Dialysis Patients fear fallout from the implications of a vote that passes Proposition 29.

Proposition 29, the third statewide dialysis initiative in the past 5 years in California, imposes new requirements on dialysis clinics such as requiring a doctor to be on hand during treatments. The other requirements included in the proposition would require clinics to report infections to the state and disclose when doctors have a stake in the clinic to patients.

              Requiring an on-site clinician is the biggest flashpoint in the prop and would cost clinics several hundred thousand dollars annually on average. This increased expenditure would cause many clinics to close, leaving patients who require the critical blood filtering treatment with no access to care (according to the clinics). Other options would include negotiating a higher rate with insurers or cutting into profit margins.

The group behind the proposition- the United Healthcare Workers West, said that reforms are necessary to keep patients safe during the arduous dialysis procedure. They also argue that the treatment is dangerous and that patients need highly trained medical professionals to deal with emergencies instead of relying on 911.

The opposition campaign, which is funded mostly by the dialysis industry states that keeping a doctor or nurse practitioner on site always is costly and unnecessary. Clinics currently employ registered nurses who check on patients and medical directors- physicians who oversee clinic operations but are only on-site part-time. 

The opposition campaign and dialysis clinics have been accused of fearmongering to defeat the proposition, telling patients that their clinic will close when they could surely either renegotiate rates with insurers or make less money. The only certain thing with proposition 29 is the complexity of the issue.