Prop 23 puts the lives of vulnerable dialysis patients at risk, increases health care costs and makes our doctor shortage and ER overcrowding even worse

SACRAMENTO – Today, a large coalition of respected organizations representing patient advocates, health care providers, doctors, nurses, physician assistants and others reiterated their strong opposition to Proposition 23 – the Dangerous & Costly Dialysis Proposition on the November 2020 ballot.  

Nearly 100 groups oppose Prop 23, including the California Medical Association, American Nurses Association\California, Chronic Disease Coalition, Dialysis Patient Citizens, Minority Health Institute, Renal Physicians Association, American Academy of Nephrology PAs and many others.

“Prop 23 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,” said Peter N. Bretan, M.D., President of the California Medical Association. “Prop 23 jeopardizes access to care for tens of thousands of patients who depend on dialysis to stay alive.”

“Prop 23 dangerously reduces access to care, putting vulnerable dialysis patients at serious risk,” said Marketa Houskova, Doctor of Nursing Practice, RN, of the American Nurses Association\California.

Opponents of Prop 23 warn the measure would jeopardize the lives of Californians with kidney failure by forcing hundreds of dialysis clinics to cut back services or shut down completely – making it more difficult for dialysis patients to access their life-saving treatments.

Furthermore, this dangerous and costly dialysis measure would make the state’s current doctor shortage and emergency room overcrowding even worse, while unnecessarily increasing health care costs for taxpayers and consumers by hundreds of millions of dollars every year. All of this, in the midst of a global pandemic, threatens to put a strain on necessary health care resources across California.

The main provision of Prop 23 requires that each of the roughly 600 dialysis clinics in California have a physician administrator on the premises during all operating hours even though this physician administrator would not be providing care to patients, and is a provision currently not mandated by the extensive state and federal regulations that already govern the dialysis community. Today, all clinics must have a physician medical director on staff and patient dialysis treatments are prescribed and overseen by patients’ own nephrologists and delivered by specially trained nephrology nurses and technicians.

“By moving nephrologists and experienced Physician Assistants (PAs) out of the hospital and offices, where a significant amount of our most vital work is done, Prop 23 will put all nephrology patients at risk,” said Kim Zuber, Executive Director, American Academy of Nephrology PAs

A study by the Berkeley Research Group, an independent economic research firm, found the physician administrator on site requirement would increase dialysis treatment costs by $320 million every year, and that nearly half of the 600 clinics in California would become financially unsustainable.

There are approximately 80,000 dialysis patients in California with failed kidneys who need machines to clean their blood and remove toxins from their bodies. Patients must receive dialysis treatment three times a week for four hours at a time to stay alive. Access to consistent dialysis treatments is so important that just one missed treatment increases patients’ risk of death by 30%.

“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, CEO of Dialysis Patient Citizens, a national, nonprofit dialysis patient-led advocacy group representing 28,000 patient members, with more than 4,000 in California.

Dialysis patients in low-income and rural communities would be especially affected if their local clinic were forced to shut down. Fewer dialysis clinic options may mean patients have to travel much farther, multiple times a week in order to continue accessing their life-saving treatment.

“Prop 23 would lead to dialysis treatment insecurity for many of California’s vulnerable dialysis patients who would find it harder to get access to a dialysis clinic close by,” said Scott Bruun, Executive Director of the Chronic Disease Coalition.We strongly oppose Prop 23 because it creates unnecessary challenges for dialysis patients accessing their life-sustaining care.”

Prop 23 is sponsored by the United Healthcare Workers West (UHW) union – the same organization that abused our initiative process two years ago by bankrolling Proposition 8 on the November 2018 ballot. Prop 8 would have also shut down dialysis clinics throughout California, dangerously threatening dialysis patients’ lives. That’s why every leading newspaper in California opposed Prop 8 and voters overwhelmingly rejected it by 20 points. Now, this special interest group is at it again with a different attempt, but the same outcome, that would put dialysis patients lives at risk.

While unions have the right to try to unionize workers, it’s not right to abuse the initiative system and use vulnerable patients as political pawns – especially now in the face of a public health crisis.

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