United Healthcare Workers (UHW) is at it again — abusing the ballot measure process and using dialysis patients as political pawns

SACRAMENTO — A broad coalition of doctors, nurses, patients, dialysis providers, social justice advocates, veterans and many others announced today it plans to defeat the Dangerous and Costly Dialysis Proposition aimed for the November 2020 California ballot. The ballot measure would put the lives of California’s dialysis patients at risk, increase health care costs for all, and hurt all Californians by making us wait longer to see our doctors.

At a time when dialysis providers and caregivers are going to extraordinary lengths to ensure patients are safe and getting the care they need, the United Healthcare Workers West (UHW) union-sponsored ballot proposition would remove thousands of physicians from emergency rooms, hospitals, clinics and doctors’ offices where they are on the front-lines, providing direct patient care, and instead put them into non-essential, bureaucratic roles in dialysis clinics.

UHW is back again in 2020 after bankrolling the failed Proposition 8 in 2018, a political attack on dialysis providers. Prop 8 was opposed by every newspaper editorial board in California and voters overwhelmingly rejected it by 20 points.

The California Medical Association (CMA) which represents more than 48,000 California physicians is opposed. President Peter N. Bretan, M.D., stated, “This ballot measure would unnecessarily increase health care costs and make the doctor shortage worse for all Californians by moving thousands of practicing doctors into non-caregiving roles in dialysis clinics. This proposition jeopardizes access to care for tens of thousands of patients who depend on dialysis to stay alive.”

Today, the federal Centers for Medicare & Medicaid Services already mandates that dialysis clinics must have a physician medical director on staff managing overall patient care. Individual patient dialysis treatment plans are prescribed and overseen by the patient’s own nephrologist and administered by specially-trained nephrology nurses and patient care technicians. According to CMS, which ranks dialysis patient care nationally, California dialysis clinics consistently rank above average in patient care quality.

The Renal Physicians Association (RPA), which represents nephrologists (kidney doctors), also opposes. Jeffrey A. Perlmutter, M.D., RPA president stated, “RPA strongly opposes this onerous and costly dialysis proposition. The proposition takes doctors away from caring for office and hospitalized patients and runs counter to the goals of the President’s Advancing American Kidney Health Initiative which emphasizes increased care for non-dialysis chronic kidney disease patients. Additionally, the nephrology workforce is already under great pressure and stretched to capacity; this proposition would place additional strains on the specialty.”

According to the independent, non-partisan Legislative Analyst, having a physician on site at all times “would increase each (clinic’s) costs by several hundred thousand dollars annually on average.”

A separate study by the Berkeley Research Group found that this provision would increase dialysis clinic costs by more than $320 million annually, and that nearly half of the 600 dialysis clinics in California would become financially unviable, including non-profit and independent providers. Rural dialysis clinics and clinics in disadvantaged communities serving a high volume of Medi-Cal patients would be more likely to reduce services or close due to financial constraints.

“This irresponsible measure would lead to clinic closures and cutbacks that reduce patient access, while unnecessarily putting the lives of some of our most vulnerable citizens in jeopardy,” said Hrant Jamgochian, Chief Executive Officer for Dialysis Patient Citizens, a national, nonprofit dialysis patient-led advocacy group representing 28,000 patient members, with more than 4,000 in California.

There are approximately 80,000 dialysis patients in California. Dialysis machines do the job of an individual’s failed kidneys, removing toxins from the body. Patients get treatment three days a week for three to four hours at a time. Dialysis is not optional. Missing even a single treatment increases a patient’s risk of death by 30%.

This measure would have a disproportionate effect on minority dialysis patients who have a higher rates of kidney failure. African Americans are 3.5 times more likely and Latinos are 1.5 times more likely to develop kidney failure than the general population.

“This dangerous dialysis proposition will disproportionately hurt minority patients and those in disadvantaged and low-income communities,” said Alice Huffman, President, California State Conference of the NAACP. 

“The lack of available dialysis treatment options will add an unnecessary burden on vulnerable dialysis patients – putting their lives at risk,” said Richard Allen Williams, M.D., President and CEO, Minority Health Institute. “Poor and minority patients will be hit the hardest.”