Proposition 8 ostensibly is about dialysis patient care, but it boils down to an ugly $125 million brawl between a powerful labor union and California’s biggest dialysis clinic operators. This labor dispute disguised as health care policy has no place on the ballot and voters should reject it on Nov. 6.
Dubbed the “Fair Pricing for Dialysis Act,” the measure was placed on the ballot via a signature drive. The union that has been seeking to organize workers at DaVita Inc. and Fresenius Medical Care clinics got behind this initiative route after failing to persuade state lawmakers to OK a measure mandating clinic staffing ratios and limiting revenues.
Beyond the massive war chests raised for this battle — as of Oct. 23 backers pulled in $19.3 million; opponents have accumulated $105.6 million — here’s what’s most troubling about Proposition 8:
A dialysis provider’s revenues, under the measure, would be limited to 115 percent of what it spends on “direct patient care and healthcare improvements.” Any money above that arbitrary limit would have to be refunded to whoever paid for the dialysis (likely a private insurer).
This would not equal a 15 percent cap on profits, but instead a cap on an arbitrarily limited scope of what it costs a facility to operate. Proposition 8 backers claim the measure will force large dialysis companies to spend more on patient care or refund extra money to insurers, which will lower coverage costs for everyone.
As reported by The Desert Sun’s Sam Metz, however, a study done by opponents of Proposition 8 found that more than 80 percent of clinics wouldn’t be able to cover their costs under such a revenue cap. Why? Because its definition of “direct patient care and healthcare improvements” does not include legitimate facility expenses such as managerial pay, security, janitorial costs or property, fire or malpractice insurance.
Critics fear the effect could be reduced hours or closures of clinics that will operate at a loss under the new cap. Such closures will force those who need dialysis three times per week in order to live to find a slot at another clinic, if possible, or seek much more expensive treatment at a hospital.
There is no guarantee that the measure will do what its backers suggest, which is force improvements or cut overall health care costs. If they’re wrong, the fact that this was a voter-approved measure rather than regulation imposed by the Legislature will make it hard to revise or undo.
As The Desert Sun’s Metz reported, clinics in Riverside and San Bernardino counties treat about 8,000 of California’s overall 80,000 patients and the Inland Empire’s population of those needing this procedure is growing at a much faster rate than across the state overall. This issue will definitely affect many who need this type of care here in the desert.
The pro-Proposition 8 campaign appears to be cynically trying to mislead voters, deeming California’s dialysis industry as “in crisis,” with poor care and unsanitary conditions. According to Desert Sun reporting, however, California dialysis clinics are rated either 4 or 5 star (out of 5) at a much higher rate than the national average by the Center for Medicare and Medicaid Services.
California’s voters are neither equipped nor should they be forced to decide on such a life-or-death health care issue. State lawmakers should be closely vetting and implementing such policy.
Vote no on Proposition 8.