Approximately 80,000 Californians must receive kidney dialysis treatment three times a week, a process in which blood is taken from a patient’s body, cleaned and returned to the patient. California Proposition 23 will require the roughly 600 dialysis clinics across California to

• employ an on-site physician while patients are being treated;
• report data on dialysis-related infections;
• obtain consent from the state health department before closing a clinic; and
• end discrimination against patients based on source of payment. 

Prop 23 is not the first ballot measure centered on dialysis clinics: California Proposition 8 was based in enacting policies on profits and refunds from the clinics, whereas Prop 23 is aimed at the specific daily operations at the clinics.

The two major camps of the campaign set the labor union SEIU-UHW West against major kidney clinic corporations DaVita, Fresenius Medical Care and U.S. Renal Care; through their contributions, made the Prop. 8 campaign the most expensive ballot proposition in 2018, at a combined contributions of $130 million. On top of this, according to the SEIU-UHW West, workers at these clinics have been attempting to unionize since 2016.

While dialysis clinic owners complain that Prop 23 measures will raise costs, Sean Wherley, a spokesperson for SEIU-UHW West, contended that dialysis workers “want these [initiative] reforms regardless of what happens with their union efforts.”

It may not come as much of a surprise that the two corporations profiting from these clinics, DaVita and Fresenius Medical Care, are funding the opposition to Prop 23. They are listed as major funders for the Stop the Dangerous & Costly Dialysis Proposition Committee, which has in turn contributed approximately $93 million toward their anti-Prop 23 campaign at the time of this article’s writing – versus the $6.2 million raised by SEIU-West.

Owners’ claims that Prop.23 would force dialysis clinics to close and would reduce the amount of available physicians are contradictory, if the presumed financial burden of one extra physician per clinic would also somehow make that physician unavailable for the job they were hired for. Nonetheless, the Stop the Dangerous & Costly Dialysis Proposition Committee is clearly in the interest of kidney clinic profits, as made evident by their donors and their opposition to measures that would protect patients.

Having an on-site physician as put forward by this proposition is very important due to the dangerous nature of kidney dialysis. According to the Center for Disease Control, “Hemodialysis patients are at a high risk for infection because the process of hemodialysis requires frequent use of catheters or insertion of needles to access the bloodstream. Hemodialysis patients have weakened immune systems, which increase their risk for infection…” Additionally, patients receiving dialysis treatment often develop heart problems, while the COVID-19 pandemic stresses the already apparent inability of the private, for-profit U.S. healthcare system to care for patients. It is clear that requiring these clinics to staff an extra physician and report data on dialysis-related infections are critical steps in ensuring patients’ safety.

Proposition 23 would further protect patients by frustrating attempts to close clinics that are not profitable by requiring the consent of the state health department. It would also forbid clinics from turning away patients they won’t profit from. At the ballot box, vote YES on Prop 23 to support our unions and protect dialysis patients! 

–written by Danny Taugher