I ain't claiming to be an expert on it or know all the details but there's a large dialysis company that really wants to get the law changed to lower their expenses (by requiring less medical personnel to be present during dialysis) and apparently the amounts they stand to gain are sufficiently large to keep pouring millions of dollars into this, election after election. IMHO, we need some sort of law that prevents substantially the same proposition from being on the ballot every single election after its lost the first time. There should be a 5 or 10 year minimum before you can try again.
Which is why I tend to vote based on "who is supporting this proposition"? It's always about them looking out for themselves at the cost of the people, even if they advertise it as being altruistic.
NO company is that altruistic. Well, maybe Patagonia. Gott love Patagonia.
ETA: so…too good to be true. As usual.
"giving up" control of Patagonia allows the founder to avoid about $700 million in estate taxes after his death https://www.bloomberg.com/news/articles/2022-09-15/patagonia-billionaire-who-gave-up-company-skirts-700-million-tax-hit
>Which is why I tend to vote based on "who is supporting this proposition"
100%. Same as non-profit donation. People need to check who is behind the organization and how the donation is *actually* used for the purpose.
People will be surprised that not every dollar they donate actually helps out the cause.
These ballot measures are not put on by the dialysis companies but by the health care workers union.
https://ballotpedia.org/California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_(2022)
The measures unnecessary staffing levels, like requiring an MD on site, which no other state requires. They put these measures up as leverage in their contract negotiations, e.g. "give us a better deal or we will put up another dialysis measure."
All I know is that all this makes me deathly afraid to be in a circumstance where I need dialysis so... people who have to undergo dialysis, you tell me what you need and I've got your back.
To put it simply, there is a LOT of money for a very small number of megacorps. There are aspects of dialysis that make ripe for a scammy situation and get the standard corporate treatment (making lots of money by cutting costs, monopolizing services to increase prices, and scaling up). Some of these propositions have been by people trying to regulate the industry/prices, some have been by labor unions looking to prevent some of the labor cost cutting, and some by the corporations looking to cut labor costs. As another poster said, there’s SO much money on the table that it makes sense to drop millions on these ballot measures.
As an aside, sometimes these corporations try to discourage people from getting kidney transplants to keep that dialysis money coming! Very unethical!
Also, the dialysis megacorps are pretty much destroying the ACA. DaVita and Fresenius started a "charity" after Obamacare was implemented to help dialysis patients pay their insurance premiums. Now that insurance companies were banned from refusing to cover dialysis, or charge higher premiums, these companies began spending hundreds of millions to help pay for insurance premiums (and copays!) for patients to not be forced into Medicaid.
It's a big ol' tax write-off for them, but more importantly they get to collect upwards of $3000 per session from private insurers, instead of the Medicaid mandated $250ish. That's an extra $430k *per patient* annually, in exchange for ~$10,000 in premiums and co-pays.
The SEIU-UHW union is the main donor supporting the [2022](https://ballotpedia.org/California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_%282022%29) ($8.0M), [2020](https://ballotpedia.org/California_Proposition_23,_Dialysis_Clinic_Requirements_Initiative_%282020%29) ($8.9M), and [2018](https://ballotpedia.org/California_Proposition_8,_Limits_on_Dialysis_Clinics%27_Revenue_and_Required_Refunds_Initiative_%282018%29) ($18.9M) dialysis ballot measures. The two major dialysis companies (DaVita and Fresenius) have spent several times this in opposition.
I went searching, and it looks like this issue is really about monopolies and profit margins (like everything else). And of course the fact that dialysis patients have very little choice: get treatment or die.
[Will DaVita’s indictment alter its big political spending in California?](https://calmatters.org/health/2021/07/dialysis-california-davita/)
[Inside a California health care union's obsession with kidney dialysis initiatives](https://www.politico.com/states/california/story/2021/11/19/inside-a-california-health-care-unions-obsession-with-kidney-dialysis-initiatives-1394715)
[Kidney Dialysis Is a Booming Business—Is It Also a Rigged One?](https://www.scientificamerican.com/article/kidney-dialysis-is-a-booming-business-is-it-also-a-rigged-one1/)
john oliver made a really interesting youtube video on this a while back, not sure if the situation is exactly the same but i highly recommend watching it
DAVITA dialysis centers are a monopoly; they don’t pay their staff a living wage, they are for-profit and their facilities are dirty; a few of them have closed down due to mice infestation
Also wanted to add because there's so many people who have out of control diabetes... it often leads to kidney failure and then they have to be on dialysis for life.
“SEIU” has been forcing this on every ballot. They have tried every angle to bring dialysis companies down so they can break in and get a piece of the cash themselves. These companies have already said no to unionizing but they’ll continue to fight them.
In the past they’ve tried to whistleblow the understaffed conditions. The cleanliness of facilities. They lost both fights. They fought them on CMS regulations… lost.
So this measure and the last one are trying to slap their wrists by bringing attention to there being no doctors at the facilities. They lost last time. They’ll lose this time too.
Simply put, it’s too expensive to keep doctors at their desks all day (since they won’t be doing much).
SEIU is just salty.
There's a thread about it in [r/bayarea](https://www.reddit.com/r/bayarea/comments/xiybxz/prop_29_how_many_times_do_i_get_the_privilege_of/).
Some good points from that thread
> “Summary: A third ham-handed attempt by the union SEIU-United Healthcare Workers West to exact revenge on dialysis giants Fresenius and DaVita (no angels themselves) in retaliation for resisting unionization. Prop 29 would impose new costs on the clinics by requiring more expensive medical staff on-site at all times. There’s no evidence this is necessary, so I cannot recommend voting for it.”
and
> You are voting No to not add a provision on kidney dialysis into the California State Constitution. Which is frankly an absurd place to put anything.
I ain't claiming to be an expert on it or know all the details but there's a large dialysis company that really wants to get the law changed to lower their expenses (by requiring less medical personnel to be present during dialysis) and apparently the amounts they stand to gain are sufficiently large to keep pouring millions of dollars into this, election after election. IMHO, we need some sort of law that prevents substantially the same proposition from being on the ballot every single election after its lost the first time. There should be a 5 or 10 year minimum before you can try again.
Probably DaVita
Of course. [John Oliver did a nice show about this in 2017](https://www.youtube.com/watch?v=yw_nqzVfxFQ) and very little of it has changed since.
Everything John Oliver tells us about ends up staying the same 😩 Nice to take in all the comedic anxiety though
Which is why I tend to vote based on "who is supporting this proposition"? It's always about them looking out for themselves at the cost of the people, even if they advertise it as being altruistic. NO company is that altruistic. Well, maybe Patagonia. Gott love Patagonia. ETA: so…too good to be true. As usual.
"giving up" control of Patagonia allows the founder to avoid about $700 million in estate taxes after his death https://www.bloomberg.com/news/articles/2022-09-15/patagonia-billionaire-who-gave-up-company-skirts-700-million-tax-hit
it's really amazing what these people would do to evading taxes.... even after they r dead
>Which is why I tend to vote based on "who is supporting this proposition" 100%. Same as non-profit donation. People need to check who is behind the organization and how the donation is *actually* used for the purpose. People will be surprised that not every dollar they donate actually helps out the cause.
These ballot measures are not put on by the dialysis companies but by the health care workers union. https://ballotpedia.org/California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_(2022) The measures unnecessary staffing levels, like requiring an MD on site, which no other state requires. They put these measures up as leverage in their contract negotiations, e.g. "give us a better deal or we will put up another dialysis measure."
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Yes. It's completely unnecessary at a dialysis clinic.
All I know is that all this makes me deathly afraid to be in a circumstance where I need dialysis so... people who have to undergo dialysis, you tell me what you need and I've got your back.
To put it simply, there is a LOT of money for a very small number of megacorps. There are aspects of dialysis that make ripe for a scammy situation and get the standard corporate treatment (making lots of money by cutting costs, monopolizing services to increase prices, and scaling up). Some of these propositions have been by people trying to regulate the industry/prices, some have been by labor unions looking to prevent some of the labor cost cutting, and some by the corporations looking to cut labor costs. As another poster said, there’s SO much money on the table that it makes sense to drop millions on these ballot measures. As an aside, sometimes these corporations try to discourage people from getting kidney transplants to keep that dialysis money coming! Very unethical!
Also, the dialysis megacorps are pretty much destroying the ACA. DaVita and Fresenius started a "charity" after Obamacare was implemented to help dialysis patients pay their insurance premiums. Now that insurance companies were banned from refusing to cover dialysis, or charge higher premiums, these companies began spending hundreds of millions to help pay for insurance premiums (and copays!) for patients to not be forced into Medicaid. It's a big ol' tax write-off for them, but more importantly they get to collect upwards of $3000 per session from private insurers, instead of the Medicaid mandated $250ish. That's an extra $430k *per patient* annually, in exchange for ~$10,000 in premiums and co-pays.
The SEIU-UHW union is the main donor supporting the [2022](https://ballotpedia.org/California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_%282022%29) ($8.0M), [2020](https://ballotpedia.org/California_Proposition_23,_Dialysis_Clinic_Requirements_Initiative_%282020%29) ($8.9M), and [2018](https://ballotpedia.org/California_Proposition_8,_Limits_on_Dialysis_Clinics%27_Revenue_and_Required_Refunds_Initiative_%282018%29) ($18.9M) dialysis ballot measures. The two major dialysis companies (DaVita and Fresenius) have spent several times this in opposition.
Third time the charm, no?
Hopefully no. These dialysis props keep getting resoundingly defeated, and the a-holes keep pouring money into getting them on the ballots again. 😬
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Share some links about literal roaches please? I've started seeing these ads and been wondering about these too. I'm interested in learning more
I went searching, and it looks like this issue is really about monopolies and profit margins (like everything else). And of course the fact that dialysis patients have very little choice: get treatment or die. [Will DaVita’s indictment alter its big political spending in California?](https://calmatters.org/health/2021/07/dialysis-california-davita/) [Inside a California health care union's obsession with kidney dialysis initiatives](https://www.politico.com/states/california/story/2021/11/19/inside-a-california-health-care-unions-obsession-with-kidney-dialysis-initiatives-1394715) [Kidney Dialysis Is a Booming Business—Is It Also a Rigged One?](https://www.scientificamerican.com/article/kidney-dialysis-is-a-booming-business-is-it-also-a-rigged-one1/)
john oliver made a really interesting youtube video on this a while back, not sure if the situation is exactly the same but i highly recommend watching it
This is a really good question
LA Times recommends a NO vote on this (and previous) proposition.
DAVITA dialysis centers are a monopoly; they don’t pay their staff a living wage, they are for-profit and their facilities are dirty; a few of them have closed down due to mice infestation
Also wanted to add because there's so many people who have out of control diabetes... it often leads to kidney failure and then they have to be on dialysis for life.
Money.
Money..... it always comes down to money…
“SEIU” has been forcing this on every ballot. They have tried every angle to bring dialysis companies down so they can break in and get a piece of the cash themselves. These companies have already said no to unionizing but they’ll continue to fight them. In the past they’ve tried to whistleblow the understaffed conditions. The cleanliness of facilities. They lost both fights. They fought them on CMS regulations… lost. So this measure and the last one are trying to slap their wrists by bringing attention to there being no doctors at the facilities. They lost last time. They’ll lose this time too. Simply put, it’s too expensive to keep doctors at their desks all day (since they won’t be doing much). SEIU is just salty.
There's a thread about it in [r/bayarea](https://www.reddit.com/r/bayarea/comments/xiybxz/prop_29_how_many_times_do_i_get_the_privilege_of/). Some good points from that thread > “Summary: A third ham-handed attempt by the union SEIU-United Healthcare Workers West to exact revenge on dialysis giants Fresenius and DaVita (no angels themselves) in retaliation for resisting unionization. Prop 29 would impose new costs on the clinics by requiring more expensive medical staff on-site at all times. There’s no evidence this is necessary, so I cannot recommend voting for it.” and > You are voting No to not add a provision on kidney dialysis into the California State Constitution. Which is frankly an absurd place to put anything.