Proposition 8, which would limit the profits of kidney dialysis clinics, is an example of a special interest trying to obtain from the ballot box what it could not achieve through other processes.
In this case, the measure was brought by a labor union, SEIU-UHW West, that has been frustrated in its efforts to organize the state’s two largest dialysis businesses, DaVita and Fresenius Medical Care. The union contends that workers at the clinics report that those companies’ cost-containing steps put patient safety at risk.
So it raises the question: If workers are so universally disgruntled, why haven’t they voted to unionize? Steve Trossman, a spokesman for the union, said it has proved impossible because of the intimidation of pro-union workers — and the employers have chosen to defy weakly enforced labor laws.
“It’s trying to achieve the same goal in a different way,” Trossman said.
That should be the first red flag for voters: The initiative process is not the place to tilt the scales in a labor dispute.
The cumbersome requirements of the initiative present some very specific concerns. It would attempt to reduce a dialysis provider’s profit margin by limiting its revenue to 115 percent of its spending on “direct patient care and healthcare improvements.” However, the definition of such is a matter of dispute. Opponents note that it would not include legitimate expenses such as clinic coordinators, professional services, regulatory compliance and security.
As a result, the clinics calculate that only about 70 percent of their costs would be counted against that limit, and that some would be forced out of business by Prop. 8. That could present serious problems for some of the nearly 70,000 dialysis patients in California, and the caseload is growing by 5 percent a year.
Supporters of Prop. 8 note that the clinics would have the option of going to court if the limits prove untenable. That should be another red flag for voters.
This flawed measure should be rejected.