatment at outpatient dialysis clinics. It also would require clinics to report infection data and publicly disclose ownership interests.
The proponents of the measure, the Service Employees International Union-United Healthcare Workers, argue that the requirements will improve patient safety. But the nonpartisan Legislative Analyst’s Office has found that they will cost clinics millions of dollars annually and could force some to close, putting patients’ lives at risk.
Voters should reject this cynical attempt to play doctor and set new health care policies at the ballot box, instead leaving those decisions to lawmakers and state and federal regulators. It’s time to put a stop to this type of unnecessary and harmful interference with the free market.
When reformers created California’s initiative system more than a century ago, they imagined citizens conquering powerful interests. Unfortunately, their system has been weaponized into a tool for political extortion.
This year, unions and two of the world’s largest dialysis providers are using ballot measure 29 to bludgeon clinics into accepting their demands to unionize. This is the third such measure the unions have put on the ballot, and voters should reject it again this time around.
A city or town attorney (or, in counties and special purpose districts with countywide boundaries, the prosecuting attorney) is responsible for drafting the concise description. The jurisdiction submitting the measure must also identify a “pro” committee and a “con” committee to prepare arguments in favor and against the proposal. The county auditor certifies these committees, but does not determine whether a proposition passed or failed. Ballotpedia scores the readability of a ballot title and summary by using the Flesch-Kincaid Grade Level and Flesch Reading Ease formulas.