Proposition 23- CA Ballot Measures Series

*****Disclaimer: This is not legal advice and is for educational purposes only. This does not create an attorney-client privilege.

We are in another election year and it is (nearly past) time to start considering not only who you want to vote for as president and to represent you regionally, but also to start doing your research on the measures on the California State Ballot this year. Or alternatively, you can follow this series of blog posts to get a summary of what's at stake with each measure, who is in support of and opposed to it, and a progressive's guide on checking No or Yes.

The next up in our series is Proposition 23; dialysis is once again on the ballot this year! You, like myself, have probably being hearing a lot of conflicting messages about how t vote on this measure. There is a divide in the opinion on this proposition, even among progressive groups. Essentially what this proposition is calling for is a requirement for a physician, nurse practitioner, or physician assistant to be present on site at all dialysis clinics while treatments are being administered. It would also prohibit clinics from reducing services without state level approval. It also would prohibit these clinics from refusing payment based on a patients ability to pay.

So now that we know the direct actions this proposition calls for, what exactly are the implications of it? There is quite a bit of debate about this. Various groups endorsing a YES on this vote say that this measure would improve care for dialysis patients; not being able to turn down a patient certainly sounds like a positive doesn't it? But how about if care costs are increasing? The reality is that a patient will be able to find care, but this does not mean they won't face crippling debt from medical bills like many other Americans.

Again, having a doctor on site sounds like it could increase the quality of care for these patients. But the reality is, it would cost millions more to have an attending physician at all clinics, and we are already facing a shortage in doctors and other healthcare professionals. These procedures generally do not require someone, like a doctor, with very specialized knowledge. These doctors, who are desperately needed elsewhere, would be wasted in non- caregiving roles at this clinics, simply to fulfill a costly requirement. And the reality is these costs will be transferred directly to the patient, who already are facing costs that often are in the hundreds of thousands.

Therefore, although the conflicting information on this proposition does make a neutral position on this proposition attractive as it can seem like a yes or no could help dialysis patients, this voter guide is softly endorsing a NO on Prop 23. There is just too much potential for harm and unfair costs for dialysis patients, without a real need for the ‘potential benefit’ of having a doctor on site.

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