OPINION: Dialysis patients deserve better care

By Michael Barragan

Vote yes on Prop. 8 for more staffing in dialysis clinics and better treatment for patients.

Prop. 8 would limit the revenue of dialysis clinics to 115 percent of whatever is spent on direct patient care and quality improvement costs.

If costs exceed this set limit, clinics will have to pay rebates to payers, primarily private insurers.

If clinics disagree with the limit and think they need more revenue they will have the option to go to court.

It would require clinics to report annual costs to the state to determine the rate of rebates.

The initiative is supported by Service Employees International Union-United Healthcare Workers West.

The union funded $18 million for support so far.

Proponents of the initiative believe it would incentivize clinics to spend more on direct patient care service costs and healthcare quality improvement costs.

The Legislative Analyst’s Office said, “Increasing allowable costs would raise the revenue cap, reduce the amount of rebates owed, and potentially leave [Chronic Dialysis Clinics] owner/operators better off than if they were to leave allowable costs at current levels.”

The allowable costs are direct patient care service costs and healthcare quality improvement costs which include: staff wages and benefits, staff training and development, pharmaceuticals, medical supplies, patient counseling and costs associated with renting and maintaining facilities.

Opponents point out that managerial positions would not fall under these costs.

They argue that this would cause clinics to close because they won’t have enough revenue to cover costs.

They cite a Berkeley Research Group study that says more than 80 percent of clinics would suffer from a loss in revenue which might cause some clinics to shut down.

The study is questionable, however, because No on Prop. 8 paid about $150,000 to Berkeley Research Group for “campaign consultants” earlier this year according to a Recipient Campaign Committee Statement from No on Prop. 8.

Opponents say clinics closing would result in more dialysis patients ending up in the emergency room because they have no dialysis facility to go to.

However, according to KCRA’s website, Wesley Hussey, an associate professor of political science at California State University of Sacramento, said, “I don’t think most dialysis patients would end up in the ER, but they might end up in other outpatient facilities.”

Marianne Gutierrez, a former ELAC student and a registered nurse from dialysis clinic East LA Plaza Davita, said, “There is always more that can be done to improve patient education, patient outcomes, and most importantly, access to care.”

That’s why voters should vote yes on the initiative because patients deserve to get better care than they have received in previous years.

According to the California Department of Public Health Annual Fee Report for Fiscal Year 2018-19, there were 1,417 deficiencies documented at chronic dialysis clinics during inspections.

The Centers for Medicare and Medicaid Services reported more than 4,400 dialysis patients dying from infections within the past five years.

Dialysis is a process by which patients with kidney failure are hooked up to machines to remove their blood to be cleaned and put back inside.

This process can last three to four hours and may occur three or so times throughout the week.

Without this treatment, patients are at a high risk of death.

Vote yes on prop. 8.

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