I am hoping most of you voters (in California) have been reading the editorials and recommendations in all the papers, as well as local TV news,  to reject Proposition 29.

You know, I wrote about this already.  This is the third attempt by the SEIU (Service Employees International Union, United Healthcare Workers)  to find a way to blackmail Fresenius and DaVita to negotiate for union representation.  Their proposition will change the way dialysis is provided in California- for some 80,000 patients.  (By the way, should the proposition pass, it would devastate the financial situation of many of the not-for-profit dialysis clinics in the state.)

Before we go too far, I am certainly NOT saying that the big two dialysis providers always provide exemplary service.  (Moreover, other states do mandate staff to patient ratios [Georgia, Louisiana, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, Texas, and Utah]- and their dialysis services are not  superior to those provided within the state of California).

What I am saying is that the provisions demanded, should Proposition 29 pass, will not make dialysis any safer.  Which is why many of the medical industry association have come out against the provisions- including the American Nurses Association, the American Academy of Nephrology Physician Assistants, and the California Medical Association, among others.

Basically, the provisions of Proposition 29 would be to require a doctor, a nurse practitioner, or a PA (physician’s assistant) – with at least 6 months of experience- to be present at all times at any one of 600 or so California’s dialysis centers are operating.  It also would require disclosure if the physician owns the facility, and to report patient infection data.  That latter requirement already is mandated.   So, the only provision would be to radically increase the operating costs for the dialysis center facility.

(Note that the California Legislature has tried to mandate staffing ratios for the dialysis centers back In 2017. That was followed by the first attempt by SEIU to pass this amendment in 2018 [Proposition *8, which also would have capped revenues for each dialysis center]  and again in 2020 ([Proposition 23, this would have required a physician to always be on premises].)

I, for one, can only hope that this proposition will be as soundly defeated as the previous two had been.   There are better ways to improve dialysis conditions for patients.  (See thoughts below and my blog post from yesterday.)

But, to keep this from reappearing on yet another ballot, perhaps a provision to make SEIU reimburse the dialysis providers for the money they spend to squash this measure (about $ 100 million),  the several hundred thousand dollars each dialysis center would have to spend should the measure pass), or the costs for California to process the vote itself may prove to be a useful deterrent.

One can only hope.

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