California Props 2020

Prop 23 changes how dialysis clinics operate

Published: Mon, Oct 12, 2020, 6:50 PM
Updated: Sun, Oct 18, 2020, 1:41 AM
California Props 2020

Prop 23 changes how dialysis clinics operate

Published: Mon, Oct 12, 2020, 6:50 PM
Updated: Sun, Oct 18, 2020, 1:41 AM

Should we require dialysis clinics to have a doctor on site and change other procedures?

If you read all the editorials from the major newspapers in California, you might be surprised to find they all say the same thing, that you should reject Prop 23 because we should not be involved in a proxy war between a labor union (SEIU-UHW West) and dialysis companies. This is the sequel to 2018's very expensive and unsuccessful Prop 8 (2018). They say the labor union continues to abuse the ballot initiative process to use it as leverage in negotiations.

With that said, let's get into it.

~80,000 Californians' kidneys don't function as they should, requiring them to go into a dialysis clinic three times a week for four hour sessions each so that a machine can filter and clean their blood like a healthy kidney would.

Prop 23 would require dialysis clinics in California

  • to have a doctor onsite at all times
  • to report infection information to the state's health dept.
  • to get consent from the health dept. before closing or limiting services
  • to provide care to all patients, regardless of payer (e.g. private health insurance, Medicare, Medi-Cal).

Have you heard about how bad conditions can be in a dialysis clinic?

John Oliver did an piece on them

ProPublica too

Great. How does Prop 23 help that tho

Cockroaches, dried blood on chairs and walls. The conditions are unsanitary. DaVita, one of the big two dialysis companies, has paid hundreds of millions to settle lawsuits.

They provide minimal care but make billions

Great. How does Prop 23 help that tho

Dialysis patients are medically fragile. A full-time doctor would be able to respond quicker than if they were rushed to a hospital.

Isn't there a shortage of renal specialists?

You suggest that these clinics are unsafe, but California has one of the lowest kidney mortality rates. If a doctor on hand would help, why doesn't the federal government mandate it?

Adding more unnecessary overhead would increase costs and likely result in clinics closing, further endangering patients.

Given how much they've spent on fighting ballot propositions and settling lawsuits, I think they can afford a doctor or nurse in each clinic.

In addition, keeping them accountable by reporting infection information, and making sure they provide care to all patients regardless of their medical insurance only makes sense.

They already report info to the CDC. More overhead.

I haven't seen evidence that they provide different care based on insurance.

Patients who come in with private health insurance make more profit for the clinic. That's for sure. There have been reports of unequal treatment.

Regardless, I don't think I or you or general public should be deciding the medical standards for 80K patients

If this is a stupid battle between a labor union and some greedy companies, then I want no part in it. Saying Yes only encourages using propositions as a weapon.


I see this as an opportunity to improve the patient care in dialysis clinics

Note: We intentionally omit links to arguments & rebuttals found in CA's official voter guide. We believe they exaggerate claims, are not fact-checked, and use ALL CAPS irresponsibly.