NO on California’s Prop 29 – Higher costs, less access to dialysis care

By Renal Support Network

Proposition 29 would unnecessarily require a doctor or doctor extender to be present during all dialysis treatment times, usually 12-16 hours a day, six days a week. This unnecessary expense will not improve the quality of care and it will not make patients any safer. It will increase costs for dialysis treatment by hundreds of thousands of dollars per clinic each year, resulting in clinic shutdowns. This will put at risk the lives of people who need dialysis, restrict patients’ access to care, and increase health care costs for everyone.

Proposition 29 doesn’t even require that the physician be a nephrologist. In fact, the medical professional needs only 6 months experience training in kidney care. This person would have no ability to participate in patient treatments or oversee patient care. They would be relegated to an administrative or bureaucratic position only.

Many dialysis clinics are open from early morning to evening, Monday through Saturday, with some open late into the night to accommodate patient/caregiver work schedules. Every one of the nearly 600 dialysis clinics in California would need at least two additional medical professionals per clinic, but most would need three or possibly four to cover vacations, breaks, and instances when a physician can’t come to work because of an emergency like a sick child.

And what if none of the clinic’s physicians are available? All patient treatments would cease until a physician could be found to come in.

There is a healthcare workforce shortage as it is, especially in rural and low-income areas. Covid-19 has exacerbated the problem. How are we going to find doctors to fill administrative positions in dialysis clinics? As a deadly pandemic still threatens lives and health, wouldn’t doctors’ time be better spent treating patients?’

There is no proof that a doctor, even the patient’s own doctor, in a dialysis clinic would improve any patient’s outcome. And there is absolute certainty that this requirement will massively increase expenses and lead to dialysis facility closures, especially in rural areas.

The real victims are people who need dialysis, being used as pawns in this game. All the money being spent to fight these awful propositions could be used to help improve their care.

Since the physician only needs to have limited kidney experience, they are just overseeing the facility and don’t necessarily have the background to provide quality care if an exigent situation arises. Basically, they would be an overpaid babysitter of the facility. This will take doctors away from their regular patients, which will inevitably lead to more ER visits and increased costs for insurance.

Sadly, the union that wants to impose these requirements keeps spending its members’ money on similar costly bills and propositions that have failed over the years. As a patient organization, Renal Support Network has never been contacted to ask what we think patients need. This is not about the patients. This is about the unions that want greater power over dialysis clinic operations. The real victims are people who need dialysis, being used as pawns in this game. All the money being spent to fight these awful propositions could be used to help improve their care.

Prop 29 would increase health care costs for taxpayers and consumers by hundreds of millions of dollars annually. These costs would get passed on to you in the form of higher insurance premiums and higher taxes for health care. We are in the middle of a global health crisis, with people unemployed and with no idea when the economy will stabilize. A large increase in health care costs would not be welcome. Proposition 29 would take doctors away from hospitals and clinics and force them into unnecessary bureaucratic jobs at dialysis clinics.  Vote NO on 29.