September 30, 2022

No on Proposition 29

La OpiniònBy La Junta Editorial de la Opiniòn

Proposition 29, under different numbers, was a bad idea in 2018 and in 2020. And it still is today. On November 8, vote no on Proposition 29!

Proposition 29, submitted for approval by the voting public on Nov. 8, proposes that dialysis clinics in California keep at least one doctor, nurse practitioner or physician assistant at each center.

It is trying to bring about a radical change in the 650 dialysis clinics, which serve more than 80,000 patients in California, usually every other day, in a blood cleansing procedure that lasts 4 hours.

The same proposal, with a different number, was rejected by most voters in 2018 and again in 2020.

It deserves to be rejected a third time. As opposed in the previous two rounds, La Opinión opposes Proposition 29.

In no other state is the physical presence of a doctor required during dialysis. The state Department of Public Health does not ask for it. Neither does the Center for Medicare and Medicaid Services (CMS).

It’s because it’s unnecessary and counterproductive.

It is a political motion inserted in the middle of the negotiations between a union and the owners of the clinics around the unionization of employees.

In the middle are the patients.

Naturally, we support the right of workers to form trade unions, to act for the improvement of their working conditions and to join trade union confederations, increasing their strength. And we salute the unions that protect their workers.

But this proposal goes further. If approved, clinics would be forced to keep a medical expert on each dialysis and bear the cost. They must hire at least two, because they are open more than 12 hours. What is the interest of the union in this case?

The aggregate cost for each clinic could reach millions of dollars per year.

Numerous dialysis clinics serving the population in rural areas will no longer be able to operate at these expenses. They will have to close, whether they belong to small businesses or large companies.

Those that will close provide services to the poorest and rural residents. The patients are mostly Latino, who along with African Americans suffer more than other high blood pressure groups and diabetes, a history of liver disease.

Dialysis is overseen by CMS, state and federal institutions.  Each change must adhere to CMS regulations and be executed through the patient’s personal nephrologist. In addition, the clinic currently has to have a dialysis nurse and additional staff.

In addition, the new doctor or nurse who should be present if the proposal is approved will not be able to participate in dialysis, in the sense of changing its duration or the drug used, because that is something determined in advance by the nephrologist who checked the patient. It will only have the administrative role of contemplating and observing.

Beyond Proposition 29, a chapter of its text comes as a surprise: The measure seeks to prohibit clinics from closing or reducing services without state approval.

Will it be legal to force a business to continue operating even if it loses? To not be able to make decisions without the approval of the government? If you are interested in the clinic continuing to operate, the state can help financially or buy it. Or, of course, create the conditions for it.

In sum, Proposition 29, under different numbers, was a bad idea in 2018 and 2020. And it still is today.

That’s why, on November 8, vote no on Proposition 29!

Paid for by No on 29: Stop Yet Another Dangerous Dialysis Proposition, sponsored by patients, doctors, nurses and dialysis providers. Committee major funding from DaVita, Fresenius Medical Care, and U.S. Renal Care.

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