People Who Need Dialysis Lose in this Game: Vote No on Prop 23

Renal Support Network

Proposition 23 would unnecessarily require a doctor to be present during all dialysis treatment times which are usually twelve to sixteen hours a day, six days a week. This unnecessary expense will not improve patient quality care and it will not make patients any safer. To the contrary, this mandate will increase costs for dialysis treatment by hundreds of thousands of dollars per clinic each year and will result in clinic shut downs, risking dialysis patients lives and access to care and increasing health care costs for everyone.

Proposition 23 doesn’t even mandate that the physician be a nephrologist. In fact, the physician need not have any special training in kidney care. This physician would have no ability to participate in patient treatments or oversee patient care. Instead, this physician 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. Thus, every one of the nearly 600 dialysis clinics in California will need at least two physicians per clinic, but most will need 3 or possibly four to cover vacations, breaks and coverage if a physician can’t come to work because of an emergency like a sick child.

And what if the physician does have a sick child and can’t make it to work? All patient treatments would cease until a physician could be found to come in.

There is a doctor shortage as it is, especially in rural and low-income areas. Where are we going to find doctors to fill administrative positions in dialysis clinics? Wouldn’t doctors be more valuable treating patients especially at times like we have now with the pandemic?

There is no proof that having a doctor, not even the patient’s own doctor, in clinics would improve outcomes and it will certainly increase expenses massively and lead to dialysis facility closures especially in rural areas.

In addition, care strategies are changing. With Covid-19 having no safe ending in site and more utilization of Telehealth and Telemedicine which can quickly connect to a physician and allow them to see what the nurse or tech is seeing in the clinic, it isn’t necessary to have a physician always on-site.

And since the physician doesn’t have to have kidney experience, they are just overseeing the facility while not necessarily being able to provide the experience needed in case an exigent situation arises. Basically, an overpaid babysitter of the facility. It also means taking thousands of doctors away from their non-CKD patients, which will inevitably lead to more ER visits and increased costs for insurance

Prop 23 would increase health care costs for taxpayers and consumers by hundreds of millions of dollars annually. These costs would get passed 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 no idea when the economy will stabilize, a large increase in health care costs would not be welcome. Proposition 23 would take doctors away from hospitals and clinics and force them into unnecessary bureaucratic jobs at dialysis clinics.  Vote NO on 23.

Learn More: Proposition 23 explained: What to make of all these dialysis ads?

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